Compare And Contrast Simulation Emergency Medical Environment

As technology evolved and based on the number of epidemics or even disasters being reported in recent years, most hospitals including the Veterans Hospital where I currently work have already opened a simulation lab. The simulation labs unlike before do not only focus on everyday concerns, but they have been having simulating drills for natural, epidemics, and man-made disasters. Based on my experience, the exercises are very intense and portrayed to be as real as it could be.

Mock Hospital simulation was the focus of the Clinical Nurse Educator Teaching project. The duration of the project span over a four-week period to meet the 22.5 hours required for the project. The simulation dates were determined in advanced for the Nursing Leadership and Management in Professional Nursing course. The preceptor and student determined dates for participating in the simulation and other deliverable activities to meet the requirements for the project. The activities to meet the project requirements were to participate in meetings to plan for the Mock Hospital simulation, to write learning objectives for the simulation, to develop an evaluation tool and debriefing questions, to participate in the Mock Hospital, and to lead debrief sessions after completion of the simulation.

Most EMT/Paramedic training programs clearly plan the didactic and lab sessions within the classroom. However, many programs lose this accountability when sending students out of the classroom to the clinical rotations. This article is aimed to aid EMT and Paramedic students in discussing pointers to keep in mind when attending their mandatory clinical rotations, especially if they are not given full preparation from the instructor or course sponsor.

The research question addressed by the article titled, “The Effect of Unit-Based Simulation on Nurses’ Identification of Deteriorating Patients” by Disher et al., are: 1. What is the effect of using unit-based, high-fidelity simulation as an educational tool on RNs’ knowledge levels in handling acute respiratory deteriorating patients on step-down cardiovascular units in a community hospital? 2. What is the effect of using unit-based, high-fidelity simulation as an educational tool on RNs’ self-confidence levels in handling acute respiratory deteriorating patients on step-down cardiovascular units in a community hospital? (Disher et al., 2014)

160) Knowledge elevates the power of critical thinking. Critical thinking is very essential to work in areas such as Intensive Care Units, Emergency Care Units. Assessment, diagnosis, planning, implementation and evaluation are best done by a BSN than an ADN because of the power of critical thinking. The skills of critical thinking, better problem solving, and development of clinical judgment are important for increase patient acuity. Since BSN is better in critical thinking and evidence based practice, they lower mortality rate significantly. (Aiken, 2003)

Simulation based learning develops skills, knowledge, and attitudes in staff that otherwise cannot be experienced. The staff are put in the client’s position and give them a better understanding of daily struggles. Also puts the focus on the client instead of task completion. 14

Cooper, S., Buykx, P., & McConnell-Henry, T. (2011). Simulation: Can it eliminate failure to rescue? Nursing Times, 107(3), 18-20.

A study was carried out to assess the required knowledge, skills and competencies to deal medical emergency incidents successfully. Study finding showed that there is superficial knowledge on medical emergencies, drug and equipments among health professionals working emergency unit (McGaghie.et al, 2010).

Simulation labs and clinical placements are effective for practicing skills and building hands-on dexterity, habits, rhythms, and confidence. Not every facet of nursing education prepares student nurses with this kind of learning; originally an, most commonly clinical hours spent in simulation labs were integrated strictly into BSN programs, eliciting the statement made by Taylor (2008) that ADN programs have had to expand their curricula and offer students more content (p.613). According to Go’s (2012) dissertation on High Fidelity Patient Simulation (HFPS), simulation labs are advantageous because they give student nurses a venue for instruction while working in a clinical setting (p. 34). HFPS promotes and validates the clinical judgment competency of nursing students; it offers opportunities for feedback, debriefing, and guided reflection; it increases the student's ability to synthesize knowledge and insight, forming the bridge between theory and practice (Go, 2012, p. 34). However, hours spent in standard clinical settings are often inadequate in preparing

-The Institute of Medicine recommends simulation as a method of teaching interventions in high risk situations.

There remain many questions regarding how and why individuals learn. The optimal methods to train and educate an individual need to be studied, as well as team training for optimal outcomes. Inserting multiple variables into individual training further complicates the issue. The “See One, Do One, Teach One” method has been used in the past, however, with simulation systems, the model should move toward “See Many, Do Many, Teach Many” as it is understood that simulation systems are relevant for novices as well as for experts providing

For years nurses have gained experience in the medical field through clinical rounds at hospitals and doctors offices. Learning has always taken place first through textbooks and then through personal experience during required clinical time. These methods have proven effective but include limitations to the amount of exposure a student can gain before entering the workforce. A new way of learning is on the rise with the use of High Fidelity Simulations (HFS) or the Sim Man. HFS is a computerized life size manikin that simulates real human responses to treatment. This new technology allows students to practice rare procedures or treat common diagnoses.

The simulation environment offers a safe place for students to practice critical scenarios and gain confidence in proscribed settings (Decker, Sportsman, Puetz, & Billings, 2008). Simulation helps faculty to facilitate learning which meets one of the NLN’s core competencies. Simulation also enhances communication through emerging leadership and delegation skills, and builds teamwork through goal and priority setting (Dillon, Noble, & Kaplan, 2009). Therefore, according to Lasater (2007) simulation is highly effective as an adjunct teaching strategy in clinical practice.

The intent of clinical simulations is to provide a safe environment for students to practice and implement skills. This is a way in which to help prepare the student for the hospital setting. Enhanced confidence, clinical judgment, knowledge, and competence are factors that come from these situations. I gained further knowledge, but I did not experience the other skills during simulation. During the postpartum-hemorrhage and birthing simulation, I purposefully picked the scenarios that I felt most comfortable with. That entailed being the spouse of the woman in labor, the nursing assistant, and the patient’s family member. When embodying those roles, I felt at ease, because I was not the fixation; I was not the one in charge of the situation. During the preeclampsia simulation, I was “dubbed” the staff nurse. I was definitely out of my comfort zone. I was in the second group, and this allowed me to observe the first group. I learned and made alterations from the first group’s performance. Observing the first group helped, but my performance was poor. I made several mistakes and was embarrassed by the end result. I did not do well with the assessments, answering the patient’s questions appropriately, and when calling the doctor, I was not fully prepared. Despite all the mistakes and feelings of embarrassment, I learned. I am very thankful for the awareness of what things went wrong. With further practice and

My answers were not decisive which reflect my weak critical thinking skill. For example, when it comes to medication administration, in instances where things are not clear, it should always be referred to the doctor which in this case I belatedly remembered. Nurses should also make sure that they knew how to use all the equipment that is used in the nursing care. In a medical emergency situation, every second counts. In the simulation, epinephrine administration was delayed since the nurse did not know how to use the automatic injection. Over-all the simulation had a significant impact to my learning process.