Simulating reality to learn life-saving skills

Long before commercial pilots get in the cockpit of a plane full of passengers, they log countless hours of flight time, many of those in flight simulators. The real-life scenarios presented in simulation without the risk of damaging or downing a plane are invaluable. Nursing, nurse practitioner and physician assistant students benefit from simulated environments as well. Through simulation-based learning, graduate students experience clinical-care situations in real time without risking safety.

Once they leave the clinical setting, students and faculty review their actions and ask questions in a debriefing that provides a deeper understanding of the students’ roles and decisions. This seamless flow between clinical and classroom instruction will be a major feature of skills and simulation labs in the new Betty Irene Moore Hall at the Betty Irene Moore School of Nursing at UC Davis.

“The simulation ensures students experience both typical health care situations and those that not all students encounter before they graduate, like a person nearing the end of life and dying,” says Theresa
Harvath, associate dean for academics and program director for the future Master’s Entry Program in Nursing to prepare new nurses. “The suites create a fluid interchange between all aspects of their education.”

A well-designed simulation curriculum develops students’ critical thinking and clinical decision-making abilities in a learner-centered environment. The three-story building will feature integrated labs where individual-care scenarios play out on one side and debriefing rooms provide an environment to discuss bedside decisions on the other side. Plans call for an inpatient eight-bed hospital ward, task and anatomy skills labs and a 15-room primary-care clinic.

A one-bedroom apartment simulation suite creates a virtual care environment unlike any other at UC Davis. The environment provides a home-like simulation, featuring glass walls for observation, to enable students’ hands-on practice with direct care outside of a hospital or clinic. This simulation is tailored to fit the course needs of students in the nurse practitioner, physician assistant and master’s in nursing programs.

“Experience has shown us that students discover their strengths and weaknesses, their reaction to stressful situations and preconceived notions when allowed to interview a real person, assess his or her symptoms and propose a course of care,” adds Gerald Kayingo, a physician assistant and clinical professor. “Our role is to prepare them not only to administer care but to become leaders of health care teams.”

Students will interact with pretend patients and families in one of two ways. Standardized patients are trained actors who are believable with a well-rehearsed script. High-fidelity mannequins are full-body machines with technology that mimics a person’s vitals and reacts based on specific interventions and treatments. These, too, create a simulated and realistic experience for students. An Institute of Medicine report determined that these learning methods hold potential for revolutionizing the education of health professionals.

“We want our students to watch care being practiced, administer care themselves, then be able to teach another team member how to care for a person seeking treatment,” adds Debra Bakerjian, senior director for the School of Nursing’s nurse practitioner and physician assistant clinical programs. “The watch one, do one, teach one philosophy is ideal for students to retain their knowledge at a very advanced level.”