Clinical Simulation - What It's Really Like

Lauren

If you're anything like me, getting put on the spot to be evaluated makes your stomach turn, no matter how small the task. So when the thought of being filmed and critiqued for clinical simulation scenarios became a reality for me last semester, I was terrified. However, simulation is NOT as nerve-racking as you may think, as long as you're prepared!

Simulation is different everywhere, but here at Decker, we partake in these experiences at our Innovative Simulation and Practice Center (ISPC). The ISPC is an awesome way to practice hands-on skills training, high-fidelity patient simulations, standardized patient experiences, and virtual-reality scenarios - but it can be a little stressful initially.

Before we enter the ISPC, we prepare for the day by familiarizing ourselves with the patient's chart, filling out a database if assigned, and looking over the provider's orders. There are also usually supplementary videos or webpages to review the relevant skills for the day. Some ISPC days I've done this year have involved wound care, chemotherapy, diabetes, postpartum care, and pediatric care.

This is what the pediatric simulation I participated in looked like!

We usually start simulation by pre-debriefing in our conference room, which consists of discussing priorities, concerns, and a general plan for the patient's care. After predebriefing, 3 people are randomly selected to participate in the simulation - usually consisting of two nurses and a family member. They are taken back to a simulation room, equipped with multiple cameras, microphones, and a mannequin with a speaker, controlled by an instructor in a different room. This robust setup provides a comprehensive setup for a challenging but realistic scenario.

Another setting we used for a home health simulation!

Those chosen to participate have to act like it is a routine round - usually consisting of performing a head-to-toe assessment, collecting vitals, medication administration, maintaining safety, patient education, and other interventions relevant to the patient's condition(s). Most times they like to throw something interesting into the mix without telling you, like a postpartum hemorrhage, wound infection, or delirium onset, and see if we can catch it based on the patient's signs and symptoms. While those participating are in the room, those watching the live camera footage will take notes and fill out a checklist of the interventions appropriate for the patients.

The observation room - where we pre-debrief, watch the simulation, and give feedback after.

After the scenario is finished (usually around 15 minutes), we all come back to debrief and discuss. The most important aspects of debriefing include *constructive* criticism, emphasis of strengths, suggestions for improvement, and confidentiality - what happens in simulation, stays in simulation! In my experience, it has been nothing less than an accepting and positive environment, despite the initial nerves. We all then usually end with one lesson we learned or a takeaway from the simulation to finish the day.

Debriefing is definitely my favorite part of simulation - it's the best time to ask questions and have great discussions!

Simulation can definitely feel intimidating as a student and it's super easy to blank on what to do once you get in the room - whether it's simulation or real life! Our professor always says to us that the two things we can always remember to do is 1) perform hand hygiene and 2) introduce ourselves, and then go from there.

While it can be uncomfortable, simulation is such a great way to familiarize yourself with catching relevant signs and symptoms, engaging in therapeutic communication, and gaining confidence as a student nurse while in a safe environment. With a little practice and preparation, these scenarios can undoubtedly help you grow into a great future RN!