1. Sandra A. Friedman C.N.M.,MSN Karen Goldschmidt Ph.D., RN
Learning To Use Their Voice: RN-BSN Students Apply QSEN Competencies to Enhance Engagement in an Online Intraprofessional Simulation
Sandra A. Friedman C.N.M.,MSN
Karen Goldschmidt Ph.D., RN

2. Objectives
Assess learners QSEN competencies in an online intraprofessional simulation.
Explore RN-BSN students’ process of transformation in an online intraprofessional simulation.

3. Overview of Course: Complex Systems of Care: Technology, Safety, & Quality
Grounded in Complex System Theory identify "simple elegant solutions“ (Clancy 2009)
Broaden patient safety education
Exposure to QSEN competencies
Build critical reflection & communication skills
Intraprofessional healthcare team

4. Five Interactive Modules
National Patient Safety Resources, Initiatives and Regulations
Quality, Safety, Cost, Effectiveness, and Efficiency of Patient Centered Care
Just Culture and Patient Safety
Teamwork and Collaboration
Nurses Involvement in Technology Design, Selection, Implementation and Evaluation

5. Teamwork & Collaboration in an Online Intraprofessional Simulation
Challenge: How can we effectively build and assess learner's skills in an online environment?
Frequent Practice
Peer Interaction
Self Reflection
Coaching and Mentoring
All Equal Assessment

6. Students Watch Challenge Video
The Elaine Bromiley Case

7. Student Video Challenge Response in ApprenNet to Challenge Video
What would you do ?
ApprenNet data attached from 3 sections W16 N380 ( 28x3) 84 students: Compare 3 sections to each other…very similar in terms of times student practiced in preparation for Challenge Response. On average students practice allot before about 3.5 times is the ApprenNet average. These students practiced their Challenge Response 2.6 times on average. This prompts frequent practice.  This is 2.6 times more than an in person response in real simulation and more than they could experience in a first encounter with this life threatening event.

8. Peer Review Students watch 3 Challenge Response videos of classmates
Assess and evaluate peer's Challenge Response Video using rubric
Learn how to give constructive criticism
Analytic skills
Community building
Give and get feedback
Many comparisons
Develop style of communication
Begin to think differently
Engagement increases

9. Student Views Expert Response
Measuring their own performance
Total 84 students: 86.4% watched Expert Response Video in its entirety. Students were invested in outcome and engaged.

10. Students Find Their Voice
The Paper Chase

11. Student Reflections
“This video (Elaine Bromiley) will always remain in my mind. It was very moving and I learned a lot from it.”
“By practicing these communication techniques, I will become more comfortable and confident in speaking out.”
“How will I change my nursing practice? I will hold myself to a higher standard. I will not succumb to normalized deviance. I will use the TeamSTEPPS principles. I will be sure to speak up in situations and use the CUS principle, 2 challenge rule, check-back, SBAR, and close loop communication. I will make sure that I act out on a daily basis, the change we want to see in healthcare.”

12. References
ApprenNet Inc. © (2015). Retrieved from Department of Defense Patient safety Program and Agency for Healthcare Research and Quality. (2013). TeamSTEPPS® 2.0 Pocket Guide (AHRQ Pub. No Replaces AHRQ Pub. No ). Retrieved from Nance, J. J. & Bartholomew, K. (2012). Charting the course: Launching patient-centric healthcare. Bozeman, Montana: Second River Healthcare Press. Podraza-Stiegler, M. (January 27, 2015).What I learned about adverse events from captain Sully it’s not what you think. JAMA, 313, (4), doi: /jama Retrieved from Simpact Pty Ltd. (2014). 'The Elaine Bromiley Case' and 'What If?' videos. Retrieved from VA National Center for Patient Safety. (2015). Root cause analysis tools, Retrieved from