Is This The Reason Healthcare Simulation Isn’t Main Stream?

clinical simulation in nursing

Key Nursing Educators have spoken against the use of simulation for a very bizarre reason. In the latest “Clinical Simulation in Nursing” Journal December 2016 Volume 12, Issue 12, INACSL Journal Editor Suzan “Suzie” Kardong-Edgren explains a major misunderstanding about the use of healthcare simulation.

In the edition, Suzie provides a powerful reminder about the challenges faced for simulation in nursing education, and “what simulation is and how it is evolving”. In my opinion, the laggards of simulation technology adoption will cite any and every reason to reject modern advances in educational practices as the scapegoat for systematic failures. Another must-read commentary by one of our community’s most influential thought leaders entitled “High Fidelity Educators” which you can read here:

“A recent Researchgate citation alert led me to a most interesting editorial by Dean, Williams, and Balnaves (2016) entitled Living dolls and nurses without empathy. The lack of general understanding about what simulation is and how it is evolving, demonstrated in the editorial, provided fodder for thoughtful commentaries from many in the simulation community. This evolving commentary can be found in the blog section of the Journal of Advanced Nursing. It is well worth a read.

It remains very clear that a segment of the nursing education community does not understand that simulation is not about the manikin. However, learner deficits identified during simulation can be easily scapegoated because of the use of simulation. The upshot of the Dean et al. editorial is that nursing students are demonstrating less empathy and that the use of plastic dolls contributes to this. I contend a noted lack of empathy is not new (Benner, Sutphen, Leonard, & Day, 2010) but that we can clearly see it now during simulation.


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Part of the skill set required of a simulation educator is choosing the right kind of simulation (standardized patient, manikin, or task trainer) to accomplish a learning outcome. It is probably not ideal to have a learning outcome of empathy embedded in a manikin-based simulation, but it is certainly possible. Many of us have seen student learners crying at the end of a manikin-based scenario.

Simulation has allowed us to more clearly identify those students who might lean toward a less empathic nature. I might not have noticed a lack of student empathy with a real patient in the past because I, as the faculty member, was there, beside the student and interacting empathetically with a patient, whether the student was capable of doing so or not. In reality, we know our students’ skills and abilities much better after a simulation than we know their abilities within the clinical setting. I became a much more astute educator after seeing my verbally skilled students say some unbelievable things to patients, during simulation.

Working in simulation, one becomes a high-fidelity educator. Admittedly, manikins provide only partial fidelity. The facilitator sets the scene, the mood, observes, diagnoses, and debriefs the scenario. If fidelity is defined as the “degree of accuracy to which a simulation, whether it is physical, mental, or both, represents a given frame of reality in terms of cues and stimuli, and permissible action” (Tun, Alinier, Tang, & Kneebone, 2015 p. 164), it is the educator (facilitator) who orchestrates this fidelity and brings it home, during the debriefing. Students missing opportunities to develop or demonstrate empathetic communication skills can be debriefed in a simulation setting and can try it again, preparing for real patients and families. Arguably, the best clinical educators today are those who work in both simulation and the clinical setting. They are true high-fidelity educators.”

Featured Articles in This Edition:

  • Utilization of the Simulation Environment to Practice Teach-Back With Kidney Transplant Patients – Kara Mangold
  • Acting With a Purpose: The Lived Experience of Actors in the Role of Standardized Patients Portraying Mental Illness – Judith M. Jarosinski, Debra A. Webster
  • Generalizability Theory: An Introduction With Application to Simulation Evaluation – Susan K. Prion, Gregory E. Gilbert, Katie A. Haerling
  • Nursing and Social Work Trauma Simulation: Exploring an Interprofessional Approach – Sara J. Manning, David M. Skiff, Lizette P. Santiago, Andrew Irish
  • Logistical Planning and Making the Move to a New Simulation Space – Jan Barber, Ashley Eberhardt, Brooklyn Kennedy, Suzie Kardong-Edgren
  • Making Sense of Methods and Measurement: Lawshe’s Content Validity Index – Gregory E. Gilbert, Susan Prion

Read the latest edition on the Clinical Simulation in Nursing Website!


