Katie Pawloski, Professor Dr. Pasquale Iemma, Adjunct Lecturer Kellany Cadogan Noland, DrPH(c), MSN, RN Marie L. Lumbart, MSN, ARNP-C, FNP, CCRN | all Utica College – ABSN Program Wendy Moore | Orbis Education TEAM PRESENTATION: Creating a Low Cost Obstetric Clinical Immersion Simulation for Medical and Nursing Students This presentation is designed to provide application level exposure to essential perinatal concepts that are often not available through traditional clinical exposure. The session features two phases of activities used in student training. Phase One: Focused contextualized skill stations utilizing leading-edge simulation skills using state-of-the-art computerized manikins (Human Patient Simulators, or HPS) and patient actors, also known as standardized patients (SP). Phase Two: Students are exposed to a multistage unfolding patient care simulation that required application of the phase one skills within the evolving scenario.

1. Developing Low Cost Simulation
Immersions
Thursday July 25, 2019

2. The “birth” of an idea!
●Private | Nonprofit | Regionally
Accredited
• Historically challenging to students.
• Accelerated course delivery.
• Developing ability to apply learned
content.
• Limited clinical exposure.
• Student anxiety surrounding
specialty.
• Documented value of high-fidelity
simulation to undergraduate
students.

3. Immersion Goals
●Private | Nonprofit | Regionally
Accredited
• To expose students to low volume high-risk client care
scenarios that capture frequently tested concepts on
NCLEX RN in a controlled replicable environment.
• To provide experiences that would enable students to
apply learned concepts towards clinical reasoning for
selected essential concepts.
• To improve student outcomes related to selected
essential concepts measured through summative
assessments.

4. Private | Nonprofit | Regionally Accredited
• Al-Ghareeb, A., McKenna, L., & Cooper, S. (2019).
– “Indicative outcomes suggest that optimal
performance was apparent when anxiety levels
were low”
What does the literature say?

5. Private | Nonprofit | Regionally Accredited
• Andersen, P., Downer, T., O’Brien, S., & Cox, K. (2019).
• Bortolato-Major, C., Perez Arhur, J., Taís Mattei daSilva, Â., de Fátima
Mantovani, M., Cestari Felix, J. V., & Boostel, R. (2018).
– Recognized the potential of simulation for teaching undergraduate
nursing courses, with opportunities to offer students practical and
theoretical knowledge in a controlled environment and close to real,
with minimizing risks to patients.

6. • Cant, R. P., & Cooper, S. J. (n.d.).
– Highlights: Simulation education statistically improves nursing students'
knowledge.
– Studies report improvements to students' confidence, competence and
self-efficacy.
– Programs demonstrate innovation and excellence, teaching a wide-
range of topics.
– Programs should be shared across the discipline to facilitate
development of multimodal learning.
●Private | Nonprofit | Regionally
Accredited

7. • Guimond, M. E., Foreman, S. E., & Werb, M. (2019).
– The unfolding, obstetric simulation was effective in helping our students
demonstrate the achievement of course objectives through improved
obstetric self-efficacy scores and scores for shift to shift
communication.
Private | Nonprofit | Regionally Accredited

8. • Lewis, R., Strachan, A., & Smith, M. M. (2012).
• Lin, H.-H. (2015).
• “Results showed that simulation-based learning significantly
improved students' self-efficacy regarding skills learning and
the skills performance that nurse educators wish students to
acquire.”
Private | Nonprofit | Regionally Accredited

9. SLS Simulation Patient
• Location: Maternity Unit
• Patient name: Aaliyah Farooqi
• Medical record #: 2750553
• Date of birth: July 11
• Age: 22
• Sex: Female
• Admitting provider: P. Iemma,
CNM
• Chief complaint: RLQ abdominal
pain and vaginal discharge of fluid
• Primary diagnosis: Pregnancy,
Rupture of membranes
Private | Nonprofit | Regionally Accredited

