Nursing students learn through use of high-fidelity patient simulators

Published on March 18, 2011
Students at Western Regional School of Nursing are using a high-fidelity patient simulator in their training. Thursday, March 17, 2011 they worked through the delivery of a baby. From left, Candice Payne, Renee Regular and Lacey Sparkes.
Geraldine Brophy

CORNER BROOK — Third-year nursing students helped deliver a baby Thursday afternoon.

There may not be anything unusual about that, except the patient was not your ordinary patient.

Noelle is a high-fidelity patient simulator and she delivered a healthy baby boy under the watchful eye of the students at the Western Regional School of Nursing.

Peggy Colbourne and Sharon Penney are lab/clinical instructors with the nursing school.

They say use of patient simulators has been a common practice at nursing schools for several years now, but is relatively new for their school.

The school also has two older, low-fidelity patient simulators that can simulate vital signs, heart sounds and lung sounds. But they can’t do the same things as the high-fidelity ones in terms of being programmed to take nursing students through a variety of scenarios involving patient care. In Noelle’s case, she can be programmed to take students through the entire birthing process, from a routine delivery to one with complications, and the care that’s required after delivery.

On Thursday, her 10-minute labour went pretty smoothly even with complaints that it was “the worst pain” she’d ever felt.

Penney said the school started using the high-fidelity simulators last fall. Noelle was the first one to arrive in November, followed by a five-year-old boy, Hal, and Infant Hal.

“The whole movement in nursing education now is towards simulation,” said Penney.

“We’re excited about it because we think it will give us a lot more options when it comes to clinical preparation and certainly for labs as well.”

She said with more students coming into the school every year there is a challenge to find adequate clinical placements for them, and the simulators help with this by providing a safe environment for the students to learn in before they have to actually have to go out onto the floors.

“They get a life-like experience in the safe environment which is very beneficial for them,” added Colbourne. She said it helps improve the students’ confidence and critical thinking.

“We can set up a scenario so that based on what actions the students take, the patient can either improve or decline. Which helps them see how actual clinical scenarios go.”

And while Noelle’s labour and delivery was preprogrammed, Penney said they can have a live feed where instructors can throw things at the students to see how they will react.

The simulators have a microphone that picks up what the students around them are saying and then instructors can have the simulators react to that.

Besides actual clinical care, working with the simulators gives the students a chance to work on their therapeutic communication and bedside nursing.

A debriefing takes place following the running of a scenario and this gives the students a chance to go over what they did and ask questions, and for the instructors to offer suggestions on how they could improve their performance and see how they can change the scenarios.

Penney said the plan is to eventually videotape the scenarios.

Using the simulators at the nursing school is just a sign the school “is moving in the right direction,” said Colbourne who enjoys using them in teaching.

She said the simulators appeal to the students. “They like the technology, and they expect it from us.”

The students reaction to using the simulators has been nothing but positive.

“It does make them think,” said Colbourne. She said she saw it in Thursday’s scenario as the students reacted to Noelle through her labour and how they asked questions both during and after.

The simulators aren’t the only new method of teaching being used at the school.

Two years ago Colbourne introduced a virtual clinical computer program.

It’s a virtual hospital with virtual patients and students can conduct assessments, do charting and check vital signs.

“Everything they would do on a normal unit, but it’s all virtual, so it’s pretty cool,” said Colbourne.

The school is also looking at bringing in people or actors to simulate patients, and at times instructors will perform the role of family members to give students an idea of the various reactions they might encounter during patient care.

The school has three more high-fidelity simulators on the way — another adult, Susie, that can be more directed towards a medical/surgical patient, a one-year-old and a premature infant. These will allow instructors to simulate pre- and post-op care, code situations, cardiac problems and how to intubate for airways.

“There’s a lot we can do with them,” said Colbourne. “We can make it as acute a scenario as we want to make it.”