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#NLNSummit2016 Video Plenary – Debra Spunt Lecture by Dr. Janice C. Palaganas

nln summit simulation talk

Miss the NLN Summit this year? No worries HealthySim has you covered with this awesome Debra Spunt Lecture sponsored by Laerdal Medical and provided by Dr. Janice Palaganas, Director of Educational Innovation and Development and the Center for Medical Simulation!

A winner of multiple honors, Dr. Palaganas most recently received the President’s Award from Loma Linda, the university’s highest honor for scholastic achievement and community participation; and the Presidential Citation Award from the Society for Simulation in Healthcare. Her professional service includes membership on the committee that produced a report for the Institute of Medicine on measuring IPE outcomes; contributing content to the NLN High-Stakes Assessment for Nursing Study; in 2012, chairing the Interprofessional Education and Healthcare Simulation Symposium, attended by more than 500 educators, a conference funded by the Josiah Macy, Jr. Foundation, the NLN, and SSH. Just this year, Dr. Palaganas received another substantial grant from the Macy Foundation for “Creating an Interprofessional Community of Practice for Health Professions Educators.”

Her primary career focus has been as an educator of educators, bringing her long experience in and passion for IPE simulation to audiences nationwide and abroad. Dr. Palaganas has instructed approximately 4800 professionals, 20 percent of whom have been nurses. Her current students are among today’s leaders in health care education, ranging from department chairs, deans, and directors to postdoctoral research fellows. In her work for the SSH, she developed training and mentoring for all SSH accreditation reviewers.

Dr. Palaganas was editor-in-chief of SSH’s first textbook, Defining Excellence in Health Simulation Programs. She serves as a journal reviewer at SSH, for the NLN’s Nursing Education Perspectives, and for the Journal of Patient Safety. Her original scholarship includes numerous published peer-reviewed articles, many considered seminal pieces, e.g., a history of simulation-enhanced IPE; the first study of co-debriefing; and an updated meta-review of IPE literature.

You can watch all the recording keynote address from this Summit on the NLN Youtube page!

Not Too Late! June INACSL Nursing Simulation Conference June 15th

nursing sim conference

INACSL always puts together a great nursing simulation conference and we can’t wait to hear the report about this year’s annual event taking place June 15-18th in Grapevine Texas. It’s not too late to sign up for this annual event!

Why attend the INACSL Conference:

International Nursing Association for Clinical Simulation and Learning (INACSL) is nursing’s portal to the world of clinical simulation pedagogy and learning environments. The INACSL conference is the leading forum for nurse educators (academic and clinical), managers and researchers to connect in person with their community of practice for simulation.

The annual conference is the ideal environment to gain current knowledge regarding the INACSL Standards of Best Practice: Simulation, patient care skill acquisition, simulation lab management and the latest methodologies using simulation to enhance the education of trainees and/or practitioners. The annual conference provides an opportunity to network and share knowledge and skills to further the science of simulation alongside simulation leaders, educators, researchers and industry partners from around the world.

  • Experience the newest innovations in nursing simulation and learning resources while you re-visit some tried-and-true methodologies.
  • Explore future simulation opportunities using EvidenceBased Practice.
  • Determine new directions for simulation and learning resource centers.
  • Explore strategies to integrate technology into curriculum and practice.
  • Examine the challenges of managing nursing simulation/ learning resource centers. • Network with colleagues and experts.

Learn more at the INACSL 2016 Event website today!


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NCSBN Simulation Guidelines for Prelicensure Nursing Programs

ncsbn simulation

The NCSBN Simulation Guidelines for Prelicensure Nursing Programs was just released! Check out this comprehensive list of guidelines for simulation programs! This document made available from the Journal of Nursing Regulation.

About this Document: The National Council of State Boards of Nursing (NCSBN) published the results of the largest, most comprehensive study to date concerning the use of simulation as a substitute for traditional clinical experience. Results of the study, which were published in 2014, demonstrated that high-quality simulation experiences could be substituted for up to 50% of traditional clinical hours across the prelicensure nursing curriculum. An expert panel convened by NCSBN evaluated the data gathered through this study, examined previous research and the International Nursing Association for Clinical Simulation and Learning Standards of Best Practice: SimulationSM, and used their collective knowledge to develop national simulation guidelines for prelicensure nursing programs. This article presents those guidelines, evidence to support the use of simulation, and information for faculty and program directors on preparation and planning for using simulation successfully in their nursing programs.

