April 10, 2017

Incorporating Clinical Simulation in Health Profession Education

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by Stacy E Harris DNP, APRN, ANP-BC, University of Central Arkansas (UCA)

The University of Central Arkansas hosted the grand opening of the Nabholz Center for Healthcare Simulation (NCHS) on December 9, 2016. The NCHS is located on the second floor of the Doyne Health Science Center (DHSC) and includes 1,341 square feet of newly created simulation area and 4,132 square feet of remodeled clinical laboratory space. The new simulation area consists of two rooms designed to replicate a hospital setting. One patient room has the ability to be transformed into a rehabilitation room with bathroom and home-like features. Each patient room is connected to a control room. The control room is where instructors use audio and video technology to control the high-fidelity patient manikins and run patient care scenarios. Besides storage areas, the new NCHS has two debriefing rooms where students watch their peers perform a patient-care scenario by observing the case via a smart TV. After the scenarios, the students and instructors discuss and debrief the scenario. The NCHS uses uniquely designed clinical experiences to bring students into real-world environments through simulation.

Currently, the senior nursing students are using an evolving simulation case: patient admitted to an emergency room setting with stable chest pain that worsens eventually leading to an Intensive Care Unit admission with a diagnosis of myocardial infarction. The patient scenario deteriorates requiring Advance Cardiac Life Support (ACLS). This type of simulation helps develop competency in high stakes skills in a low pressure environment. One of the Interprofessional simulations involves occupational and physical therapy students assessing patient stability. The simulated case has the patient’s vital signs becoming gradually unstable. The goal of the scenario is to improve communication between the different healthcare disciplines to better meet patient needs.

The nurse practitioner students collaborated with senior exercise science students in a splinting workshop. In the workshop, exercise science instructors presented information about casting, splinting, and musculoskeletal injuries followed by hands-on splinting and casting simulation in the NCHS. Other simulations are based on specific disease states. The occupational therapy instructors have focused on competency testing over assessment of autonomic dysreflexia and seizures disorders.

The NCHS is providing a wide range of activities for students in the College of Health and Behavioral Sciences. Opportunities vary from assessing patients, designing and implementing interprofessional interventions and evaluating patient outcomes in various clinical situations across the life span. Students use clinical reasoning to make clinical judgments and key decisions that impact the patient’s care. Students are also given the opportunity to learn about and perform specific skills (such as medication administration or sterile procedures). The emphasis of the NCHS is providing students with opportunities to develop competency in skills and situations before entering real-world healthcare environments. The NCHS provides learning opportunities for students in nursing, physical therapy, occupational therapy, family and consumer sciences, communication sciences and disorders, health sciences, and psychology. The simulation program is being developed by representatives from all departments within the College of Health and Behavioral Sciences.