Simulated Training Prepares Clinicians and Learners for Real Life

New ICU nurses applying skills and knowledge learned in the classroom in a mocked patient environment before performing such tasks on patients.

You arrive outside a patient’s room and put on your personal protective equipment. As you enter the room and say, “Good morning”, you only hear a faint moan. You try to rouse the patient, but you notice they aren’t responding. Over the last three days, the patient has been experiencing fluctuations in their blood sugars and was diagnosed with a bladder infection requiring antibiotics. What do you do next?

In this situation, the patient is a manikin. And this is an example of simulation training. 

Simulation is an educational pathway that helps participants interact with and respond to real-life scenarios in a safe space. Participants practice clinical skills as well as non-technical skills such as communication, decision making, and adaptability to build confidence in everyday and emergency situations.

For the last 12 years, Dr. Rick Penciner, Director of Medical Education, and an emergency physician, has advocated for simulated training at NYGH. He says, “We recognized early that simulation was essential to ensure our learners, staff, and physicians can excel at what they do in a safe way.” Since May 2021, Sarah Branton, Manager of Simulation at our Centre for Education, and her team have led over 300 sessions with 1,900 participants.

Our interprofessional team from the NICU completing hands on training to be prepared for an evacuation event.

Simulations can span across inpatient and outpatient units, departments, levels of experience and job roles. It starts with Sarah connecting with the team interested in refreshing their training. From this consultation, she understands their learning goals to determine how she can best help achieve them. “The needs of each unit and team can differ greatly so it’s important to take time to really understand their challenges and goals before developing a training program”, says Sarah. Since May, she’s worked with 18 different teams and units.

Training material is often developed from scratch at NYGH, but the broader simulation community is also very active. Sarah says, “there is a tremendous simulation sharing community, within Ontario, Canada and North America”. Simulation community resources are a great starting point but tailoring the training programs to fit the diverse staff and community we serve is what makes them so effective.

Simulation training is also an excellent example of how NYGH is moving towards a better tomorrow. Using virtual gamification to create escape rooms, competitive games, and team-building activities are just a couple of ways our simulation team continues to innovate this space. Sarah says her aim is to “collaborate with units and teams to create the best training opportunities for our staff, physicians and learners”.

Simulation training allows NYGH to meet the learning needs of physicians, staff and learners. This means using several training formats and often working within the unit and with their own teams to address their most pressing challenges.

Miriam Shamou, a Registered Nurse at NYGH who participated in simulation training said, “I could develop my technical skills by performing under the supervision of someone with experience. Once I felt confident, I no longer required supervision!”

Her experience doesn’t just end at technical skills. Mariam also noted, “The instructor of the simulation training also came up with evolving scenarios based on the actions of the student so the simulation would expose students to situations where we needed to adapt.”

We also heard from Sarah on the importance of communication skills in collaborative care. “We know that most errors happen because of poor communication.”, says Sarah, “That’s why communication is always a part of our learning objectives for each simulation-based learning activity”.

Through simulation training, learners are guided on how to interact with the broader health team to ease this pressure. Miriam expressed that “after the SIM training, I got a better understanding of the members of the healthcare team. I now know to ask for guidance from other team members and Clinical Nurse Educators.”

Nurses from the RCC refreshing and supporting each other’s skill development specific to IV insertions.

How does this impact our patients and families? Ultimately, it equips our team with the skills and knowledge needed to better support our patients. Dr. Penciner says, “Whether it's learning individual skills, or improving team performance, it's all about patient outcomes.”.

Our patients are also involved in the development of training programs. Sarah and her team often consult with former patients and community members to ensure training is relevant and meets patient needs. This is key as Sarah asks, “though the training looks really good on paper, how is it going to translate to patient care?”. Feedback on cases from patients and families ensures training is focused on patient needs alongside staff and learner needs.

“Learning doesn’t stop outside the classroom” is a mindset that Sarah and the simulation team are very familiar with and encourage at every simulation training. The simulation team at NYGH works with staff, learners, and patients to ensure everyone is well equipped with the skills, knowledge, and confidence to provide the best possible care.

This article first appeared in the May 2022 issue of The Pulse.

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