1. Online Simulation as a Process for Gaining and Measuring Competency with Procedures
Nancy Moureau, BSN, CRNI, CPUI, VA-BC; Brian Peck, BA, PES, CES
PICC Excellence, Inc.
ABSTRACT
Introduction: Simulation for medical practices is a growing method to measure competency with procedures. Guidelines recommend provision of education as a strategy to prevent infections and other complications. The Society for Healthcare Epidemiology of America in the 2014 Strategies to Prevent CLABSI states require education of healthcare personnel involved in insertion, care and maintenance of central venous catheters.; ensure that all complete an education on basic practices and credentialing program to verify competency before independently inserting central venous catheters. Various practices for vascular access insertion and care require validation of understanding and competency. With growing shortages of personnel it is not always possible to provide supervision and one on one teaching to individuals on a regular basis. Online simulation training and competency assessment provides a first level validation of processes such as aseptic technique, dressing change steps and care of devices in an innovative and easy to access educational environment.
METHODOLOGY
A review of literature was performed for simulation and simulator training specific to healthcare training. A feasibility process was conducted to determine interface with learning management systems to fully integrate education and simulation.
RESULTS
(continued) an educational process was constructed with scoring for correct procedure, an error system to deduct and direct the learner, milestones for incentives and required steps, along with visual indicators when milestones are reached. Similar to a video game, clinicians can play within the procedure and complete required competency assessments.. The feasibility study established a simulator process for vascular access procedures that will serve as a foundation for adding competency measures that train and test for understanding.
Figure 2: Integration of procedure and supplies
Figure 3: Patient and Clinician Avatars figures for simulation
Figure 1: Feasibility study of simulator environments
RESULTS
Literature search of 24 publications supported simulation training as a valuable means of education to positively impact performance. Use of simulation with manikins and other simulators of veins and device insertion are presented in the literature. For physician, resident, nursing and technologist training with intravenous devices, primarily central venous catheter insertion to increase skill and decrease complications.
The feasibility study was conducted with a systems based server network where a learning management system provided integration with the educational processes. Through a series of experiments a virtual healthcare environment was created to simulate a patient room and procedures normally conducted by clinicians with vascular access device insertion and care. Working together with a systems analyst, programmer, and clinician
CONCLUSIONS
As a process in early stages of development, the online simulator education provides a means to educate and evaluate procedures, understanding and infection prevention practices. By providing access through computer based learning, hospital and staff efficiency is increased, allowing access 24 hours per day 7 days per week. Documentation is facilitated, creating a process to credential inserters and those performing procedures, in a process that can be performed annually, modified and updated as needed. Evidence suggests simulation based education provides benefits for the learner and now for the hospital to confirm and enable recommended education through a cost effective online simulator method.
OBJECTIVE
To establish an online process to provide accessible education, validation of understanding and measurement of competency for vascular access concepts and procedures.
References: Ma 2011, Gerolemou 2014, Evans 2010, Davidson 2012, Barsuk 2009, Taylor 2012, Zorcolo 1999, Britt 2009, Dong 2010, Ball 2012, Zingg 2014.