Simulation-Based Learning: Bringing Clinical Rotations to Campus Challenged with providing nursing students with rich clinical experiences in a safe environment, Lone Star College System is using simulation mannequins and software to help future nurses save lives. Learn how the creation of a SIM Hospital improves student performance and facilitates active learning. Lee Jerls MSN, RN Professor Oscar Ramos Executive Director, Technology Services

Presentation Overview Introduction to Lone Star! Simulation Overview Technology Overview Literature Review A Day in the Life of a Student Nurse Questions

Overview LSCS - Enterprise 13 Locations across 1,400 square miles 5 Colleges 2 University Centers 5 Instructional Centers Systems Office and Training Center 21 new buildings this year 5 new geographic locations Our Customers (90,000 strong) 69,363 Credit Students 21,000 Non Credit Students Average 25% growth per semester Over 4,800 employees Supported by 152 OTS staff members

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

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.”

Learning Theories Constructivism learning theory Adult-learning theory Brain-based learning theory Social-cognitive learning theory Experiential learning theory Novice-to expert theory

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

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

Nursing and OTS became partners early on in the SIM Hospital Project Nursing and Technology Partnership Nursing and OTS became partners early on in the SIM Hospital Project Planning Site Visits Presenting

Advanced Video System

Setup is a collaborative process which include Station setup and location Camera and Microphone location Software views Secondary classroom for observation

Literature Review

Jeffries Simulation Model (2005)

Simulation Take Educator Preparation (Jeffries, 2008) 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

Strengths Weakness Opportunities Threats S.W.O.T. Method (Rothgeb, 2008) Strengths Weakness Opportunities Threats Simulation specialist Debriefing facilitator Curriculum development Curriculum intergration Scenario writing Scheduling Equipment Audiovisual (Seropian et al, 2004a, p. 173)

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

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

Evaluation Process Debriefing Reflection Tools

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 SIRC - National League for Nursing Simulation Innovation Resource Centers

Lone Star Kingwood College Hospital A day in the life of a student nurse… Lone Star Kingwood College Hospital 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.

LSC-K Hospital- High Acuity Center Orientation Process LSC-K Hospital- High Acuity Center Roles and responsibilities Patient information Confidentiality form Scavenger hunt Equipment Crash carts Paging system Documentation EMAR

Patient Census Level Roles and responsibilities Report Primary nurse Secondary nurse Family member Observer Interdisciplinary team

IMCU Medical Surgical OB/GYN ICU Multi-Patient Unit Things to discuss: Unique to LSC-K Hospital Time limit Objectives General and instructional OB/GYN ICU

Debriefing Discuss: Length of time Questions to facilitate discussion Bringing it all together here

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.

Wrapping it up OTS and Nursing…life long relationship…commitment Research driven Competency Student-centered focus Limitation…is the lack of ability to “dream”