Simulation: Multi-Patient and Multi-Learner

Janet Willhaus, PhD, RN, CHSEBoise State University, Boise, ID

Suzan Kardong-Edgren, PhD, RN, ANEF, CHSERobert Morris University, Moon Township, PA

Disclosures

• Janet Willhaus– None

• Suzan Kardong-Edgren-NLN-USAF-AHA research funding. Editorial stipend from Elsevier for Clinical Simulation in Nursing

Objectives

1. Compare and contrast various multi-patient, multi-learner scenario strategies.

2. Participate in multi-patient, multi-learner mini-scenarios.

3. Envision using multi-patient, multi-learner scenarios in your own program.

Overview of types of simulations

• Large scale:– Community Action Poverty Simulation (44-80

participants)– Red Cross disaster planning simulations (unlimited)

• Medium scale:– Hospital unit with multiple patients and multiple staff

• Small scale:– 2-3 patient scenarios – You should have copies written by Jayne Josephsen

and Ann Butt of Boise State University

Large Scale Scenarios

• Community Action Poverty Simulation (CAPS)– Missouri Association for Community Action– Advantages:

• Large kit comes with all parts• Planning guidance included• Can be used with various audiences including

interprofessional learners

– Disadvantages:• Requires planning• Requires large room or space with many chairs/tables• Requires 15 plus support staff

Disaster Planning

• http://www.drc-group.com/project/dhsc.html

• Red Cross tabletop exercise

Medium Scale

• Hospital unit with multiple patients and staff– Advantages:

• Allows for interprofessional work• Allows for prioritization practice• Promotes communication and leadership practice

– Disadvantages:• Requires a lot of work writing and piloting scenarios• Requires multiple instructors/staff to observe and

provide feedback• Requires support staff/SP’s to play roles or voices of each

patient

Small Scale

• Scenarios with 2-3 patients– Advantages:• Allows for prioritization practice• Promotes communication practice• Can include interprofessional learners

– Disadvantages:• Requires a minimum of two facilitators• Requires planning and piloting of scenarios• A word here about SP’s

Debriefing multi-patient scenarios

• THIS TAKES SKILL and multiple eyes• Large scale: – Directions come with the CAPS and Red Cross

packages• Medium scale:– Will require skill and support of other facilitators

• Small scale:– Structured debriefing appropriate

Upping your debriefing game…

• Expect things will not be perfect…• Be ready for what you might find…• Process why this might be….• Words to use and ways to phrase your

debriefing

Our Observations

• Real patient vs. stroke or quiet patient• Students do not understand order priority• No need to make “trick” students, hard

enough without trickery• Prebriefing is also of great importance

Sharing time…

• Who has mult-patient/multi-learner sims?– Table top– Large scale– Medium or smaller scale

• Share within your group first• Share with the larger group next

Break Time!

Group work

• Writing a mini scenario: 45 minutes• Use a template (provided)• Task – Write a mini scenario which could be used as part

of a larger multi-patient activity – Don’t forget objectives for this patient’s are– Plan a timeline– Discuss prebriefing– Discuss training for Standardized Patients

Sharing time…

• Discuss how mini-scenarios can be combined into a multi-patient simulation

• How many learners?• What are your objectives for the larger

simulation?• How do your objectives change with the

complexity?

Break Time!

Multipatient Sim Practice

Place media clips here.

Debrief

• Debrief together the simulation

Pause and discuss

• What are the ways you can debrief when the faculty did not see/hear the interactions?

• How do you engage all learners, including observers?

• How can you “make corrections” in learner actions without attacking/criticizing?

• How will you evaluate the learning?

Break Time!

Using what you have learned

• Go back to the mini-scenarios• Access drop box invitation• Name your file using this convention:– ATI_Hipfx_mini

• You may utilize this link to write your own scenarios in the future.

Wrap up

• How will you use this in the future?• What types of students will you engage?• Networking with others– What do you notice about yourself and others?– What will you take forward from the experience?