PP02 Learning from community simulation

Abstract

Aim: To help prepare community nurses to manage complex scenarios in practice. Objectives: To design and deliver two full days of simulated scenarios within a community setting, split across the academic year To obtain feedback from participants, both learners and faculty, with regards to realism and application of learning to practice To provide faculty development with regards to debriefing and scenario delivery To provide an opportunity for peer review of debriefing Summary of work undertaken: Initially, the simulation team at the University were approached by the Specialist Community Public Health Nursing (SCPHN) course lead to design and co-deliver a day of simulated scenarios designed to challenge experienced nurses starting on the SCPHN course. It is reported that there remains a lack of community-based simulation in current nursing education.1 Four scenarios were designed in collaboration with the SCPHN course team which were intended to address common issues that may be encountered in the role, e.g. gaining access to review a disengaged service user, safeguarding, recognising a deteriorating child and safety in the home. The first simulation day was delivered within the students’ first week at university, for them to gain a feel for the role, and encourage team building and peer support. It was also intended to add something different to the induction week, with a practical aspect, in order to stimulate future learning and help students consider new learning needs from an early point. All the scenarios were delivered in a community setting, using a small house on the university premises. Due to this setting (with limited space) and the fact that the students were at an early stage within their course, video recording was not carried out, however, using a community setting added to the realism of the scenarios, as evidenced through learner feedback. In response to positive feedback and a drive for further challenge, a second day was developed and delivered approximately six months later with additional scenarios designed to incorporate a higher level of complexity. At the start of both days, learners had a period of preparation timetabled and were given a brief overview of the themes the scenarios might cover. This allowed time to review policies, protocols and procedures as needed. Post-simulation debrief was led jointly by a member of the simulation team and SCPHN lecturer. Both learners and faculty were asked to provide feedback through a questionnaire for evaluation and future development. Debriefing peer review was also undertaken amongst faculty using the Harvard Debriefing Assessment for Simulation in Healthcare tool.2 Impact on practice: Faculty: Prior to the first day, a faculty development session was delivered to those staff unfamiliar with simulation-based education (SBE) to support and develop the staff team. An online learning package was developed for those who were unable to attend the face to face session. This supported the effective delivery of both simulation days from a faculty perspective (particularly regarding debriefing skills), and in turn the quality of teaching and learning opportunities. This will hopefully also benefit future practice, instilling knowledge and confidence in lecturers previously less familiar with simulation. The simulation days supported interprofessional learning and faculty cohesion, allowing the simulation team to learn more about the SCPHN role and the SCPHN team to develop knowledge, skills and attributes within SBE. Peer review of debriefing was also extremely valuable with regard to personal/professional development, thus supporting The Association for Simulated Practice in Healthcare (ASPiH) SBE Standards 2 and 3.3 Learners: Students developed increased confidence in patient management and safe practice, demonstrated by learner feedback. The simulations and debriefs encouraged learners to reflect on practice, helping to identify strengths, learn from others, and generate an awareness of gaps in practice and priorities for future personal development. Whilst it is acknowledged that this is only level 2 evaluation,4 further evaluation will take place at the end of the course to determine how learning from the two simulation days has been put into practice. References Hartman SA. An innovative strategy for community nursing student simulation experiences. Journal of Nursing Education 2018;57(10):630. doi:http://dx.doi.org.hallam.idm.oclc.org/10.3928/01484834-20180921-13. Accessed 16 May 2019. Simon, R., Raemer, D.B., Rudolph, J.W. (2018). Debriefing Assessment for Simulation in Healthcare (DASH)© – Rater Version, Long Form. Centre for Medical Simulation, Boston, Massachusetts. Retrieved from https://harvardmedsim.org/dash-rv-long-scoresheet-en-2018/. Accessed 20 May 2019. The Association for Simulated Practice in Healthcare (ASPiH). (2016). Simulation-based education in healthcare. Standards framework and guidance. Retrieved from http://aspih.org.uk/wp-content/uploads/2017/07/standards-framework.pdf. Accessed 20 May 2019. Kirkpatrick Partners. (2019). The New World Kirkpatrick Model. Retrieved from https://www.kirkpatrickpartners.com/Our-Philosophy/The-New-World-Kirkpatrick-Model. Accessed 1 June 2019.