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Creating a Low Cost Obstetric Clinical Immersion Simulation for Medical and Nursing Students

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Creating a Low Cost Obstetric Clinical Immersion Simulation for Medical and Nursing Students

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Katie Pawloski, Professor
Dr. Pasquale Iemma, Adjunct Lecturer
Kellany Cadogan Noland, DrPH(c), MSN, RN
Marie L. Lumbart, MSN, ARNP-C, FNP, CCRN | all Utica College – ABSN Program
and Wendy Moore | Orbis Education
TEAM PRESENTATION: Creating a Low Cost Obstetric Clinical Immersion Simulation for Medical and Nursing Students (Double Session)

This presentation is designed to provide application level exposure to essential perinatal concepts that are often not available through traditional clinical exposure. The session features two phases of activities used in student training.

Phase One:
Focused contextualized skill stations utilizing leading-edge simulation skills using state-of-the-art computerized manikins (Human Patient Simulators, or HPS) and patient actors, also known as standardized patients (SP).

Phase Two:
Students are exposed to a multistage unfolding patient care simulation that required application of the phase one skills within the evolving scenario.

Presented by the
Serious Play Conference
seriousplayconf.com
at
Orlando,
University of Central Florida,
UCF,
July 24-26, 2019

Katie Pawloski, Professor
Dr. Pasquale Iemma, Adjunct Lecturer
Kellany Cadogan Noland, DrPH(c), MSN, RN
Marie L. Lumbart, MSN, ARNP-C, FNP, CCRN | all Utica College – ABSN Program
and Wendy Moore | Orbis Education
TEAM PRESENTATION: Creating a Low Cost Obstetric Clinical Immersion Simulation for Medical and Nursing Students (Double Session)

This presentation is designed to provide application level exposure to essential perinatal concepts that are often not available through traditional clinical exposure. The session features two phases of activities used in student training.

Phase One:
Focused contextualized skill stations utilizing leading-edge simulation skills using state-of-the-art computerized manikins (Human Patient Simulators, or HPS) and patient actors, also known as standardized patients (SP).

Phase Two:
Students are exposed to a multistage unfolding patient care simulation that required application of the phase one skills within the evolving scenario.

Presented by the
Serious Play Conference
seriousplayconf.com
at
Orlando,
University of Central Florida,
UCF,
July 24-26, 2019

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Creating a Low Cost Obstetric Clinical Immersion Simulation for Medical and Nursing Students

