1. DEVELOPING A MULTI-DISCIPLINARY SIMULATION HOSPITAL Presented by: Lee Jerls MSN, RN and Terri Currie BSN, RN

2. Definition Simulation – An attempt to mimic essential aspects of a clinical simulation with the goal of understanding and managing the situation better when it occurs in actual clinical practice. – A technique that uses a situation or environment created to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions (

3. Definition: Fidelity  Fidelity  The degree to which either a simulation encounter or simulation equipment approaches reality (http://sirc.nln.org/mod/resource/view )http://sirc.nln.org/mod/resource/view  Types:  Low fidelity manikins  Medium fidelity manikins  High fidelity manikins

4. Why Simulation?  “Carnegie Foundation for the Advancement of Teaching Report” (Benner, Sutphen, Leonard, & Day, 2009)  “ From focus on covering decontextualized knowledge…to sense of salience, situated cognition and action in a particular situation;  From a sharp separation of clinical and classroom teaching to integration of classroom and clinical teaching;  From an emphasis on critical thinking to clinical reasoning and multiple ways of thinking that include critical thinking; and  From an emphasis on socialization and role taking to an emphasis on formation.”

5. Learning Theories  Constructivism learning therapy  Adult-learning theory  Brain-based learning theory  Social-cognitive learning theory  Experiential learning theory  Novice-to expert theory  A new pedagogy??

6. The Journey…. LSC-K Hospital  History (2007)  Appreciative Inquiry (early 2008)  Lack-of-realism  Roles and responsibilities  Orientation to the unit and equipment  Faculty continuity Scenario development

7. Literature Review

8. Jeffries Simulation Model (2005)

9. S.T.E.P. Educator Preparation Plan  S.T.E.P.  Simulation Take Educator Preparation (Jeffries, 2008) Standardized Materials Train the Trainer Encourage the development of a simulation design and integration team Plan to coordinate the simulation development and implementation activities

10. S.W.O.T. Method  Strengths  Weakness  Opportunities  Threats (Rothgeb, 2008)

11. Integration Into the Program  Identification of a champion  Scheduling  Simple first steps  Flexibility  Debriefing (Leigh & Hurst, 2008)

12. Simulation Design  Objectives  Planning  Fidelity  Complexity  Cues  Debriefing (Jeffries, 2005)

13. Evaluation Process  Debriefing  Reflection  Tools

14. National League for Nursing The Simulation Design Scale (student version), a 20-item instrument using a five- point scale, was designed to evaluate the five design features of the instructor- developed simulations used in the NLN/Laerdal study. Educational Practices Questionnaire (student version), a 16-item instrument using a five-point scale, was designed to measure whether four educational practices (active learning, collaboration, diverse ways of learning, and high expectations) are present in the instructor-developed simulation, and the importance of each practice to the learner. Student Satisfaction and Self-Confidence in Learning, a 13-item instrument designed to measure student satisfaction (five items) with the simulation activity and self-confidence in learning (eight items) using a five-point scale. http://sirc.nln.org/mod/resource/view  Chickering, A.W., & Gamson, A.F., (1987). Seven principles for good practice in undergraduate education. Racine, WI: The Johnson Foundation, Inc./Wingspread

15. A day in the life of a student nurse at LSC-K Hospital… Lone Star College- Kingwood Hospital

16.  Mission: to deliver safe and prudent quality care while maintaining ethical, professional, and culturally acceptable standards through utilization of evidence-based practice an innovative technology  Vision: to facilitate the growth of the novice learner to the expert clinician, enhancing critical thinking skills and self- confidence in a safe, realistic, and non-threatening environment. Lone Star College- Kingwood Hospital

17. Orientation Process LSC-K Hospital – Roles and responsibilities – Patient information – Confidentiality form – Scavenger hunt – Equipment – Crash carts – Paging system – Documentation – EMAR I want to insert a picture here

18. Report  Patient Census  Level  Roles and responsibilities Primary nurse Secondary nurse Family member Observer Interdisciplinary team

19. Multi-Patient Unit

20. Multi-Disciplinary Unit  Nursing disciplines  Nursing levels  Respiratory therapy  Occupational therapy

21. Debriefing

22. References Benner, P., Sutphen, M., Leonard, V., & Day, L. (2009). Educating nurses: A call for radical transformation. San Francisco: Jossey-Bass. Jeffries, P. R. (2005). A framework for designing, implementing, and evaluating simulations used as teaching strategies in nursing. Nursing Education Perspectives, 96-103. Jeffries, P. R. (2008). Getting in S.T.E.P. with Simulations: Simulations Take educator Preparation. Nursing Education Perspectives, 70-73. Leigh, G., & Hurst, H. (2008). We have a high-fidelity simulator, now what? making the most of simulators. International Journal of Nursing Education Scholarship, 1-10. Rothgeb, M. K. (2008). Creating a nursing simulation laboratory: a literature review. Journal of Nursing Education, 489-494.