Written By: Maryann Alexander, PhD, RN, FAAN; Carol F. Durham, EdD, RN, ANEF, FAAN; Janice I. Hooper, PhD, RN, FRE; Pamela R. Jeffries, PhD, RN, FAAN, ANEF; Nathan Goldman; Suzan “Suzie” Kardong-Edgren, PhD, RN, ANEF, CHSE; Karen S. Kesten, DNP, APRN, CCRN, PCCN, CCNS, CNE; Nancy Spector, PhD, RN, FAAN; Elaine Tagliareni, EdD, RN, CNE, FAAN; Beth Radtke; and Crystal Tillman, DNP, RN, CPNP

Read the Full NCSBN Simulation Guidelines here!

Reminder to Nursing Simulation Champions: INACSL 2015 June in Atlanta

inacsl 2015

Calling all Nursing Simulation Champions! Reminder that the 14th annual INACSL simulation conference is taking place June 10th-13th in Atlanta Georgia. You can download the full event brochure here. Of course, all professional simulationists are encouraged to attend.

Why attend the INACSL Conference:

International Nursing Association for Clinical Simulation and Learning (INACSL) is nursing’s portal to the world of clinical simulation pedagogy and learning environments. The INACSL conference is the leading forum for nurse educators (academic and clinical), managers and researches to connect in person with their community of practice for simulation. The annual conference is the ideal environment to gain current knowledge regarding the Standards of Best Practice: Simulation, patient care skill acquisition, simulation lab management and the latest methodologies using simulation to enhance the education of trainees and or practitioners. The annual conference provides an opportunity to network and share knowledge and skills to further the science of simulation alongside simulation leaders, educators, researchers and industry partners from around the world.

INACSL Objectives:

  • Experience the newest innovations in nursing simulation and/ learning resources while you re-visit some tried-and-true methodologies.
  • Explore future simulation opportunities using Evidence-Based Practice.
  • Determine new directions for simulation and learning resource centers.
  • Explore strategies to integrate technology into curriculum and practice.
  • Examine the challenges of managing nursing simulation/ learning resource centers.
  • Network with colleagues and experts.

Opening Keynote Address “Importance of Structured Debriefing” will be by Jenny Rudolph, PhD of Harvard Medical School’s Center for Medical Simulation.

Learn more and register now for INACSL 2015!


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SimEMR From Pocket Nurse Interview from IMSH 2014

simulated electronic medical record

SimEMR.com, a division of Pocket Nurse, was on hand at IMSH 2014 to showcase their online simulated electronic medical record learning tool. I spoke with Beth Telesz RN, MSN about the product, including learning opportunities, utilization and fee structure. The product is very comprehensive and will defiantly add a great deal of learning potential to  your healthcare simulation program! SimEMR can be used on any web enabled device including laptops, ipads or other handheld devices.

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SimEMR Benefits:

  • Web based
  • Easy to navigate
  • No software to install
  • Access to updates automatically
  • Accessible from mobile services
  • Economical yearly fee
  • No set up fees

SimEMR Features:

  • Realistic hospital charting from
  • Admission to Discharge
  • Ability for instructors to customize own scenarios
  • Care plans structured to schools own format
  • Ability to shadow students on-lineStudents can create medication cards on-line
  • Online forum allows instructors to communicate with other instructors across the state or globe

Here’s the official SimEMR video product breakdown:

For more information or to schedule a webinar visit SimEMR.com today!

Building the Future of Nursing: New Book Has Healthcare Simulation Strategies

building the future of nursing

The NLN recently released a collection of peer-reviewed articles in a book entitled Innovations in Nursing Education: Building the Future of Nursing edited by Linda Captui, EdD, RN which was co-published by: Wolters Kluwer and Lippincott Williams & Wilkins.

Chapter 6, entitled “Putting It All Together: Building A Multidisciplinary, Multi-Institutional Clinical Simulation Center”, was co-authored by myself, Dr. Carolyn Yucha, Dr. Shirlee Synder, Dr. Bar-on and David Frommer AIA. The article covered the three year development process of building the Clinical Simulation Center of Las Vegas – which is a 31,000 sq. ft. facility shared among the University of Nevada Las Vegas School of Nursing, Nevada State College School of Nursing and the University of Nevada Reno School of Medicine.