  1. 1. Developing Low Cost Simulation Immersions Thursday July 25, 2019
  2. 2. • Historically challenging to students. • Accelerated course delivery. • Developing ability to apply learned content. • Limited clinical exposure. • Student anxiety surrounding specialty. • Documented value of high-fidelity simulation to undergraduate students. The “birth” of an idea!
  3. 3. • To expose students to low volume high-risk client care scenarios that capture frequently tested concepts on NCLEX RN in a controlled replicable environment. • To provide experiences that would enable students to apply learned concepts towards clinical reasoning for selected essential concepts. • To improve student outcomes related to selected essential concepts measured through summative assessments. Immersion Goals
  4. 4. What does the literature say? • Al-Ghareeb, A., McKenna, L., & Cooper, S. (2019). – “Indicative outcomes suggest that optimal performance was apparent when anxiety levels were low”
  5. 5. Private | Nonprofit | Regionally Accredited • Andersen, P., Downer, T., O’Brien, S., & Cox, K. (2019). • Bortolato-Major, C., Perez Arhur, J., Taís Mattei daSilva, Â., de Fátima Mantovani, M., Cestari Felix, J. V., & Boostel, R. (2018). – Recognized the potential of simulation for teaching undergraduate nursing courses, with opportunities to offer students practical and theoretical knowledge in a controlled environment and close to real, with minimizing risks to patients.
  6. 6. • Cant, R. P., & Cooper, S. J. (n.d.). Highlights: – Simulation education statistically improves nursing students' knowledge. – Studies report improvements to students' confidence, competence and self-efficacy. – Programs demonstrate innovation and excellence, teaching a wide- range of topics. – Programs should be shared across the discipline to facilitate development of multimodal learning. ●Private | Nonprofit | Regionally Accredited
  7. 7. • Guimond, M. E., Foreman, S. E., & Werb, M. (2019). – The unfolding, obstetric simulation was effective in helping our students demonstrate the achievement of course objectives through improved obstetric self-efficacy scores and scores for shift to shift communication. Private | Nonprofit | Regionally Accredited
  8. 8. • Lewis, R., Strachan, A., & Smith, M. M. (2012). • Lin, H.-H. (2015). • “Results showed that simulation-based learning significantly improved students' self-efficacy regarding skills learning and the skills performance that nurse educators wish students to acquire.” Private | Nonprofit | Regionally Accredited
  9. 9. What about cultural awareness? Roberts, S., Warda, M., Garbutt, S., & Curry, K., Associate Professor, Associate Director, Department of Nursing. (2014). • “With the increasing demands of the nursing curriculum and the limited time frame to prepare competent clinicians, the search continues for innovative strategies that will produce culturally competent providers. Patient simulation is a technique that replicates real-world scenarios in a controlled and nonthreatening environment. “
  10. 10. Location: Maternity Unit Patient name: Aaliyah Farooqi Medical record #: 2750553 Date of birth: July 11 Age: 22 Sex: Female Admitting provider: P. Iemma, CNM Chief complaint: RLQ abdominal pain and vaginal discharge of fluid Primary diagnosis: Pregnancy, Rupture of membranes ●Private | Nonprofit | Regionally Accredited Addressing Culture…
  11. 11. ●Private | Nonprofit | Regionally Accredited Our journey… Idea! Internal Team Collaboration Reaching Out Stakeholder Support Reality Vs Ideal Immersion Creative Solutions Creative Solutions
  12. 12. Private | Nonprofit | Regionally Accredited Next Steps… Summative Assessment Clinical Practice Planning for the second immersion! Review of Findings
  13. 13. Private | Nonprofit | Regionally Accredited Prebriefing Concept Foci Highlighting the ESSENTIALS! • Intrapartum Care • MamaBirthie, Standardized Patient • Fetal Heart Monitoring • Table Top Scenarios, LLEAP EFM Software • Post Partum Hemorrhage • PROMPT Flex PPH Module • Newborn Assessment • High-fidelity SimMom
  14. 14. Exam Outcomes by Content…
  15. 15. Exam Average…
  16. 16. Course Averages…
  17. 17. Private | Nonprofit | Regionally Accredited Debriefing of Concepts • Nursing Process Framework • Plus/Delta • Maslow’s Hierarchy of Needs • Jeopardy Game • Teach back Getting to the AH – HA moment!
  18. 18. Creative Staffing… Berro & Knoesel (2016) – Utilizing recent graduates – Exposure to the teaching role – Maintaining and enhancing newly acquired nursing skills – Giving back to their alma mater – Strengthening their own novice clinical expertise http://childrensministryonline.com
  19. 19. Simulation for Specialty Areas… Curl, Smith, Chisholm, McGee, & Das (2016) – STRIPES group had clinical and simulation – Control group only simulation – Pre and post testing completed – The experimental group scored the same or higher than the control group.
  20. 20. Mental Health Immersion- https://youtu.be/L8UGu7MFEI8
  21. 21. Mental Health Immersion… • Simulated telemedicine patient interviews • Student created, student led simulations
