Simulation and Health Care - Medical Education and Simulation.ppt

1、Simulation and Health Care:The METI Solution,Judy Johnson-Russell Ed.D., RN Clinical Educator Education and Training Services Medical Education Technologies, Inc Professor Emerita Texas Womans University - Dallas,Medical Education Technologies, Inc.,Its a new world!,Nation is facing a crisis in heal

2、th care quality and safety presenting many challenges Health care agencies Schools preparing health care practitioners,Medical Education Technologies, Inc.,Common Challenges,Shortage of Qualified Graduates and Faculty Critical Thinking, Diagnostic Reasoning, Problem Solving Prioritization Safety Tea

3、mwork and Interdependence Communication and Collaboration Skills, Technology, and Use of Resources,Medical Education Technologies, Inc.,Meeting the Challenges with METI,All of these challenges can be addressed with the right simulators, the right simulated clinical experiences (SCEs) and the right e

4、quipment METI family of simulators Program for Nursing Curriculum Integration Nurse Residency Program METIVision eDose,Medical Education Technologies, Inc.,Emergency Care Simulators (ECS),Adult patient mannequin (ECS) Length: 5 feet, 11 inches (180 cm) Weight: 75 pounds (34 kg) Pediatric patient man

5、nequin (PediaSIM-ECS) Length: 4 feet (122 cm) Weight: 38 pound (17 kg) Infant patient mannequin (BabySIM) Length: 26 inches (65 cm) Weight: 16 pounds (7 kg),Medical Education Technologies, Inc.,METI Simulators,With these simulators you have a patient that: Blinks, variable pupil size, chest moves wi

6、th respirations Normal/Abnormal Heart, Lung, Bowel Sounds All Pulses, Blood pressure measurement Waveform monitors can be used or disabled to include: ECG, SpO2, Temperature, NIBP, arterial Line, CVP, Pulmonary Artery Catheter, EtCO2, Thermodilution Cardiac Output.,Medical Education Technologies, In

7、c.,METI Simulators,IVs and IM Injections Intubation, Tracheotomy, Chest Tube placement and maintenance Use of various forms of O2 may be simulated Pacing and defibrillation Exchangeable Genitalia Continuous or catheterized urinary output Moulage with wounds, edema, emesis, stools, bleeding, cyanosis

8、, all types of trauma, pregnancy and postpartum,Medical Education Technologies, Inc.,iStan,Adult patient mannequin Length: 5 feet, 10 inches (178 cm) Weight: 100 pounds (45.5 kg) Wireless & Tetherless Controlled wirelessly and the mannequin is tetherless Fully Self Contained Blood, gases and fluids

9、are 100% on-board the simulator Realistic Suits of Skin Ability to self-seal True Articulated Motion Fully Loaded Same features as ECS Realistic bodily secretions & sweating Jugular distention Trismus & Jaw thrust,Medical Education Technologies, Inc.,METI Difference: The METI Family,METI Simulators

10、contain modeled patients to represent the physiologic responses for: Standard Man (woman), Healthy person, 33 yrs old Unhealthy Middle Aged person (male or female) Stannette: Normal full term pregnant female Standard Elderly male or female Soldier, extremely fit, hypermetabolic 20 year old The child

11、, PediaSIM The infant, BabySIM,Medical Education Technologies, Inc.,The METI Difference,Preprogrammed scenarios (simulated clinical experiences) for different levels of students Program for Nursing Curriculum Integration (PNCI) v.4 100 Adult, Child, Infant PNCI Choice Modules: limited number from th

12、e PNCI Adult Nursing (20 SCEs) Pediatric Nursing (16 SCEs) Infant Nursing (8 SCEs) Nurse Residency Program,Medical Education Technologies, Inc.,Program for Nursing Curriculum Integration (PNCI),100 Simulated Clinical Experiences (SCEsTM) 76 adult, 16 child and 8 baby Patients are all ages, male and

13、females From various cultural backgrounds Wide variety of conditions, acute and chronic, all stages of illness from emergency room to discharge In a variety of settings, both hospital and non hospital (rehab, health fair) Different interventions, skills, medications, safety issues, communications, h

14、ealth beliefs and ethical issues are imbedded in the SCEs,Medical Education Technologies, Inc.,100 Simulated Clinical Experiences (SCEs),Semester I Health Assessment - 9 SCEs Skill Validation - 1 SCE Semester II Adult Medical Surgical - 18 SCEs Childbearing - 5 SCEs,Medical Education Technologies, I

15、nc.,100 Simulated Clinical Experiences (SCEs),Semester III Chronic Care - 11 SCEs Community Care - 5 SCEs Semester IV Adult High Acuity Medical Surgical - 9 SCEs Adult Critical Care - 17 SCEs Leadership/Management 1,Medical Education Technologies, Inc.,100 Simulated Clinical Experiences (SCEs),Pedia

