Keokuk students learn the basics of a patient exam.
Ask any nurse about the most difficult skill they had to learn while in school and they’ll likely say clinical decision making. Putting together all their learning to assess, treat and reassess patients can only be learned through experience—a lot of experience.
So that students can get vital experience to hone their clinical decision making, SCC recently purchased two SimMan® human simulators for its nursing programs.
Pam Bradley, recently retired Dean of Health and Natural Sciences, explains that, in addition to taking traditional college courses, nursing students must spend time in an actual healthcare environment. However, it can be difficult to place students in clinical locations where they’re guaranteed to get the diverse experiences they need to build their skills.
The number of patients receiving care in a facility such as a hospital, termed patient census, has been steadily declining across the nation.
Both Keokuk Area Hospital Chief Nursing Executive Sue Pankey and Education Director Dixie Fink attribute lower patient census trends to advances in medicine and treatment.
Pankey and Fink explain that many patients now get procedures that used to be performed in a hospital on an outpatient basis, and for those who check in to the hospital, their length of stay is shorter, due in part to less invasive methods.
Low patient census isn’t a bad thing. Today’s patients benefit from modern technology’s ability to provide better treatment and faster recovery times. However, where nursing education is concerned, fewer patients can mean fewer learning opportunities.
Anticipating potential dilemmas with diminished clinical experiences, SCC identified technologies it could incorporate into the nursing program so that the College could stay ahead of the curve. Simulation technology rose to the top of the list. However, due to the hefty price tag, it would be impossible for SCC to purchase simulation equipment without outside funding. If the College could show initiative and cooperation between education and healthcare, grant sources might be interested.
So SCC secured support from Great River Medical Center (GRMC) in West Burlington and Keokuk Area Hospital (KAH), and submitted a federal earmark request. The College was awarded $118,000 for the purchase of two SimMen® in July of 2009. They also received $20,000 from the Vincent and Nina Cullen Foundation for the same project.
With funding secured, SCC worked with GRMC and KAH to formalize partnerships and identify sharing opportunities. GRMC agreed to house a SimMan® in their facility in West Burlington. SCC and KAH elected to locate the other SimMan® on SCC’s Keokuk campus.
GRMC’s Director of Corporate Education Sue Ferguson says that SCC’s sharing arrangement is unique and could become a model for other colleges and hospitals to follow. “There aren’t a lot of partnerships like ours. Others can learn from what we’ve done. That’s pretty exciting.”
Second-year Keokuk nursing students prepare to insert a nasogastric tube.
Among Iowa’s community colleges, SCC is ahead of the curve. No other community college has partnerships with area hospitals quite like SCC.
Bradley is a strong advocate for using simulators. “Conventional wisdom was that the only way to learn was by interacting with live patients. Not so. Using simulators in nursing instruction isn’t just a substitute for interacting with live patients. In many ways, simulators are actually superior.”
Teresa Colgan, GRMC Vice President of Nursing says that today’s clinical rotations occasionally lack the frequency of patient cases vital to student learning.
“Some students may never see a patient’s condition deteriorate severely or participate in a birth.”
Unlike working with live patients, instructors can simulate scenarios that students may never experience in a typical clinical rotation.
“Simulations are an excellent way to fill in the gaps,” adds Colgan.
Additionally, human simulators take away the risk factor, allowing students to practice their skills in a safe, less stressful environment. Instructors can give them immediate critical feedback regarding clinical decision making during a simulation.
So what exactly is SimMan®?
Nursing Instructor Deanna Kline demonstrates a procedure..
SimMan® is a patient simulator with realistic anatomy and clinical functionality. It provides simulation-based education to challenge and test students’ clinical decision making skills during realistic patient care scenarios. It consists of an interactive manikin, a patient monitor, and a control computer.
Students can measure pulse, blood pressure, and body temperature, and listen for breathing, heart, and bowel sounds. They can administer IVs, catheters, and tracheotomies. SimMan® can even speak. Through the use of prerecorded responses and sound effects, he can tell students how he feels and answer basic questions as they assess his condition.
The lifelike scenarios can be intense and demanding for inexperienced students.
SCC second-year nursing student Susan Kempker says, “even though it’s not real, you actually get a sense of panic when things start going bad. You feel a sense of urgency to do something to make him better.”
Fellow student Rebecca Westercamp adds that decision making during a scenario is not easy. “You can learn it out of a book, but until you actually do it in real life, you don’t think about those things.”
West Burlington Nursing Instructor Cole Roberts explains the readout on the SimMan patient monitor.
Roberts observes students through a two-way mirror during a
practice scenario.
Glenda Moeller, SCC Coordinator of Health Careers Continuing Education, worked closely with SCC nursing faculty and both hospitals to implement SimMan® installation and training. This spring, GRMC converted a vacated office into a learning lab. While one SimMan® is currently installed, there is space for two more. SCC will remodel an existing nursing classroom on its Keokuk campus over the summer to house the other SimMan®.
GRMC will use SimMan® for orientation, internship, residency, competency assessment and skills remediation. It plans to integrate SimMan® simulations into all aspects of nurse education by 2011. KAH plans to use it for specialized education starting in the spring. As many as 200 staff could use it over the course of a year.
For Bradley, the most important thing the College can do is to keep making the case that there is a need for this kind of technology. “We can’t possibly purchase things like SimMan® without grants and partners, so we have to keep the ball rolling.”
Colgan agrees that partnering together provides the best opportunities. “As resources get tighter, it’s a good thing to share. It benefits all of us, and it helps to be on the same page.”
Moeller sums, “we’ve always had a strong relationship with our hospitals.
This is just another example of their fantastic support.”
See SCC’s SimMan® in action online at www.youtube.com/secciowa.
See more photos of SCC's SimMan on our flickr page:
www.flickr.com/scciowa