NURS FPX 6112 Assessment 4 Implementation Plan for a New Simulation Product
Student name
Capella University
NURS- FPX6112
Professor Name
Submission Date
Implementation Plan for a New Simulation Product
Slide 1
Hi, I am Emily. This presentation discusses the development of the new simulation system Sentinel U; it is an online simulator designed to enhance students’ clinical reasoning when it comes to nursing. The proposal identifies the identified learning gaps in the current programme, and sets out measurable measures of outcomes of the programme. The presentation aims to help students improve their competence and self-confidence based on evidence-based studies through the use of standardized vignettes of patients from the virtual world. Leveraging Sentinel U will complement current methods used to teach nursing creating a significant impact on nursing education.
Overview of the Technology
Slide 2
Sentinel U is an innovative, web-based simulation system designed to help turn nursing education upwards to the real clinical setting using the immersive virtual patient cases. This integrated approach to the three central domains of nursing practice, physical assessment, pharmacology and pathophysiology has been translated into engaging and interactive cases that elicit and support thinking and decision making. The students are given an opportunity to take health histories, interpret their symptoms, read their diagnostic information and select interventions in a safe environment: They can learn by themselves and they receive immediate feedback; they get to view the impact of the intervention, which enables them to continuously improve their clinical judgment. Sentinel U can be particularly beneficial at the preclinical and early clinical rotation phase when students are exposed in a systematic fashion to complex patient situations prior to exposure to real patients.
The simulation scenarios include a variety of medical & surgical, pediatric, maternal-child and mental health scenarios. For instance, a student might be presented with a virtual patient of someone with hypertension and peripheral neuropathy, ask him/her to analyse the blood pressure pattern, evaluate neurological symptoms then decide if it is appropriate for the medications to be adjusted or not, based on pharmacological principles. To enhance the application of the theoretical content of modules, especially Fundamentals of Nursing, Advanced Health Assessment and Pharmacology for Nurses, Sentinel U modules can be used directly as part of the module. Research indicates that the Sentinel U modules can be utilized directly within a module, where the theoretical content is enhanced with practical application, particularly in the modules: Fundamentals of Nursing, Advanced Health Assessment and Pharmacology for Nurses. It’s also based on the cloud and can be used in a hybrid or fully online curriculum, making it versatile to all disciplines and clinical training programs.
Addressing the Educational Gap
Slide 3
A recent needs analysis revealed that there is a significant need for a gap between students’ confidence to apply theoretical knowledge to clinical decision making (CDM) in pathophysiology, physical assessment and pharmacology. In addition, many students struggle to correlate disease processes with interventions, as they have limited practicum experiences and different clinical placements, and instructors report that they have trouble providing personalized feedback when using high fidelity manikins, because of resource and time constraints. Sentinel U helps fill this void by offering students scalable, repeatable and standard virtual experiences that will help to practice clinical reasoning safely without the need to rely on a physical simulation laboratory, or on the availability of a clinical environment.
Through curriculum integration, students are exposed to a wide variety of cases throughout their experience of Sentinel U’s student module, requiring the application of physical findings into understanding the underlying pathophysiology, and the safe application of pharmacology to treat their patients. The diabetic virtual patient needs to be treated with insulin, for instance, and a diabetic student needs to interpret the laboratory values, know what the respiratory compensations are and know how to dose insulin for the virtual diabetic patient, taking into mind co-morbidity and drug interactions (. Such a level of thought strengthens the correlation between classroom learning and clinical application, ensuring students that they’ll be competent and confident in their clinical skills before working with patients in real world environments
Needs Assessment
Slide 4
Fundamentally this involved a needs assessment which involved surveys, focus groups and performance data analysis with 120 nursing students and 15 faculties and involved a number of major issues identified in the current teaching practice. Over two thirds of the students stated that they were under-prepared to conduct physical examinations in detail themselves and 65% said they found it difficult to integrate the knowledge of drugs to different situations. Although faculty reported that high fidelity manikin training was beneficial, they noted that for each student, there was a time limit on high fidelity (one session/ semester) due to equipment and staffing. In addition, 70% of the teachers reported lack of clinical reasoning skills of students being present regularly at clinical rotations, leading to increase in anxiety and less effective learning by students. The more specific questions that involved applying pathophysiology to the examination of a clinical situation (average 72%) and applying a drug to a specific clinical situation (average 68%) were found to have poorer exam scores, by comparison to the questions that involved recall of foundational knowledge (average 85%). These findings suggest the need to bridge the theoretical-actual divide by asking for the use of more user-friendly, stable and interactive learning tools that can stimulate higher order thinking skills.
