Family-centered clinical simulation is an emerging and incredibly valuable tool for clinical teams and families involved with pediatric care teams in all pediatric clinical environments. Thankfully, healthcare simulation teams have the skills required to create and maintain a psychologically safe education environment for pediatric clinical staff, pediatric patients and also family members. This article by Erin Carn-Bennett, RN, MSN will explore the versatility of a family centered discharge simulation program and what the future may hold in this rapidly developing space.
Connection and Storytelling are Important and Powerful before Clinical Simulation
Connection and trust with family members is essential prior to even an incredibly basic clinical simulation scenario. Many healthcare workers find healthcare simulation intimidating and overwhelming. For many if not most families there has been a lot of power taken from them as patients and families in a clinical space. Therefore time to build trust and connection by clinical simulation educators with families is imperative and should be prioritized as useful prior to any clinical simulation taking place.
As much as a clinical simulation program requires structure when working alongside families there may be the possibility that families need to have some control over scheduling and program advancement. Particularly long term inpatients and their families will carry a lot of trauma and distress around experiences in clinical environments that will need to be honored and made space for by both the clinical and healthcare simulation based teams. Without this, there may be limited acquisition of clinical skills as family members are not able to be in a learning zone headspace without psychological safety foundations present.
Learning and engagement contracts and timelines may be useful but consideration as to who holds the final say in sign off will be useful. Attempts should be made to start trust building and connections with the family as early in the clinical picture as possible. At IPSSW 2024, in her keynote talk Dr. Jen Arnold from Immersive Design Systems at Boston Children’s Hospital, spoke about how for patients who require a tracheostomy the family centered clinical simulation scenarios and pre-work commence even before the patient goes for their operation to get the tracheostomy.
View the LEARN CE/CME Platform Webinar Using Healthcare Simulation to Train Patient Families in Pediatric Ventilation Care to learn more!
Take a strategic approach in who to train in clinical simulation debrief skills for pediatric discharge simulation services. There may be particular staff members that are often involved consistently in long term pediatric care such as nurse specialists that would benefit to upskill in psychologically safe debrief methods that clinical simulation courses can offer. Consider other specialities other than medical and nursing to be trained as clinical simulation debriefers as well. These may include specialities such as child life specialists and other allied health professionals.
Each family or child dependent on who is receiving the clinical simulation based education should have an individualized education plan, agreement and goals decided. As with clinical simulation in any other environment, clear rules of engagement, a basic assumption and a clear debrief structure should be followed in order to maintain psychological safety of everyone involved. The value in these points should never be underestimated.
As technology advances in all areas of healthcare simulation, the area of family centered clinical simulation is no different. Clinical simulation packages may be centered around a specific event for the family such as an operation or an alteration of care requirements. Other events that can benefit from family centered simulation include discharge simulation and also clinical simulation for the pediatric patient themselves. For example: in some pediatric hospitals child life therapists make use of VR headsets to provide pediatric patients treatment and also relief from procedural anxiety and Ptsd. There is room within this space to include VR based clinical simulation to other areas of family centered discharge simulation and for other similar topics.
Provision of Clinical Simulation to Family Members as Learners is Different
Provision of healthcare simulation based education to clinical staff is a very different experience in contrast to simulated experience for parents or caregivers of a medically fragile child. There needs to be a lot more time allocated to build and foster relationships with the family prior to any clinical simulation. There may be much baggage to unpack of historical experiences in the hospital. By allowing space for this to occur, the clinical simulation will have an increased chance of success and should not proceed without this step.
Parents and caregivers are the experts of their child and their care requirements in this educational environment. Healthcare simulation faculty need to be highly experienced to be able to make allowances for this and to install confidence into the family to care for their child. This will allow for families to feel more psychologically safe and to bring forward any major concerns for them.
Learning Objective Should be Created in Order of the Families Preferences
Family centered healthcare simulation sessions should be focused on learning needs of the family, not the clinical healthcare teams agenda whether hidden or not. There needs to be reciprocal trust between the healthcare simulation team and the family. Trust in the process and to focus on the main concerns of the family may mean more clinical simulation sessions are required but will pay dividends in the end for the patient and also family.
Involvement of clinical simulation teams in long term pediatric patients care and discharge planning earlier rather than later will assist with best outcomes for clinical teams and also families. Collaboration of all multidisciplinary team members alongside the clinical simulation team can be beneficial for everyone as well. Cultural considerations for all family members should be prioritized and respected to assist with trust building and engagement with healthcare simulation staff. This can be achieved to an in depth level through collaboration with hospital cultural support services and other support services such as social workers.
This article has discussed family centered discharge clinical simulation for pediatric patient populations. Provision of clinical simulation to parent, caregiver or pediatric patient is a very different experience to a healthcare professional. Particularly for parents and caregivers clinical simulation can be an incredibly transformational and empowering experience. As clinical simulation faculty there needs to be awareness of the differences in this style of clinical simulation and why these differences are so critical.
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