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Development and Evaluation of the Simulated Hospital Environment: A Qualitative Pilot Study. Constance J. Ayers, Brenda Binder, Karen Lyon, Anne Koci, Diane Montgomery, Constance Jennings, William A. Foster. Study Aims. The aims of the study were to:
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Development and Evaluation of the Simulated Hospital Environment: A Qualitative Pilot Study Constance J. Ayers, Brenda Binder, Karen Lyon, Anne Koci, Diane Montgomery, Constance Jennings, William A. Foster
Study Aims The aims of the study were to: • Translate space industry integrated simulation techniques into development of a simulated hospital environment, and • Determine the experience of participating in an integrated simulation experience among undergraduate and graduate students and nursing faculty.
The Simulated Hospital Environment: • 96 hour,4-day, continuous simulation. • MS student actors as patients. • Undergraduate senior nursing students provided care: • 8 hour shifts. • 4 patients per student. • NP students as providers: • Taking call • Writing orders • Managing medical care. • Space program integrated simulation approach: • Scripting methods • Timeline and execution
Methods Pilot Project Qualitative Mixed Methods Design • Data Collection • Participant and Faculty Focus Groups • Participant debriefing • EHR Documentation • Field notes • Data analysis • Focus groups: audiotaped; transcribed verbatim. • Individually coded & categories identified. • Themes validated using: • Focus groups data • Participant Debriefing • EHR Documentation • Field notes
Methods Sample: • More than 100 student and faculty focus group participants. • 12 BS students at end of program. • 60 Graduate NP students as patients and providers. • 5 PhD students participating with researchers to design and execute the simulation. • 24 Faculty volunteers as facilitators in the simulation.
Results 1. Translate space industry integrated simulation techniques into development of a simulated hospital environment. • Used the techniques to create a realistic hospital environment, 24 hours a day for 4 days; 3 shifts/day. Themes: • True to Life: • Participant responses: • Realistic environment. • Exposed student weaknesses. • Provided method to address weaknesses. • Apparent on shift 1 day 1 that the methods work. • Resource intensive • Highly detailed timeline and set-up • Shift coverage: faculty/staff/NP providers/student patients.
Results 2. Determine the experience of participating in the integrated simulation experience among undergraduate and graduate students, and nursing faculty. Themes: • Not ready for prime time: • Student knowledge-practice gap. • Faculty - Employer disconnect. • It’s Golden: • Better than clinical experiences. • Value of the patient role. • Eyes and ears of the researchers: • Graduate student patients and providers. BUT: • Conflicting views about grad student roles.
Conclusions We can use space industry techniques to provide nursing practice experiences that cannot be provided in actual clinical settings because of legal and practical constraints. • Clinical as practiced in the past is no longer working. • Further study is needed to establish curricular implications and scalability of the integrated simulation.
