Eugenie on simulations and debriefings
Virtual Tour of the Learning/Simulation Center
Learning/Simulation Center
Technological Advances Enhance Student Learning Environment
The possibilities of technology are changing the process and content of nursing curricula. The tools of learning are more available to students and faculty and the Learning/Simulation Center (LSC) has become a major setting where a wide variety of simulated clinical experiences can be accessed without risk to actual patients.

Trinitas School of Nursing is located at the Elizabeth campus of Union County College on the third floor of the newly built Elizabeth I. Kellogg building. The School occupies the whole third floor at the center of which is a 3500 square foot state-of-the-art Learning/Simulation Center or LSC. The LSC has two sections: the Main Center with a 12 patient units and the Annex with four patient units. The LSC is a well-equipped learning center where students can put into practice what they learn in the classroom. Instructors, who have successfully met the required School's simulation competencies, are available to supervise, tutor, test and provide support to students as they progress through the nursing program.

Simulation is a teaching/learning tool which mimics actual situations in clinical practice as closely as possible to teach content, assess progress, develop clinical reasoning skills and learn or practice psychomotor and communication skills. It is a great teaching tool because it integrates best educational practices such as active learning, collaboration, diverse learning styles and high learner expectations.

At Trinitas School of Nursing, simulation-based learning has been a part of faculty's teaching strategies since 2005 when the School acquired its first SimMan – a high-fidelity human patient simulator (HPS) from Laerdal Medical Corporation. Since then, our population of high and medium fidelity HPS has steadily grown and our faculty has become more comfortable and effective in using them to teach concepts and skills with the goal of improving the competencies of students in providing safe patient care. Simulation-based nursing skills evaluation using the latest technology such as computer tablets for data collection, and portable medication carts are being used at the LSC. Our students have learned to expect simulation as part of their learning experience while at Trinitas. They have consistently rated their simulation experience very highly because it challenges their ability to critically think on their feet and allows them to learn from their mistakes in a safe environment.

The Learning/Simulation Center is equipped with numerous technological features such as:

--Eight high-fidelity, computer operated human patient simulators that have heartbeats, can breathe, talk, sweat, and can simulate a wide range of medical conditions and biological responses to treatment.

--Ten medium-fidelity HPS with features similar to the high-fidelity HPS except their chests don't move with their breathing since they are not connected to a compressor. These HPSs can also simulate a wide variety of medical conditions.

--Two birthing simulators called "Noelle" and "SimMom" that can simulate the birth of a baby and the complications of pregnancy and childbirth.

--Part task trainers which are smaller simulation equipment that mimic parts of the human body used to practice procedures such as intravenous therapy, urinary catheterization and colostomy care.

--A digital audio-visual system that transmits and records scenarios in simulated environments to facilitate learning.

--Control rooms for the simulation area where the instructor and simulation technician remotely operate the HPS.

--Debriefing rooms where instructors and learners can review the video recording of the simulated scenario and engage in a reflective discussion of what occurred during simulation. These rooms have debriefing session audio-visual recording devices that are used to evaluate the debriefing competencies of the instructors.

One of the most important benefits of simulation is it allows instructors to create both common and uncommon high-risk clinical situations that students may not experience while they are in the clinical setting. Situations that they will be called upon to manage and deal with when they become licensed RNs. For example, instructors can create scenarios where a patient will have a heart attack or a stroke; respiratory distress, diabetic coma, bleeding, traumatic brain injury, drug overdose and so on. They can also create scenarios that deal with errors that can occur as a result of miscommunication between and among the healthcare providers. The best part of all these is that we can allow the natural consequences of these mistakes without harming any patient.

One of the situations that students are afraid of is a code – the medical term that is used for a cardiac arrest. While in the hospital, students very rarely participate or allowed to participate in a code. In the simulation lab, they can play the role of RNs providing resuscitative measures to the patient simulator and evaluate their performance during debriefing. Debriefing after a simulation allows students and instructors to discuss what occurred, both positive and negative. Therefore everyone learns from their mistakes without harming the patient. Simulation, therefore, prepares students for the realities of patient care in a safe learning environment.

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