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Ozkara San E. The influence of the oncology-focused transgender-simulated patient simulation on nursing students' cultural competence development. Nurs Forum 2020; 55:621-630. [PMID: 32608020 DOI: 10.1111/nuf.12478] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Disparities experienced by transgender patients, especially in cancer care, leads to poorer outcomes and overall health. Simulation, using transgender simulated patients (SPs) with a focus on cancer care can be an effective way to foster cultural competence nursing education. METHODS Guided by the National League for Nursing (NLN)/Jeffries Simulation Theory and Cultural Competence and Confidence Model, this grant funded pretest (n = 48) and posttest (n = 41) comparison group, quasi-experimental study aimed to understand changes in students' transcultural self-efficacy (TSE) following the transgender-simulated patient simulation (TSPS) focusing on an oncological emergency management. Developed by following recommended guidelines and standards, the TSPS had content validity review and pilot testing. It aimed to improve students' knowledge, skills, and attitudes with regard to providing culturally congruent nursing care. The statistical methods included paired sample t-tests, independent t-tests, and correlation analyses. RESULTS Students who participated in the TSPS intervention had significantly higher posttest TSE scores (P < .05). DISCUSSION SP methodology can be an effective way to foster cultural congruence in nursing care. The findings contribute to the importance of continuous efforts for the inclusion of lesbian, gay, bisexual, transgender, queer (LGBTQ) topic in nursing education to enhance culturally congruent care.
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Affiliation(s)
- Eda Ozkara San
- Center for Excellence in Healthcare Simulation, College of Health Professions, Lienhard School of Nursing, Pace University, New York, New York
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Peterson E, Porter M, Calhoun A. Mixed-Reality Simulation for a Pediatric Transport Team: A Pilot Study. Air Med J 2020; 39:173-177. [PMID: 32540107 DOI: 10.1016/j.amj.2020.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/01/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Transport medicine requires a complex set of skills including fast-paced medical decision making, in-depth medical knowledge, procedural competence, interpersonal and communication skills, leadership, and professionalism. There has been a call for more training in these areas. Simulation-based training can be a way to acquire these necessary skills and bridge the gap to higher-quality transport care. The purpose of this study was to develop a novel mixed-reality simulation program to enhance medical and communication skills for a pediatric transport team. METHODS A mixed-reality simulation program using standardized patients portraying family members and high-fidelity manikins to simulate a medical emergency was developed and implemented for a pediatric transport team. Ten nurses, 9 respiratory therapists, and 8 emergency medical technicians participated. Pre-post self-perceptions of skill and program quality were assessed prospectively. RESULTS Team members rated the overall program quality highly, with a median 5 on a 5-point Likert scale. There was a statistically significant change in pre- versus postprogram self-perceptions of skill in the areas of communication (premedian = 3 vs. postmedian = 4, 5-point Likert scale, P < .001). CONCLUSION Mixed-reality simulation programs can enhance standard technical skills training by providing an additional relational element. Such programs are translatable to other institutions.
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Affiliation(s)
- Eleanor Peterson
- Department of Pediatrics, Division of Critical Care Medicine, University of Louisville School of Medicine, Louisville, KY.
| | - Melissa Porter
- Department of Pediatrics, Division of Critical Care Medicine, University of Louisville School of Medicine, Louisville, KY
| | - Aaron Calhoun
- Department of Pediatrics, Division of Critical Care Medicine, University of Louisville School of Medicine, Louisville, KY
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Fioravanti MA, Hagle H, Puskar K, Knapp E, Kane I, Lindsay D, Terhorst L, Mitchell AM. Creative Learning Through the Use of Simulation to Teach Nursing Students Screening, Brief Intervention, and Referral to Treatment for Alcohol and Other Drug Use in a Culturally Competent Manner. J Transcult Nurs 2017; 29:387-394. [DOI: 10.1177/1043659617727832] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Introduction: Cultural competency is an integral component in undergraduate nursing education to provide patient-centered care and addressing patients’ cultural differences. Students need to consider the prevalence of alcohol and other drug use/misuse in patients from all cultures. This project combines cultural competency education, simulation, and educating students to use screening, brief intervention, and referral to treatment for alcohol and other drug use. Method: Culturally diverse simulation scenarios were developed and used in the simulation lab with students to reduce stigma surrounding other cultures while learning an evidence-based practice to screen and intervene with patients who use/misuse substances. Results: Results show students value simulation and 91% of the students felt that they were able to apply culturally competent knowledge after the simulation experience. Discussion: Cultural competency principles can be embedded in teaching the broader evidence-based practice of screening, brief intervention, and referral to treatment with undergraduate students. This is a replicable teaching methodology that could be adapted in other schools of nursing.
