Competency Based Orientation Simulation Lab

Why? Competencies support high-quality, safe care. Defines the roles and expectations of new employees. Ensures every employee gets the same information. Incorporates evidence into practice.

ASPAN Recommendation ASPAN leadership developed Competency Based Orientation A recent update released last year We should incorporate these competencies into our orientation programs. There are multiple competencies conducive to simulation.

What is Simulation ? Reproduce clinical scenarios in real time Provide a safe, forgiving environment Allow participants to practice skills and decision making Allow participants exposure to visual and auditory modalities to improve educational experience

Types of Simulation Low fidelity Examples include Static models used Provides little feedback Often poorly relates to real life situations Used with simple tasks and skills Helpful for beginning learners Examples include IV starts on a plastic model

Types of Simulation Moderate fidelity Examples Uses elements of static and dynamic models Offers some relationship to real life situations Useful for more advance learners Incorporates some elements of critical thinking Examples Setting up PCA using real life pump and equipment

Types of Simulation High fidelity Uses highly dynamic models Attempts to reproduce real life situations Useful for advanced learners Helpful to teach complex decision making and critical thinking High risk, low frequency and complex clinical situations

Examples of Simulation use in the PACU environment Airway management laryngospasm, bronchospasm Circulation-hemodynamic monitoring, patient decline and code Neurological drains and neuro changes Malignant Hyperthermia Age specific competencies-pediatric decline, geriatric considerations

Elements of successful teaching via simulation Well defined with correlations to real life scenarios Strong leadership and support Participant characteristics

Well defined and real life scenarios Clear beginning and ending Choose scenarios where direct interventions are done High risk and or urgent situations that occur at low frequency

Strong leadership and support Support from educators and management are essential Educators familiar with the use of high fidelity simulation are important Group leaders must explain and reinforce the forgiving nature of the simulation environment

Participant characteristics Highly motivated learners Technology engaged learners Participants must interact and engage in the experience Group size is most efficient with 4-6 participants depending on material covered

Benefits of simulation Improved performance of skills Increased levels of learner engagement Increased levels of confidence of the learner Links to improved patient outcomes and decrease patient complication

Why use high fidelity simulations for competency ? Meet many of the elements that create successful teaching using simulation Advanced engaged learners Focus on preforming skills High risk, low frequency clinical situations

AT UK We conducted simulation for annual PACU competencies Overwhelming positive feedback Comments: “focused on real world scenarios”, “improves muscle memory for a real situation”. Many suggestions for more things to see in simulation.

References Harder, B. N. (2010). Use of simulation in teaching and learning in health sciences: a systematic review. Journal of Nursing Education, 49(1), 23-28 26p. doi: 10.3928/01484834-20090828-08 Hooper, B., Shaw, L., & Zamzam, R. (2015). Implementing High-Fidelity Simulations With Large Groups of Nursing Students. Nurse Educator, 40(2), 87-90 84p. doi: 10.1097/NNE.0000000000000101 McGaghie, W. C., Issenberg, S. B., Barsuk, J. H., & Wayne, D. B. (2014). A critical review of simulation-based mastery learning with translational outcomes. Medical Education, 48(4), 375-385 311p. doi: 10.1111/medu.12391 Sparacino, L., & Vecchia, E. D. (2013). Using high-fidelity simulation to close the teaching and learning gap. Online Journal of Nursing Informatics, 17(1), 37-44 38p.