Simulations for Success: Robert Morris University Simulations for Success | Robert Morris University

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WRITTEN BY VALENTINE J. BRKICH

Mrs. Gonzales lies in a hospital bed as she recovers from leg surgery. All around, high-tech equipment monitors her condition, while her concerned daughter sits at the foot of the bed, waiting.

Two nurses enter the room to see how she is doing. “My leg,” she says, “it really hurts.” One of the nurses checks the surgical wound on Mrs. Gonzales’ leg and finds that it’s bleeding and needs immediate attention. The other nurse calls the doctor for guidance on the proper medication and dosage.

Suddenly, Mrs. Gonzales is having trouble breathing. The nurses jump into action. They check the woman’s blood pressure, temperature, pulse. They determine the cause to be acute pain and do their best to bring her comfort. Once the situation is under control, they explain everything clearly to Mrs. Gonzales’ anxious daughter, in order to ease her mind.

And just like that, the simulation is over.

RMU simulation specialist Janice Sarasnick, RN, MSN, leaves the observation room, where she has been watching this unfold, and goes out to congratulate nursing students Lauren Matkan and Dustin Huerta on a job well done and to debrief them on the hospital emergency exercise. Mrs. Gonzales, by the way, is fine. After all, she’s just a dummy—a really smart dummy.

This is just another day in RMU’s new state-of-the-art simulation laboratory in the university’s School of Nursing and Health Sciences. It’s the university’s latest effort to provide a hands-on, engaged education to its students.

“Robert Morris University has always believed that learning doesn’t just take place in the classroom,” says school Dean Lynda Davidson, Ph.D., RN. “This new simulation laboratory is another example of our commitment to provide our students with real-life experiences that will enhance their education and better prepare them for their future career.”

The new lab was made possible by a $250,000 grant from Highmark Blue Cross Blue Shield; a $500,000 state grant from the Pennsylvania Department of Labor and Industry, which was presented by state Rep. Mark Mustio and state Sen. John Pippy; as well as a $95,000 federal grant made possible through the efforts of U.S. Sens. Robert Casey Jr. and Arlen Specter. Located inside RMU’s John Jay Center, it features two high-fidelity treatment rooms, one critical-care room, two classrooms, one low-fidelity nursing practice lab, and multiple office areas, as well as advanced audio-visual and IT equipment that allows for scheduling and administrative support, debriefing recordings, and live audio-visual feeds.

“The additional funding allowed us not only to purchase the new mannequins and state-of-the-art recording equipment but also to hire and train dedicated staff to assist in the simulation lab,” says Valerie M. Howard, Ed.D., M.S.N, R.N., associate professor and director of the simulation lab.

  • The current facility was a much-needed upgrade to RMU’s previous nursing simulation capabilities, which lacked the technology and space to provide a realistic learning experience for the students. As the demand for this type of simulation-based training grows among regional health care organizations, the university plans to further expand its capabilities with a new 23,000-square-foot simulation center, which will be known as the RMU Regional Research and Innovation in Simulation Education (RISE) Center. This new facility is tentatively scheduled to be completed in 2011.

“Simulation is great for providing students a variety of experiences,” says Katherine J. Perozzi, MSN, RN, associate professor and low-fidelity simulation lab coordinator. “It allows them to feel that they have indeed managed such a situation before, and it makes them feel more confident in the actual clinical setting.”

Perozzi has a bachelor’s degree in math and nursing and a master’s in nursing education. Before coming to RMU, she taught fundamentals and obstetric nursing for 10 years at the University of Pittsburgh. She says that this first phase of the RISE Center will provide valuable simulation opportunities to hospital personnel, nursing schools, and other medical professionals in the region.

Both the military and the aviation industry have been using simulation for decades to safely train their people in real-life situations. Over the years, schools of nursing have used computer simulation to promote critical thinking skills.

Now, thanks to recent technological innovations, simulation-based training is becoming more common in the health care industry. RMU’s School of Nursing and Health Sciences began utilizing high-fidelity simulation with its nurse training in 2005. Since that time, the nursing educational curriculum has evolved to employ simulation across the board, in clinical undergraduate, master’s level, and doctoral courses.

“This type of hands-on learning is so important because it allows them to make mistakes now rather than later”, says Howard, whose research, which focuses on evaluating learning outcomes related to the use of simulation, shows that students find simulation superior to the case study approach.

  • Many universities and health care organizations across the country are already taking advantage of simulation as a learning tool. What’s unique about RMU’s simulation lab is that it’s meant to be an open educational resource not just for the university but for the region’s health care providers also. Already, local organizations like Heritage Valley Health System, St. Clair Hospital, Ohio Valley General Hospital, Valley Ambulance Authority, Pittsburgh Technical Institute, and other patient safety organizations and initiatives have shown an interest in collaborating with RMU for training and educational purposes. Once these partnerships are finalized, RMU will serve the region as a major source for simulation-based training and competency testing.

“The new simulation lab was developed with strong participation and coordination across health care specialties, in order to provide multidisciplinary health care training to positively impact patient safety”, says Howard. “It gives us the opportunity to provide simulation-based education to our regional partners in health care and research.”

The real stars of this new lab are the patient simulators. At first glance, you may think you’re looking at a normal, department store mannequin. Then you see its eyes blink and its chest rising up and down. And then you hear it cough. These aren’t your mother’s mannequins. They’re high-fidelity simulators that can mimic any number of medical conditions, and they help the students feel as if they’re working with real, live patients in a safe and controlled environment.” We not only have the best equipment,” Howard says, “we have the best, most capable team of experts who know how to use it to its full capacity.”

The lab features two high-fidelity adult simulation mannequins, a birthing simulator with newborn, an infant (6-month-old) mannequin, a pediatric (5-year-old) mannequin, and model body parts called “partial task trainers,” which are used to teach different skills. Each is computerized with interactive capabilities to simulate physiological and pharmacological responses in real time. You can even interchange parts on them to simulate various conditions, such as a bleeding wound or a swollen ankle.

  • “This technology in this new lab is much more advanced than what the students used to work with,” says Chuck Simon, simulation lab technician. “Overall, it’s a more realistic hospital atmosphere.” The scenario described above is called “Gonzales 28;” instructors also have access to 30 other scenarios, each with a customized electronic medical record that allows for a more realistic clinical setting.

The new lab utilizes three separate software packages to conduct the simulations. One microphone in the control room enables the instructor to be the voice of patient, and another, which they call the “Voice of God,” is an intercom used for other communications. The simulation rooms themselves closely resemble typical hospital rooms, from the IV drips to the bedside monitors, all the way down to the in-room phone. Audio-visual equipment, such as digital video recorders, editing software, monitors, and microphones, provide live remote viewing, immediate feedback, and after-action review during the debriefing period. The lab also features an information management system that assists with scheduling, monitoring of usage, and measuring outcomes.

“I used to work in a hospital, and I found the simulation to be very lifelike,” said Huerta, a second-degree student, who earned a B.S. in political science/biology at RMU before coming back for nursing. “For example, being able to call the doctor on the phone in the room was very realistic.”

Jill Barney, who played Mrs. Gonzales’ concerned daughter in the scenario, is also impressed by the power of simulation. “It’s fun, stress-free, and with all of the new technology, you really feel as if you’re in a hospital. I think simulation is a great way to learn how to care for a patient in a learning environment.”