Evaluating Educational Effectiveness in the Simulation Labaty Brenda Smith, MSN, RN, CMSRN Wendy Grbach, MSN, RN, CCRN, CLNC UPMC Shadyside School of Nursing
Presentation Objectives Define and describe the process of Problem Based Learning in medical surgical courses Discuss the implementation of simulation scenarios to strengthen PBL education Engage in video review of PBL scenario Discuss development of UPMC Shadyside School of Nursing s evaluation tool as a feedback mechanism
Problem Based Learning Process s participate in a concept-based case review After identification of their learning needs and research presentation to their peers, they develop a plan of care They then participate in a simulation session based on the PBL patient presented Simulation scenarios randomly selected based on 3 levels of acuity Nmal post-op / pain evaluation Overnarcotization Hemrhage 3
WHY PBL? Content-laden didactic Inconsistent mastery of the content Faculty prepare me than the student -centered learning opptunity No me Sage on the Stage! 4
WHY INCORPORATE SIMULATION? Reproducible situations Application of new learning Practice Ensure comprehension Promote clinical reasoning 5
Video example Meet Mrs. Kane 3 days post right hip arthroplasty PCA Dilaudid f pain management, Lumbar and sciatic nerve blocks Hemodynamically stable Insignificant past medical histy Hemovac and JP drains with minimal drainage Nurses have patient chart with physician ders, both verbal and electronic hand-off repts, medications f administration 6
Evaluation Overall, new graduate nurses are fully prepared to provide safe and effective care in a hospital setting. 90% of nursing school leaders 10% of hospital nurse executives 7
Evaluation Tool UPMC SHADYSIDE SCHOOL OF NURSING SIMULATION EVALUATION : Course: Date: Safety Noticing QSEN Competency: Centered Care and Safety Crectly and consistently adheres to standard and transmission based precautions. Crectly identifies patient using two patient identifiers: name and date of birth. Utilizes 60 second and situational assessments to provide safe patient care. Perfms hand hygiene on entry to room Identifies patient pri to procedures Perfms hand hygiene between patients Positions side rails appropriately (minimum 2) Perfms hand hygiene on exiting room Positions call bell within patient reach Gloves as appropriate Positions bed height appropriately Identifies patient with initial contact Maintains HIPAA standards Identifies patient with medication Safely prepares and administers medications administration Comments: Communication and Teamwk Responding QSEN Competency: Evidence Based Practice, Centered Care, Safety, and Teamwk and Collabation Actively engages as a member of the healthcare team utilizing therapeutic, professional, standardized communication, and teamwk principles. Introduces self to patient Actively engages as a team member Engages in therapeutic communication Delegates to team members Engages in professional communication Collabates with multi-disciplinary team I S B A R R SBAR content: I S B A R R SBAR content: Comments: Focused Assessment Noticing and Interpreting QSEN Competency: Evidence Based Practice, Centered Care and Safety Perfms a focused assessment based on the scenario objectives. BP Perfms expected focused assessment Pulse Neurological Cardiovascular RR Pulmonary Abdominal/GI Temp GU Musculoskeletal Pulse Ox Integumentary Psycho-Social Pain Vascular Access Comments: Debriefing Reflecting QSEN Competency: Evidence Based Practice, Centered Care, Safety, and Teamwk and Collabation Reflects and evaluates perfmance. Crectly identifies strengths of perfmance Independently Prompted Crectly identifies areas f improvement Independently Prompted Articulates a plan to crect areas f improvement Independently Prompted Receives feedback to improve practice Receptive Resistant Takes ownership of perfmance/decisions Justifies self protects perfmance/decisions Comments: Initiation of a Learning Contract: Yes No N/A (Circle one) PBL points: Areas f remediation: Plan of Care and Interventions Interpreting and Responding QSEN Competency: Evidence Based Practice, Centered Care and Safety Plan of care and interventions are evident and appropriate based on the scenario objectives. Comments: Crectly identifies priity problem Develops appropriate plan of care Implements patient specific interventions Initiates appropriate patient education Administers appropriate medication Faculty Signature: Date: Signature: Date: Do not re-produce use without permission from UPMC Shadyside School of Nursing. 8
Lessons Learned Inter-rater reliability Development Buy in Lack of preparation Rubric Faculty Development Buy in Whose Sim experience is this anyway? 9
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Questions? F me infmation, please contact Brenda Smith (smithbl@upmc.edu) Wendy Grbach (grbachwj@upmc.edu) UPMC Shadyside School of Nursing Pittsburgh, PA Thank you f your attention and interest!
References Advisy Board Company. (2008). Bridging the preparation-practice gap, Volume I: Quantifying new graduate nurse improvement needs. Advisy Board Company. (2008). Bridging the preparation-practice gap, Volume II: Best practices f accelerating practice readiness of nursing students. Berkow, S., Virkstis, K., Stewart, J., & Conway, L. (2008). Assessing new graduate nurse perfmance. Journal of Nursing Administration, 38(11), 468-474. Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, D.T., Warren, J. (2007). Quality and safety education f nurses. Nursing Outlook, 55(3), 122-130. 12
References Herm, S.M., Scott, K.A., & Copley, D.M. (2007). Sim sational revelations. Clinical Simulation in Nursing Education, 3(1), e25-e30. Lasater, K. (2007). Clinical judgment development: Using simulation to create an assessment rubric. Journal of Nursing Education, 46(11), 496-503. Tanner, C.A. (2006). Thinking like a nurse: A research-based model of clinical judgment. Journal of Nursing Education, 45(6), 204-211. Wolf L, Dion K, Lamoureax E, et al. (2011) Using simulated clinical scenarios to evaluate student perfmance. Nurse Educat, 36(3), 128-134. 13