1.
Developing Low Cost Simulation
Immersions
Thursday July 25, 2019

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.
• 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.
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.
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.
• 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.
• 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.
• 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.
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.
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.
●Private | Nonprofit | Regionally
Accredited
Our journey…
Idea!
Internal Team
Collaboration
Reaching
Out
Stakeholder
Support
Reality
Vs
Ideal Immersion
Creative
Solutions
Creative
Solutions

12.
Private | Nonprofit | Regionally Accredited
Next Steps…
Summative
Assessment
Clinical Practice
Planning for the second immersion!
Review of Findings

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.
Exam Outcomes by Content…

15.
Exam Average…

16.
Course Averages…

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.
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.
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.
Mental Health Immersion-
https://youtu.be/L8UGu7MFEI8

21.
Mental Health Immersion…
• Simulated telemedicine patient interviews
• Student created, student led simulations

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.
Mental Health Scores

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.
Future thoughts… IPE Immersions
This Photo by Unknown Author is licensed under CC BY-SA

26.
Lab Fees Alumni donations
and fundraising
Grant Funding
Money, Money, Money!

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.
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.
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.
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.
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