The peer-reviewed paper covers the initial funding model, collaborative meeting structure, room layout designs, initial staffing roadmaps and important lessons learned of the three-school simulation center. Most importantly the article touches on the administrative commitments that were necessary to build a collaborative healthcare learning space – which were indeed permanent and quite serious as “meetings were generally held biweekly over the course of 18 months before the center opened”.

Staffing notes reminded the reader that “because the field of healthcare simulation is rather new, hiring experienced healthcare simulation technicians was a challenge. Therefore, simulation technicians were selected based on their backgrounds in either healthcare of technology, work ethic, interpersonal and organizational skills, ability to work as a team, and comfort with ambiguity.”

A few of the lessons learned include:

  • Plan to invest far more time in collaborative projects.
  • Identify the stakeholders early in the process
  • Take time to reflect on achievements when it seems as though profess is not forthcoming.

The 24-chapter book also includes other simulation-based papers including “Out of the SimLab and into the Classroom: Using High-Fidelity Simulation as an Active Classroom Teaching Strategy” and “Mid-Scenario Reflection: A Teaching Strategy for Simulation in Nursing Education”.

You can buy Building the Future of Nursing on amazon.com!


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International Nursing Association for Clinical Simulation and Learning Launches 2013 Meeting with Keynote on Evidence Based Practices

inacsl 2013

President Valarie Howard EdD RN opened the 2013 INACSL conference at the Paris Hotel in Las Vegas. This annual event hit another record high for attendance with nursing simulation champions coming from around the World. The key take away for me was learning about a new mentorship program the organization is development to connect the community to one another. More about this to follow tomorrow after the committee meeting.

inacsl logo

Dr. Bernadette Mazurek Melnyk PhD, CPNP, FNAP then provided the keynote address “Nothing Happens Unless First a Dream”. Dr. Melnyk is the Dean, Associate VP for Health Promotion and the University Chief Wellness Officer at Ohio State University. She quickly reminded the audience that those who encounter a medical error will have a 5-15% chance of death or permanent disability – as over 200,000 patients die this way every year with such wasteful healthcare spending costing the healthcare system 1.2 trillion dollars annually.

melnyk

Siting a lack of real world setting research Dr. Melnyk suggested that out of 10,093 articles screened only 50 reported patient outcomes for 3,221 trainees and 16,742 patients.  For the past fifteen years, Dr. Melnyk has traveled the globe to teach others about evidence-based practices in education and urges all nursing simulation champions that are engaging in future research to explore the patient-outcomes “so what factors” that will end up affecting the healthcare system right now. The recommendation here is to utilize some form of quality assurance program to demonstrate that the “strength of the evidence plus the quality of the evidence equals the confidence to act”, which is crucial for evidence-based practices. But what does it take for clinicians to develop and promote EBP within their programs in a world “routed in tradition” (such as daily changing of iv dressings, perineal shaves before child birth, or mayonnaise for head lice). She reminded us that no one was calling to implement her COPE NICU training program until after she published a “so what” clinical trial which demonstrated a cost savings of $5000 per infant and an average 8 day shorter LOS.  After this “so what” real world study Dr. Melnyk said “the phone never stopped ringing” with clinicians looking to to improve outcomes for patient care.

Her key take away is the consideration to add so what outcomes factor for research and simulation program development designed at directly affecting patient outcomes through evidence-based approaches. She further stresses that healthcare administrators must understand that they must encourage and reward clinicians for evidence-based practice research in-order to continue to improve patient care outcomes. Key strategies for those implementing EBP include:

  • Using the best evidence available
  • Inspire a spirit of clinical inquiry
  • Reinforce the steps of EBP in simulations
  • Role model EBP in all simulations and discuss benefits
  • Build randomized clinical trials that show translations from simulation to pt care

international nursing simulation conferences

You can get connected with more EBP information by reading Worldviews on Evidence-Based Nursing, edited by Dr. Melnyk!

Stay tuned to HealthySimulation.com’s @HealthySim Twitter account for posts throughout the day and this post for all the latest from the world’s largest nursing simulation event, INACSL!