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Affiliation(s)
| | - Holly Hagle
- Institute for Research, Education, and Training in Addictions, Pittsburgh, PA, USA
| | | | - Emily Knapp
- University of Pittsburgh, Pittsburgh, PA, USA
| | - Irene Kane
- University of Pittsburgh, Pittsburgh, PA, USA
| | - Dawn Lindsay
- Institute for Research, Education, and Training in Addictions, Pittsburgh, PA, USA
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Roussin CJ, Weinstock P. SimZones: An Organizational Innovation for Simulation Programs and Centers. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:1114-1120. [PMID: 28562455 DOI: 10.1097/acm.0000000000001746] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The complexity and volume of simulation-based learning programs have increased dramatically over the last decade, presenting several major challenges for those who lead and manage simulation programs and centers. The authors present five major issues affecting the organization of simulation programs: (1) supporting both single- and double-loop learning experiences; (2) managing the training of simulation teaching faculty; (3) optimizing the participant mix, including individuals, professional groups, teams, and other role-players, to ensure learning; (4) balancing in situ, node-based, and center-based simulation delivery; and (5) organizing simulation research and measuring value. They then introduce the SimZones innovation, a system of organization for simulation-based learning, and explain how it can alleviate the problems associated with these five issues.Simulations are divided into four zones (Zones 0-3). Zone 0 simulations include autofeedback exercises typically practiced by solitary learners, often using virtual simulation technology. Zone 1 simulations include hands-on instruction of foundational clinical skills. Zone 2 simulations include acute situational instruction, such as clinical mock codes. Zone 3 simulations involve authentic, native teams of participants and facilitate team and system development.The authors also discuss the translation of debriefing methods from Zone 3 simulations to real patient care settings (Zone 4), and they illustrate how the SimZones approach can enable the development of longitudinal learning systems in both teaching and nonteaching hospitals. The SimZones approach was initially developed in the context of the Boston Children's Hospital Simulator Program, which the authors use to illustrate this innovation in action.
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Affiliation(s)
- Christopher J Roussin
- C.J. Roussin is academic and research director, Boston Children's Hospital Simulator Program, research associate, Department of Anesthesia, Perioperative and Pain Medicine, Division of Critical Care Medicine, Boston Children's Hospital, and instructor of anesthesia, Harvard Medical School, Boston, Massachusetts. P. Weinstock is anesthesia chair, director of pediatric simulation, and senior associate in critical care medicine, Department of Anesthesia, Perioperative and Pain Medicine, Division of Critical Care Medicine, Boston Children's Hospital, and associate professor of anesthesia, Harvard Medical School, Boston, Massachusetts
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Abstract
Simulation in multiple contexts over the course of a 10-week period served as a core learning strategy to orient experienced clinicians before opening a large new urban freestanding emergency department. To ensure technical and procedural skills of all team members, who would provide care without on-site recourse to specialty backup, we designed a comprehensive interprofessional curriculum to verify and regularize a wide range of competencies and best practices for all clinicians. Formulated under the rubric of systems integration, simulation activities aimed to instill a shared culture of patient safety among the entire cohort of 43 experienced emergency physicians, physician assistants, nurses, and patient technicians, most newly hired to the health system, who had never before worked together. Methods throughout the preoperational term included predominantly hands-on skills review, high-fidelity simulation, and simulation with standardized patients. We also used simulation during instruction in disaster preparedness, sexual assault forensics, and community outreach. Our program culminated with 2 days of in-situ simulation deployed in simultaneous and overlapping timeframes to challenge system response capabilities, resilience, and flexibility; this work revealed latent safety threats, lapses in communication, issues of intake procedure and patient flow, and the persistence of inapt or inapplicable mental models in responding to clinical emergencies.
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Kneebone R, Weldon SM, Bello F. Engaging patients and clinicians through simulation: rebalancing the dynamics of care. Adv Simul (Lond) 2016; 1:19. [PMID: 29449988 PMCID: PMC5806370 DOI: 10.1186/s41077-016-0019-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 04/22/2016] [Indexed: 11/13/2023] Open
Abstract
This paper proposes simulation-based enactment of care as an innovative and fruitful means of engaging patients and clinicians to create collaborative solutions to healthcare issues. This use of simulation is a radical departure from traditional transmission models of education and training. Instead, we frame simulation as co-development, through which professionals, patients and publics share their equally (though differently) expert perspectives. The paper argues that a process of participatory design can bring about new insights and that simulation offers understandings that cannot easily be expressed in words. Drawing on more than a decade of our group's research on simulation and engagement, the paper summarises findings from studies relating to clinician-patient collaboration and proposes a novel approach to address the current need. The paper outlines a mechanism whereby pathways of care are jointly created, shaped, tested and refined by professionals, patients, carers and others who are affected and concerned by clinical care.
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Affiliation(s)
- Roger Kneebone
- Centre for Engagement and Simulation Science, Imperial College London, Chelsea and Westminster Hospital (Academic Surgery), 3rd Floor, 369 Fulham Road, London, SW10 9NH UK
| | - Sharon-Marie Weldon
- Centre for Engagement and Simulation Science, Imperial College London, Chelsea and Westminster Hospital (Academic Surgery), 3rd Floor, 369 Fulham Road, London, SW10 9NH UK
| | - Fernando Bello
- Centre for Engagement and Simulation Science, Imperial College London, Chelsea and Westminster Hospital (Academic Surgery), 3rd Floor, 369 Fulham Road, London, SW10 9NH UK
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