Abstract

Background: Simulation laboratories have become an important part of nursing education. Simulation labs use an advanced technology manikin that can mimic many human physiological responses such as a pulse that can be felt by the student. Eye blinking as well as heart and lung sounds can also be listened to by the student. This type of simulation manikin is known as a high-fidelity simulator because of its advanced technology.

The manikin can be programmed to show various changes in vital signs (such as an increase in blood pressure or heart rate) that represent different health conditions. This presentation will use a video recording in addition to the interactive lecture to showcase how high-fidelity simulation was used to teach different aspects of a life-threatening situation known as a code blue.

Objective: The mock code blue simulation was designed to improve communication skills, competence, and self-confidence of senior nursing students when they provide care to clients experiencing a life threatening cardiovascular problem. Each simulation incorporates special skills and equipment commonly used in the critical care and emergency department settings.

Methods: Prior to each simulation experience students complete preparatory assignments and the instructors review a list of supportive materials and key teaching points. Students are then segregated into groups of six for the mock code blue simulations and assigned roles according to the Positions for Six-Person High Quality CPR Teams (AHA, 2015). The instructors remain in the room for all simulations providing guidance and incorporating the content as the scenarios unfold. Each group completes a minimum of two mock code blues that are video recorded and later reviewed during the post simulation debriefing. All simulations conclude with a post simulation survey. The mock code blue simulation scenarios, preparatory assignment questions, and post simulation surveys were developed from recommendations the American Heart Association (AHA) (Morrison, et al., 2013).

Results: Students reported increased levels of confidence and comfort with providing care to clients experiencing life threatening cardiovascular problems. After participating in mock code simulations students felt much more confident in their decision-making skills (88.8%), communication skills (92.3%), assessment skills (88.4%), and knowledge (87.4%) of pathophysiological conditions that may lead to a life threatening cardiovascular problem.

Conclusion: The transition to clinical practice gap is one of the major factors that contribute to difficulties newly graduated nurses experience during the first year on the job. Nurse residency programs and other strategies have been developed to improve newly graduated nurses’ transition to practice in postgraduate clinical settings. It is also essential to address this problem in the educational setting prior to graduation. Newly graduated nurses consistently identify emergency (ER) code responses and communicating with physicians as skills that felt most uncomfortable performing in the clinical setting (Goode et al., 2013). Simulation is an ideal teaching strategy to help students improve confidence and decrease anxiety in situations that require teamwork, effective communication, and collaboration (Alluri, Tsing, Lee, & Napolitano, 2016). This teaching strategy can be used to improve post graduate transition into the work setting for other disciplines.

Objectives

• Define transition to work/practice gap.
• Describe how hi-fidelity simulation is used as a best practice teaching strategy to decrease the transition to work/practice gap.
• Apply hi-fidelity simulation as a teaching strategy in a variety of disciplines to decrease the transition to work/practice gap.

Presenters

Rebecca Owings, UA Capstone College of Nursing
Dr. Owings is an assistant professor at the Capstone College of Nursing. She received her Doctor of Education degree from the University of Alabama and a Master of Science in the Family Nurse Practitioner Program from the University of Alabama at Birmingham. She holds two undergraduate degrees in Biology and Nursing. Dr. Owings has worked as a critical care and perioperative nurse for over 20 years and an educator for 12 years. Her research interests include transition to practice issues and improving care for critically ill clients.

Betty Key, UA Capstone College of Nursing
Dr. Betty Key is an assistant professor at the Capstone College of Nursing. She received her Doctor of Education degree from the University of Alabama as well as the Master of Science in nursing degree with Rural Case Management focus. Dr. Key is a certified adult critical care nurse and has worked 28 years as a bedside nurse in critical care serving in many different roles before joining the Capstone College of Nursing faculty. Her research interests are in nursing education and chronic disease management in vulnerable populations. She has presented her research locally, nationally and internationally.