  22. 22. Mental Health Immersion Each group will utilize the simulation they created and act it out with another group. See schedule below. Group 1: Borderline Personality Disorder Group 2: Bipolar Disorder Group 3: Substance Abuse Disorders Group 4: Dementia Group 5: Anorexia/bulimia 0900 0945 1030 1115 1200 Group 1 Acting Students with Group 5 Students with Group 2 Acting Observe group 4 Group 2 Students with Group 1 Acting Acting Observe 5 Students with Group 4 Group 3 Acting Students with Group 2 Observe group 4 Acting Students with Group 5 Group 4 Students with Group 3 Observe group 2 Acting Students with Group 1 Acting Group 5 Observe group 1 Acting Students with Group 4 Students with Group 3 Acting
  23. 23. Mental Health Scores
  24. 24. Expanding the Model • Replicate at all 3 sites • Obstetrics • Pediatrics • Psychiatric population • Standardized patients This Photo by Unknown Author is licensed under CC BY-SA-NC
  25. 25. Future thoughts… IPE Immersions This Photo by Unknown Author is licensed under CC BY-SA
  26. 26. Lab Fees Alumni donations and fundraising Grant Funding Money, Money, Money!
  27. 27. How can this integrate into your curriculum? What other ideas do you have? Do you currently have shortages in clinical placement or experiences?
  28. 28. Faculty Presenters Dr. Pasquale Iemma- paiemma@utica.edu Dr. Wendy Moore- wlmoore@utica.edu Professor Katie Pawloski- kmpawloski@utica.edu Professor Kellany Noland- kscadoga@utica.edu Professor Marie Lumbart- malumbar@utica.edu
  29. 29. References Al-Ghareeb, A., McKenna, L., & Cooper, S. (2019). The influence of anxiety on student nurse performance in a simulated clinical setting: A mixed methods design. International Journal of Nursing Studies, 98, 57–66. https://doi.org/10.1016/j.ijnurstu.2019.06.006 Andersen, P., Downer, T., O’Brien, S., & Cox, K. (2019). Wearable simulated maternity model: Making simulation encounters real in midwifery. Clinical Simulation in Nursing, 33, 1–6. https://doi.org/10.1016/j.ecns.2019.04.007 Berroo, E & Knoesel, J. (2016). An Innovative Approach to Staffing a Simulation Center in a College of Health Professions. Journal of Nursing Education. 55(1), 53-55. doi:10.3928/01484834-20151214-13 Bortolato-Major, C., Perez Arhur, J., Taís Mattei daSilva, Â., de Fátima Mantovani, M., Cestari Felix, J. V., & Boostel, R. (2018). Contributions of the Simulation for Undergraduate Nursing Students. Journal of Nursing UFPE / Revista de Enfermagem UFPE, 12(6), 1751–1762. https://doi.org/10.5205/1981-8963-v12i6a230633p1751-1762-2018 Cant, R. P., & Cooper, S. J. (n.d.). The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis. Nurse Education in Practice, 27, 45–62. https://doi.org/10.1016/j.nepr.2017.08.012
  30. 30. References Curl, E. D., Smith, S., Chisholm, L. A., McGee, L. A., & Das, K. (2016). Effectiveness of Integrated Simulation and Clinical Experiences Compared to Traditional Clinical Experiences for Nursing Students. Nursing Education Perspectives (National League for Nursing), 37(2), 72–77. https://doi-org.library.capella.edu/10.5480/15-1647 Guimond, M. E., Foreman, S. E., & Werb, M. (2019). Evaluation of an unfolding obstetric experience simulation in an undergraduate nursing program. Nurse Education Today, 79, 124–128. https://doi.org/10.1016/j.nedt.2019.05.003 Lewis, R., Strachan, A., & Smith, M. M. (2012). Is high fidelity simulation the most effective method for the development of non-technical skills in nursing? A review of the current evidence. The Open Nursing Journal, 6, 82–89. doi:10.2174/1874434601206010082 Lin, H.-H. (2015). Effectiveness of simulation-based learning on student nurses’ self-efficacy and performance while learning fundamental nursing skills. Technology and Health Care: Official Journal of the European Society for Engineering and Medicine, 24 Suppl 1, S369– S375.
  31. 31. References MacKinnon, K., Marcellus, L., Rivers, J., Gordon, C., Ryan, M. & Butcher, D. (2015). Student and educator experiences of maternal-child simulation-based learning: a systematic review of qualitative evidence protocol. JBI Database of Systematic Reviews & Implementation Reports, 13(1), 14-26. doi: 10.11124/jbisrir-2015-1694 MacKinnon, K., Marcellus, L., Rivers, J., Gordon, C., Ryan, M. & Butcher, D. (2017). Student and educator experiences of maternal-child simulation-based learning: a systematic review of qualitative evidence. JBI Database of Systematic Reviews and Implementation Reports, 15(11):2666–2706, DOI: 10.11124/JBISRIR-2016-003147 Ogard-Repal, A., De Presno, A. K., & Fossum, M. (2018). Simulation with standardized patients to prepare undergraduate nursing students for mental health clinical practice: An integrative literature review. Nurse Education Today. doi: 10.1016/j.nedt.2018.04.018 Roberts, S., Warda, M., Garbutt, S., & Curry, K., Associate Professor, Associate Director, Department of Nursing. (2014). The use of high-fidelity simulation to teach cultural competence in the nursing curriculum. Journal of Professional Nursing, 30(3), 259-265. doi:10.1016/j.profnurs.2013.09.012

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