Brenda Smith, MSN, RN, CMSRN
Wendy Grbach, MSN, RN, CCRN, CLNC
UPMC Shadyside School of Nursing
Evaluating Educational Effectiveness
in the Simulation Laboratory
Presentation Objectives
• Define and describe the process of Problem
Based Learning in medical surgical courses
• Discuss the implementation of simulation
scenarios to strengthen PBL education
• Engage in video review of PBL scenario
• Discuss development of UPMC Shadyside
School of Nursing’s evaluation tool as a
• Students participate in a concept-based case review
• After identification of their learning needs and research
presentation to their peers, they develop a plan of care
• They then participate in a simulation session based on the
PBL patient presented
– Simulation scenarios randomly selected based on 3 levels of acuity • Normal post-op / pain evaluation
• Overnarcotization • Hemorrhage
• Content-laden didactic
• Inconsistent mastery of the content
• Faculty prepare more than the student
• Student-centered learning opportunity
• No more “Sage on the Stage
!”
• Reproducible situations
• Application of new learning
• Practice
• Ensure comprehension
• Promote clinical
reasoning
• Meet Mrs. Kane…
– 3 days post right hip arthroplasty
– PCA Dilaudid for pain management, Lumbar and sciatic nerve blocks – Hemodynamically stable
– Insignificant past medical history
– Hemovac and JP drains with minimal drainage
• Nurses have patient chart with physician orders, both
verbal and electronic hand-off reports, medications for
administration
• “Overall, new graduate nurses are fully prepared to provide
safe and effective care in a hospital setting.”
– 90% of nursing school leaders – 10% of hospital nurse executives
Evaluation
Evaluation Tool
UPMC SHADYSIDE SCHOOL OF NURSING SIMULATION EVALUATION©
Student: Course: Date: Safety—Noticing
QSEN Competency: Patient Centered Care and Safety
Correctly and consistently adheres to standard and transmission based precautions. Correctly identifies patient using two patient identifiers: name and date of birth. Utilizes 60 second and situational assessments to provide safe patient care.
Patient or Student #1 Patient or Student #2 Patient or Student #1 Patient or Student #2
Performs hand hygiene on entry to room Identifies patient prior to procedures
Performs hand hygiene between patients Positions side rails appropriately (minimum 2)
Performs hand hygiene on exiting room Positions call bell within patient reach
Gloves as appropriate Positions bed height appropriately
Identifies patient with initial contact Maintains HIPAA standards
Identifies patient with medication administration
Safely prepares and administers medications
Comments:
Focused Assessment—Noticing and Interpreting
QSEN Competency: Evidence Based Practice, Patient Centered Care and Safety
Performs a focused assessment based on the scenario objectives.
Patient or Student #1 Patient or Student #2 Patient or Student #1 Patient or Student #2
BP Performs expected focused assessment
Pulse Neurological Cardiovascular
RR Pulmonary Abdominal/GI
Temp GU Musculoskeletal
Pulse Ox Integumentary Psycho-Social
Pain Vascular Access
Comments:
Plan of Care and Interventions—Interpreting and Responding
QSEN Competency: Evidence Based Practice, Patient Centered Care and Safety
Plan of care and interventions are evident and appropriate based on the scenario objectives.
Patient or Student #1 Patient or Student #2 Patient or Student #1 Patient or Student #2
Correctly identifies priority problem Implements patient specific interventions
Develops appropriate plan of care Initiates appropriate patient education
Communication and Teamwork—Responding
QSEN Competency: Evidence Based Practice, Patient Centered Care, Safety, and Teamwork and Collaboration
Actively engages as a member of the healthcare team utilizing therapeutic, professional, standardized communication, and teamwork principles.
Patient or Student #1 Patient or Student #2 Patient or Student #1 Patient or Student #2
Introduces self to patient Actively engages as a team member Engages in therapeutic communication Delegates to team members
Engages in professional communication Collaborates with multi-disciplinary team I S B A R R SBAR content: I S B A R R SBAR content: Comments: Debriefing—Reflecting
QSEN Competency: Evidence Based Practice, Patient Centered Care, Safety, and Teamwork and Collaboration
Reflects and evaluates performance.
Correctly identifies strengths of performance Independently Prompted Correctly identifies areas for improvement Independently Prompted Articulates a plan to correct areas for improvement Independently Prompted Receives feedback to improve practice Receptive Resistant Takes ownership of performance/decisions Justifies or self protects performance/decisions
Comments:
Initiation of a Learning Contract: Yes No N/A (Circle one) PBL points: Areas for remediation:
Faculty Signature: Date: Student Signature: Date:
• Inter-rater reliability
• Student Development
– “Buy in” – Lack of preparation – Rubric• Faculty Development
– “Buy in”– Whose “Sim” experience is this anyway?
Questions?
• For more information, please contact
– Brenda Smith (
[email protected]
)
– Wendy Grbach (
[email protected]
)
• UPMC Shadyside School of Nursing • Pittsburgh, PA
• Advisory Board Company. (2008). Bridging the preparation-practice gap, Volume I: Quantifying new graduate nurse improvement needs.
• Advisory Board Company. (2008). Bridging the preparation-practice
gap, Volume II: Best practices for accelerating practice readiness of nursing students.
• Berkow, S., Virkstis, K., Stewart, J., & Conway, L. (2008). Assessing new graduate nurse performance. Journal of Nursing Administration, 38(11), 468-474.
• Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, D.T., …Warren, J. (2007). Quality and safety education for nurses. Nursing Outlook, 55(3), 122-130.
• Herm, S.M., Scott, K.A., & Copley, D.M. (2007). “Sim”sational
revelations. Clinical Simulation in Nursing Education, 3(1), e25-e30. • Lasater, K. (2007). Clinical judgment development: Using simulation to
create an assessment rubric. Journal of Nursing Education, 46(11), 496-503.
• Tanner, C.A. (2006). Thinking like a nurse: A research-based model of clinical judgment. Journal of Nursing Education, 45(6), 204-211.
• Wolf L, Dion K, Lamoureax E, et al. (2011) Using simulated clinical
scenarios to evaluate student performance. Nurse Educator, 36(3), 128-134.
