Simulation boosts learning for RIC students

SIM CITY: Rhode Island College nursing students, from left, Andrew Sharpe, Heather Us-Spaziano and Amy Schnabel, train in the SIM lab. / COURTESY ?EUGENE ?ST. PIERRE
SIM CITY: Rhode Island College nursing students, from left, Andrew Sharpe, Heather Us-Spaziano and Amy Schnabel, train in the SIM lab. / COURTESY ?EUGENE ?ST. PIERRE

Theresa Harten, a senior at the Rhode Island College school of nursing, will never forget one especially life-like mannequin used in the school’s simulation lab, where students train in mock hospital settings. It had a beating pulse, eyes that dilated in response to light, and a voice provided by an instructor in another room speaking into a microphone.During one class the pulse stopped and the voice became silent. “It seemed to actually die,” she recalled. “We left class feeling much more somber than usual.”Like Harten, almost all of RIC’s nursing graduates give the Simulation Center and Nursing Resource Laboratory high marks for providing a realistic experience while they’re preparing for medical careers. “Students consistently rate simulation training as one of their favorite parts of the program,” said Penni Sadlon, coordinator of the simulation center and a registered nurse herself. “We’ve integrated it into every course.”Now others are applauding that effort. Earlier this year the Society for Simulation in Healthcare accredited RIC’s Simulation Center and Nursing Resource Laboratory in the area of teaching and education, making RIC and Yale University the only two accredited simulation centers in New England. Last month Sadlon attended the organization’s annual conference in New Orleans to accept the recognition.Nationally the society has accredited just 38 simulation centers, which are used to create clinical scenarios to which nursing students must react in real time.Colleges have long used simulations to train future doctors and nurses. In the past, however, simulation mannequins were little more than life-size rag dolls, and the exercises required some suspension of disbelief. Today’s computer technology has changed all that. With their life-like reactions, lab mannequins have come to resemble the animatronic figures seen at Disney theme parks. And computerized medical equipment can be programmed to create simulation scenarios, too.RIC’s simulation lab isn’t new. The college has been improving the facility over the past five years. A $250,000 grant from the Health Resources and Services Association helped buy video cameras, mannequins and computer software. The school has 540 students enrolled in its bachelor of science in nursing program, and another 80 enrolled in its master of science in nursing program.The RIC lab is equipped with more than a dozen mannequins, including models that represent a baby, a toddler, and a child between ages 4 and 10. Interchangeable parts allow them to resemble males or females.”We pretty much cover the lifespan,” said Jane Williams, dean of the school of nursing. “Their eyes dilate. They foam at the mouth. They make noise. We can use pre-recorded screams and moans, or they can appear to talk by having someone in a neighboring room – usually me – speak into a mic. I change my voice to sound old or young, male or female. Anything to add realism. That’s what we strive for.”The lab rooms also include real hospital equipment or realistic models of those items found in a patient’s room or an emergency room. “That means hospital beds, oxygen equipment, blood pressure cuffs, simulation thermometers, and sometimes defibrillators and laptop patient monitors,” said Williams. “The monitor lights up in the same situations that occur in a patient’s room.”One of the three lab rooms is also equipped with a video camera in the ceiling, allowing instructors to watch from another room while students respond to the simulations. The scene can also be recorded, allowing students to later study their own reactions.”By viewing themselves, they can see and understand what they could do better,” Williams said.While the lab’s equipment is impressive, Williams notes it’s the instruction that won the school national recognition. “This accreditation … could not have occurred without the proven expertise of a faculty and staff who have mastered the technology and the teaching skills to support the program,” she said. “Our program is more about simulation pedagogy and integrating the lab into the curriculum. Our faculty and staff have special training. It’s their commitment and expertise that make our program different.” Students use the lab from their first semester to their last. RIC runs more than 150 simulations for graduate and undergraduate students each year. “A first-year student might use the lab for experience with a blood-pressure cuff, while a senior student might be learning to respond to a code,” Williams said. Figures show that effort is helping RIC students become better nurses. On the latest national licensing exam for nurses – the NCLEX-RN – graduates scored 9 percentage points above the national average. Students agree the simulation lab enhances learning.The video recording of lab sessions adds more value to the experience, said Harten. Instructors use the tapes to focus students’ attention on their response to the different scenarios. “We really appreciate the debriefing after a simulation,” she said. “It helps you reflect on things you could have done better.”Amy Parsons, also a senior, has used the lab many times. “It really takes you beyond the textbook,” she said. “It really helps remove the nervousness you might feel the first time you’re with a patient. It builds confidence. The first time you hear a mannequin speak, it can be surprising. The second or third experience, it starts to feel like you’re dealing with a real patient.” n

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