SIM is the use of technology to recreate real world patient care environments.
Prebriefing of participants includes discussion related to simulation as well as orientation to the simulators. Logistics are reviewed. Rules of engagement are discussed. All participants are considered valuable intelligent members of the healthcare team. Confidentiality is required to create a safe learning environment.
Different levels in healthcare
- Low fidelity--such as an orange for injections
- Medium Fidelity—full body simulator with some physiologic functions such as lung sounds, blood pressure.
High Fidelity—full body with advanced physiologic programming
- High fidelity simulators are used to create real world patient scenarios. These simulators mimic human physiologic functions, from breath sounds to changes in vital signs as a result of interventions. Participants engage in caring for a patient for a specified time period. Patients may be chosen based on educational needs.
- Standardized Patients--real people as actors who portray patients with defined conditions
Why Use Simulation as a teaching modality?
- Limited Clinical space
- Simulation use supported by Institute of Medicine Future of Nursing Report 2010
- Decrease participant anxiety by providing a safe environment. Increase confidence
- Choose patient based on desired outcomes, not on availability. Tailor scenario to participant needs.
- High risk, low incidence patients
- Progress from fundamental care to advanced skills and complex scenarios
- Significant rise in use of high fidelity simulation
- Found to be effective teaching modality
Improvement in participant outcomes
- Clinical skills
- Team work
- Situational awareness
- Safety with medication administration
- Management of deterioration of in patient condition
- Decision making
- Facilitators receive feedback about the simulation.
- Feed back to participants occurs immediately.
- Participants can see and hear what they did
- Participants remember the experience and can reflect upon their learning
- Theory is applied to the clinical situation