10. Roberts, S., Warda, M., Garbutt, S., & Curry, K., Associate
Professor, Associate Director, Department of Nursing. (2014).
The use of high-fidelity simulation to teach cultural
competence in the nursing curriculum. Journal of
Professional Nursing, 30(3), 259-265.
doi:10.1016/j.profnurs.2013.09.012
• “With the increasing demands of the nursing
curriculum and the limited time frame to prepare
competent clinicians, the search continues for
innovative strategies that will produce culturally
competent providers. Patient simulation is a
technique that replicates real-world scenarios in a
controlled and nonthreatening environment. “
Private | Nonprofit | Regionally Accredited

11. ●Private | Nonprofit | Regionally
Accredited
Our journey…
Idea!
Internal Team
Collaboration
Reaching
Out
Stakeholder
Support
Reality
Vs
Ideal Immersion
Creative
Solutions
Creative
Solutions

12. Private | Nonprofit | Regionally Accredited
Next Steps…
Summative
Assessment
Clinical Practice
Planning for the second immersion!
Review of Findings

13. Private | Nonprofit | Regionally Accredited
Prebriefing Concept Foci
Highlighting the ESSENTIALS!
• Intrapartum Care
• MamaBirthie, Standardized Patient
• Fetal Heart Monitoring
• Table Top Scenarios, LLEAP EFM Software
• Post Partum Hemorrhage
• PROMPT Flex PPH Module
• Newborn Assessment
• High-fidelity SimMom

14. Exam Outcomes by Content

15. Exam Average

16. Course Averages

17. Private | Nonprofit | Regionally Accredited
Debriefing of Concepts
• Nursing Process Framework
• Plus/Delta
• Maslow’s Hierarchy of Needs
• Jeopardy Game
• Teach back
Getting to the AH – HA moment!

18. Creative Staffing
Berro & Knoesel (2016)
– Utilizing recent graduates
– Exposure to the teaching role
– Maintaining and enhancing newly acquired nursing
skills
– Giving back to their alma mater
– Strengthening their own novice clinical expertise

19. Simulation for Specialty Areas
Curl, Smith, Chisholm, McGee, & Das (2016)
– STRIPES group had clinical and simulation
– Control group only simulation
– Pre and post testing completed
– The experimental group scored the same or
higher than the control group.

20. Mental Health Immersion-
https://youtu.be/L8UGu7MFEI8

21. Mental Health Immersion
• Simulated telemedicine patient interviews
• Student created, student led simulations

22. Mental Health Immersion
Each group will utilize the simulation they created and act it out with another group. See
schedule below.
Group 1: Borderline Personality Disorder
Group 2: Bipolar Disorder
Group 3: Substance Abuse Disorders
Group 4: Dementia
Group 5: Anorexia/bulimia
0900 0945 1030 1115 1200
Group 1 Acting Student
s with
Group
5
Student
s with
Group
2
Acting Observ
e group
4
Group 2 Student
s with
Group
1
Acting Acting Observ
e 5
Student
s with
Group
4
Group 3 Acting Student
s with
Group
2
Observ
e group
4
Acting Student
s with
Group
5
Group 4 Student
s with
Group
3
Observ
e group
2
Acting Student
s with
Group
1
Acting
Group 5 Observ
e group
1
Acting Student
s with
Group
4
Student
s with
Group
3
Acting

23. Mental Health Scores

24. Expanding the Model
• Replicate at all 3
sites
• Obstetrics
• Pediatrics
• Psychiatric
population
• Standardized
patients This Photo by Unknown Author is licensed under CC BY-SA-NC

25. Future thoughts… IPE Immersions
This Photo by Unknown Author is licensed under CC BY-SA

26. Lab Fees Alumni donations
and fundraising
Grant Funding
Money, Money, Money!

27. How can this integrate into your
curriculum?
What other ideas do you have?
Do you currently have shortages in
clinical placement or experiences?