NLN Recorded Simulation Session & Senior Care Resources

nln

In 2011 at the National League for Nurses (NLN) Summit a Simulation-based ‘Debra L. Spunt Lecture’ session was recorded between Sharon Decker, PhD, RN, ACNS-BC, ANEF, Janet L. Grady, DrPH, RN, FAAN, ANEF, Pamela Jeffries, PhD, RN, FAAN, ANEF and Suzan Kardong-Edgren, PhD, RN, ANEF, which was entitled “Leadership in Simulation: Looking Back, Looking Forward”. Theory-Practice gaps are identified as problems not just in nursing, but in all higher learning communities.  These speakers cover the challenges of developing simulation research and utilization in nursing, and although from 2011 still has huge relevance for our community today. You can watch the 1-hour session below and visit the NLN website for more information.

As well, the NLN has provided free downloadable content for educating the care of older adults through innovations in nursing education, called ACES – which stands for Advancing Care Excellence for Seniors. This grant-funded initiative was developed to foster gerontological nursing education for pre-licensure nursing programs. The ACES website is the go-to place for gerontological resources for faculty and students, classroom-ready teaching tools and strategies, and information about upcoming faculty development events related to integration of care of older adults into nursing program curricula.

The ACES free downloadable cases include:

  • A first-person monologue that introduces the individual or couple and the complex problems to be addressed.
  • Simulation scenarios designed to help students practice assessing function and expectations of their patient(s), with links to appropriate evidence-based assessment tools, including those from the Try This® and How to Try This® Series.
  • An innovative final assignment that asks students to finish the story.
  • An instructor toolkit with suggestions on how to use the various components of the unfolding cases and incorporate them into the curriculum.

NLN ACES

Visit the NLN ACES website to get these resources today!

6th Annual WISER Symposium on Nursing Simulation June 6th-7th

wiser nursing symposium

Early next month the University of Pittsburgh’s WISER center will be hosting their 6th annual meeting to support simulation in nursing. Registrations for this June event are still available at $400 per person here.

The Peter M. Winter Institute for Simulation, Education, and Research (WISER) of the University of Pittsburgh, allied with the UPMC Health System, is dedicated to healthcare education and educational research. The Institute features advanced instructional technologies and methods to develop innovative healthcare education programs that are ultimately targeted towards improving the public welfare and safety

wiser nursing conference

Dr. Paul Phrampus, current President of the Society for Simulation in Healthcare and Director of WISER will be providing this year’s keynote address.  Paul let me know that this year the meeting will provide a blend of didactic learning at the hotel and more interactive based sessions across the street at the WISER center itself.  I am also happy to report that WISER has invited HealthySimulation.com out to cover the event with video, so stay tuned!

Remember, there is still time to Register so learn more about the event at the WISER Nursing Symposium website.

Simulation-based Learning Highlights include:

  • Best practices
  • Leadership skills
  • Assessment methods
  • Program development
  • Interactive workshops
  • Debriefing methods and practices
  • Practical pointers and demonstrations
  • Use of supplemental educational technology
  • Internationally recognized simulation experts
  • Overcoming problems and pitfalls in building your simulation program
  • Developing competencies through simulation
  • Networking opportunities

*10.75 CNE contact hours will be awarded to individuals that complete this 1.5 day symposium.*


AGENDA:

Thursday, June 6th

  • Building the Simulation Bridge: Past, Present & Future
  • Simulation-The Bridge to Patient Safety
  • Crossing the Bridge from Simulation to Publishing
  • Breakout sessions (Select 3 choices. Participant will be added to their top two choices. Third choices is a back-up. Sessions will be filled on a first come first serve bases.):
    • Creating Simulation Policies & Procedures
    • Building Simulation Projects & Papers
    • Obstetrics and Pediatric Simulation
    • Structured and Supported Debriefing: How to Reinforce Your Students Learning
    • Curriculum Development & Integration

Friday, June 7th

  • Climbing the Bridge to the Top Ten Simulation Articles
  • Simulation on the Cheap: Making the Most of Your Resources
  • Becoming a Certified Simulation Instructor
  • Assessment in Simulation: Making it Fun
  • Question and Answer Town Hall Meeting

Learn more about the event at the WISER Nursing Symposium website.