16、trics PediaSIM - 16 SCEs BabySIM - 8 SCEs Tools SBAR,Medical Education Technologies, Inc.,Simulated Clinical Experiences,Components include Synopsis Learning objectives with cognitive taxonomy Patient background information and history Healthcare providers orders Questions for learner preparation Si

17、mulator set-up and instructor notes Scenario including simulator enabled findings, minimum behaviors expected and prompts, questions and teaching points. All evidence-based and updated every 3 yrs,Medical Education Technologies, Inc.,Simulated Clinical Experience Process Tool,Simulated Clinical Expe

18、rience Process Tool,Outpatient, Health Promotion,.,All Inpatient Areas are Represented,Medical Education Technologies, Inc.,Nurse Residency Program,Developed at Dartmouth-Hitchcock utilizing simulation Graduate nurse residency orientation program focused on: Skill-based learning Critical thinking Hu

19、man factors engineering Patient safety,Medical Education Technologies, Inc.,Nurse Residency Program,Program includes: Weekly didactic presentations Weekly structured simulation experiences Clinical time with a qualified preceptor Self directed learning materials Simulated clinical experiences includ

20、e concepts of patient safety, including human factors, communication, resource management and situational awareness,Medical Education Technologies, Inc.,Nurse Residency Program,Dartmouth-Hitchcock was able to: Decrease orientation time of new nurses from 22-34 weeks to 12 weeks Decrease turnover by

21、70% Increase retention by 75% after 18 months Decrease vacancy rate to 3% Eliminate reliance on traveling nurses Keep nurses for 18-24 months”For Life”,Medical Education Technologies, Inc.,Nurse Residency Program,“Found that a Nurse Residency Program that incorporates simulation increases new grads

22、readiness for independent clinical practice and provides a more predictable process for acquisition of skills” Beyea, von Reyn, Slattery (2007). A Nurse residency program for competency development using human patient simulation. Journal for Nurses in Staff Development 23 (2) 77-82.,Medical Educatio

23、n Technologies, Inc.,Meeting the Challenges with Simulation,A Simulator and the Simulated Clinical Experiences (SCEs) provide you with the opportunity to meet the needs of your learner, whatever they may be You decide on the patient situation in need of interventions and the level of the students Fo

24、cus on learners needs, not the patients You have the time to facilitate critical thinking, diagnostic reasoning and problem solving Patient safety is not an issue Retention improves as students see the results of their actions (experiential learning),Medical Education Technologies, Inc.,All SCEs Pro

25、vide the Possibility for Meeting Multiple Objectives with Multiple Learners,Recipes for Disasters Cookbook Blood RecipesCardiovascular RecipesEnvironment RecipesGastrointestinal Recipes Respiratory Recipes Sputum Recipes Urine RecipesWound Recipes,Medical Education Technologies, Inc.,An Integrated A

26、udio / Video SolutionDeveloped in collaboration with:,Medical Education Technologies, Inc.,METIVision,Web-based system that fully integrates and synchronizes the simulation experience Audio and video Physiological data Waveform display Simulation event logs Captured real-time annotations Real time o

27、r recorded,Medical Education Technologies, Inc.,METIVision,eDose,Innovative, web-based learning and assessment environment that uses screen-based simulations to facilitate understanding and mastery of the skills needed to safely and accurately perform medication dosage calculations,Medical Education

28、 Technologies, Inc.,Facilitating Competency in Nursing Numeracy:A shift from abstract to authentic learning environments,eDose,Based on a sound theoretical base of research that identified three core skills required to understand and accurately solve medication dosage calculation problems Understand

29、 and correctly set up the problem to be solved Accurately compute the numerical calculation Understand the design of the medication measurement and delivery device, and accurately measure the dose to be administered,Medical Education Technologies, Inc.,eDose,X 2 = 2ml,Understand & correctly set up t

30、he problem to be solved,Accurately compute the numerical calculation,Understand the design of the medication measurement accurately measure the dose to be administered,Medical Education Technologies, Inc.,eDose,Components of eDose Medication Dosage Calculation Skills Authentic Diagnostic Assessment

31、Authentic Assessment,Medical Education Technologies, Inc.,MDCS Learning Environment,Authentic Diagnostic Assessment,Authentic Assessment,Remedial skill development within the MDCS learning environment,Exposure to Authentic Diagnostic Assessment at pre-determined points in the curriculum,Exposure to Authentic Assessment prior to graduation,Exposure to Authentic Diagnostic Assessment to identify specific areas of skill deficit,Begin skill development within the MDCS learning environment,Exposure to Authentic Assessment to audit level of com