Abstract W P337: Using Simulation Mannequins to Train Nurses in Stroke Dysphagia Screening

Abstract

Background and Purpose: Screening patients admitted with stroke symptoms for risk of dysphagia is often the responsibility of registered nurses (RNs). Simulation technology has become a widely used evidence-based form of training for healthcare professionals. Simulation mannequins allow for training in a controlled environment, eliminating the need for practice of skills with live patients. The purpose of this pilot study was to compare effectiveness of in-service training to a comprehensive training method utilizing a medical simulation mannequin as a main component to teach administration of swallowing screening items. Methods: RNs (N=32) were randomly assigned to one of two training groups. Both groups received a 20 minute didactic training in administration and interpretation of non-swallow (dysarthria, wet voice, abnormal volitional cough) and water swallow (cough, throat clear, wet voice) screening components. The control group (n=16) received only didactic training. The experimental group (n=16) received didactic training plus additional training with a medical mannequin programmed to simulate auditory elements of acute stroke patients, e.g., dysarthria, cough after swallow. Acquisition of skills was evaluated for both groups using the medical mannequin simulated with various stroke patient profiles. Fisher’s Exact Test was used to assess the association between type of training and acquisition of skills. Results: No significant association was evident for acquisition of interpretation or procedural skills between groups. Raw data revealed that the experimental group achieved accurate interpretation and procedural skills in fewer trials than the control group. This was particularly evident for procedural skills in which 69% in the experimental group achieved accurate administration within one trial while only 31% in the control group demonstrated accuracy. Conclusion: Results indicate that simulation training is a feasible method to teach and evaluate obtainment of skills necessary to accurately complete dysphagia screenings in acute stroke patients. Further research should focus on retention of skills learned and translation of skills from the simulated patient to live patients admitted with stroke symptoms.