28. Faculty Presenters
Dr. Pasquale Iemma- paiemma@utica.edu
Dr. Wendy Moore- wlmoore@utica.edu
Professor Katie Pawloski-
kmpawloski@utica.edu
Professor Kellany Noland-
kscadoga@utica.edu
Professor Marie Lumbart-
malumbar@utica.edu

29. References
Al-Ghareeb, A., McKenna, L., & Cooper, S. (2019). The influence of anxiety on student nurse
performance in a simulated clinical setting: A mixed methods design. International Journal
of Nursing Studies, 98, 57–66. https://doi.org/10.1016/j.ijnurstu.2019.06.006
Andersen, P., Downer, T., O’Brien, S., & Cox, K. (2019). Wearable simulated maternity model:
Making simulation encounters real in midwifery. Clinical Simulation in Nursing, 33, 1–6.
https://doi.org/10.1016/j.ecns.2019.04.007
Berroo, E & Knoesel, J. (2016). An Innovative Approach to Staffing a Simulation Center in a
College of Health Professions. Journal of Nursing Education. 55(1), 53-55.
doi:10.3928/01484834-20151214-13
Bortolato-Major, C., Perez Arhur, J., Taís Mattei daSilva, Â., de Fátima Mantovani, M., Cestari Felix,
J. V., & Boostel, R. (2018). Contributions of the Simulation for Undergraduate Nursing
Students. Journal of Nursing UFPE / Revista de Enfermagem UFPE, 12(6), 1751–1762.
https://doi.org/10.5205/1981-8963-v12i6a230633p1751-1762-2018
Cant, R. P., & Cooper, S. J. (n.d.). The value of simulation-based learning in pre-licensure nurse
education: A state-of-the-art review and meta-analysis. Nurse Education in Practice, 27,
45–62. https://doi.org/10.1016/j.nepr.2017.08.012

30. References
Curl, E. D., Smith, S., Chisholm, L. A., McGee, L. A., & Das, K. (2016). Effectiveness of
Integrated Simulation and Clinical Experiences Compared to Traditional Clinical
Experiences for Nursing Students. Nursing Education Perspectives (National League for
Nursing), 37(2), 72–77. https://doi-org.library.capella.edu/10.5480/15-1647
Guimond, M. E., Foreman, S. E., & Werb, M. (2019). Evaluation of an unfolding obstetric experience
simulation in an undergraduate nursing program. Nurse Education Today, 79, 124–128.
https://doi.org/10.1016/j.nedt.2019.05.003
Lewis, R., Strachan, A., & Smith, M. M. (2012). Is high fidelity simulation the most effective method
for the development of non-technical skills in nursing? A review of the current
evidence. The Open Nursing Journal, 6, 82–89. doi:10.2174/1874434601206010082
Lin, H.-H. (2015). Effectiveness of simulation-based learning on student nurses’ self-efficacy and
performance while learning fundamental nursing skills. Technology and Health Care:
Official Journal of the European Society for Engineering and Medicine, 24 Suppl 1, S369–
S375.

31. References
MacKinnon, K., Marcellus, L., Rivers, J., Gordon, C., Ryan, M. & Butcher, D. (2015). Student and
educator experiences of maternal-child simulation-based learning: a systematic review of
qualitative evidence protocol. JBI Database of Systematic Reviews & Implementation
Reports, 13(1), 14-26. doi: 10.11124/jbisrir-2015-1694
MacKinnon, K., Marcellus, L., Rivers, J., Gordon, C., Ryan, M. & Butcher, D. (2017). Student and
educator experiences of maternal-child simulation-based learning: a systematic review of
qualitative evidence. JBI Database of Systematic Reviews and Implementation Reports,
15(11):2666–2706, DOI: 10.11124/JBISRIR-2016-003147
Ogard-Repal, A., De Presno, A. K., & Fossum, M. (2018). Simulation with standardized patients to
prepare undergraduate nursing students for mental health clinical practice: An integrative
literature review. Nurse Education Today. doi: 10.1016/j.nedt.2018.04.018