WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH RESEARCH IN SIMULATION: Why, Who, How, Now, and… (what do we know, now?) DEBRA L. SPUNT LECTURE, NATIONAL LEAGUE FOR NURSING Suzie Kardong-Edgren PhD, RN Washington State University | College of Nursing October 2, 2010

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH ACKNOWLEDGEMENTS  Mindi Anderson PhD, RN (for pulling SimMan out of the box)  Mary Lou Bond PhD, RN (mentor)  Carolyn Cason PhD, RN (best researcher!)  Clive Patrickson (your “global-ness”)  Pam Jeffries (kickstarter)  Marilyn Oermann (PI extraordinaire)  The INACSL board (for journal!)

OBJECTIVES  Discuss the importance of simulation research  Discuss advantages of a team approach to simulation  Discuss 2 strategies for developing a research program  Discuss 2 current large nursing research projects.

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH

CURRENT STATE OF AFFAIRS WHAT DO WE KNOW now?

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH NCSBN 2010 SURVEY  Published in Journal of Regulatory Nursing  1060/1729 for 62% response rate  87% US programs using HFS  55% use in 5+ courses  Most used: Med-surg/OB/pedi  Least used: Mental health/capstone/community health

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH CURRENT CLINICAL HOURS IN US PROGRAMS  Mean hours 733  Max hours 1540  Median hours 765

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH NCSBN FINDINGS (AHH FINDINGS)  59% use faculty peer review of scenarios  83% thought we should be using more simulation  76% reported more faculty need to be trained to facilitate simulation  30% amount of time thought they would comfortably substitute simulation for clinical

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH NCSBN FINDINGS (ARGH FINDINGS)  Only 29% faculty writing scenarios have been trained  72% judge scenario quality by students comments  Only 44% pilot test a scenario  69% report not enough staff to run simulation controls and oversee students

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH WHAT DO WE KNOW NOW?  Beyea, Slattery, von Reyn, nursing residency with simulation  Lampkin, Levett-Jones, Bellchambers, Fernandez, systematic review of lit  Draycott –increeased Apgar, decreased brachial plexus injuries

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH PRINCIPLES WE THINK WE KNOW 2010  Feedback  Deliberate practice  Curriculum integration  Outcome measurements  Simulation fidelity  Skill maintenance and decay  Mastery learning  Transfer to practice- translational science

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH  Team training  High stakes testing  Instructor training  Education and professional context PRINCIPLES WE THINK WE KNOW 2010

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH RESEARCH…WHY?

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH

WHY? A Perfect Storm  Timing  Fits US paradigm of expensive technology  Clinical slots disappearing  IOM report  No alternative to clinical educational practices  Societal and accrediting agency demands

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH RESEARCH…WHO?

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH Imagine the Tin Man from the Wizard of Oz here

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH Imagine the Cowardly Lion from the Wizard of Oz here

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH Get a research partner if you are new to research.

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH RESEARCH…HOW? No NINR funding for nursing education research… “We know everything we need to know about teaching nursing…” No change in educational practices in 30 years

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH Imagine the Scare Crow from the Wizard of Oz here.

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH

PLEASE…  Read conference abstracts  Read journals  Repeat good studies  Improve upon published studies  Use reliable and valid tools  Do a power analysis  Use proper n  Use the strongest research design you can

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH

FORM A RESEARCH TEAM  Statistician  Educational psychologist  Another school  Someone with research experience  Seek a mentor  Other health disciplines

KIRKPATRICK’S LEVEL OF EVIDENCE  Level 1 – Reactions  Level 2 – Learning  Level 3 – Transfer to another setting  Level 4 - Translation to practice

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH WE NEED QUALITATIVE STUDIES ABOUT SIMULATION

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH WE NEED INTERDISCIPLINARY STUDIES WITH OTHER HEALTH CARE PROFESSIONALS AND/OR STUDENTS

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH RESEARCH…NOW

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH

UTSTEIN CONFERENCE ON STATE OF THE SCIENCE IN SIMULATION NORWAY JUNE 2010 AGENDA FOR RESEARCH IN SIMULATION

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH

PLEASE LIST YOURSELF IN SIRC WEBSITE UNDER SIMULATION RESEARCHERS!

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH

YOUR HOMEWORK! Researchers: List yourself on SIRC website

Questions?

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH | WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING | RESEARCH REFERENCES  McGaghie, W., Issenberg, S.B., Petrusa, E., Scalese, R. (2010). A critical review of simulation-based medical educational research Medical Education 44,  Kirkpatrick, D. (1994). Evaluating training programs: The four levels. San Francisco: Berrett-Koehler.  Benner, B., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses. San Francisco: Jossey-Bass.  Beyea, S. C., Slattery, M. J., & von Reyn, L. J. (2010, September). Outcomes of a simulation-based nurse residency program. Clinical Simulation in Nursing, 6(5), e169-e175.  Lampkin, Levette- Jones, Bellchambers, Fernandez (2010) Clinical Simulation in Nursing. In press.