Necessity and Potential Impact of Sentinel U
Slide 5
Sentinel U is rolled out directly as a response to these gaps identified due to its flexible, evidence-based solution that makes clinical decision-making more accessible, while providing the opportunity for repetition. That’s not the case with Sentinel U which can be accessed remotely and learners could be offered the opportunity to run the simulation many times, at their convenience. Being exposed to multiple cases brings a wealth of experience in how the disease progresses, the effect of the medicine and timing indications in terms of safe patient care. The potential impact is to improve student’s preparedness for clinical rotations, critical thinking skills and deeper knowledge integration of inter-professional knowledge. There are anecdotal evidences and empirical studies that accounting for the effectiveness of using virtual simulations in the improvement of knowledge recall and clinical judgment, a study showed that the students that were exposed to virtual simulation had been shown to have an increase in diagnostic accuracy when compared with students that were only exposed to traditional lecture. Sentinel U can be used to standardise the learning experience, minimise the variation in clinical preparedness skills and ensure that the clinical preparedness requirements are met prior to engaging in high stakes clinical practice.
Integration Strategy
Slide 6
A phased implementation will be conducted in three important courses (Fundamentals of Nursing, Pathophysiology for Practicing Nurses and Pharmacology and Therapeutics) to make a seamless transition of Sentinel U to existing courses. 2-3 Sentinel U modules will be required for each course with learning goals that will be based on the weekly requirements. For example, during Pathophysiology, students will take part in a scenario involving a heart failure, during which they will have to analyze changes in vital signs, and understand compensatory mechanisms and what complications may arise. Other than that, faculty will be able to take advantage of these modules in their pre-clinical preparation and/or post-lecture reinforcement as well as in line with didactic content. The study has shown that the Learning Management System (LMS) of the institution being used will be used to simplify the process of integration as teachers will be able to monitor student performance, view the performance analytics and even grade students based on indicators of how checklist items are fulfilled and decisions made are correct based on the performance of the students. Interprofessional support and guidance between the nursing instructors and simulation laboratory coordinators will help to ensure uniformity in learning outcomes across modalities (virtual and hands-on).
Staff Training and User Preparation
Slide 7
The teaching and simulation staff will all be introduced to Sentinel U’s training by the Sentinel U training team for a two-week orientation before the rollout. This consists of live webinars, special support portal and practice cases with pilot products. Staff will be trained in how to distribute scenarios, Student performance reporting and de-briefing of the results of the simulation. The training will be delivered through a train the trainer approach to train simple simulation trainer(s) who will help colleagues within each department; and a tutorial video and guided tour of a simple simulation and a practice module without penalty to academics, during orientation week. Technical support staff will be available for you to assist if you have any problems logging in or if you’re not compatible with a device. To ensure access equity, there will be loaner laptops available and wireless hotspots will be available for students who have limited access to wireless technology as well as or do not have access to their laptops, in accordance with the requirements for ADA conformity and digital inclusion.
Benefits and Enhancements
With Sentinel U, the clinical experience of being faced with a real, decision-making situation is greatly enhanced to better prepare students for physical examination, pathophysiology and pharmacology. Physical Examination: Learners are provided with opportunities to rank physical examination findings, such as the “crackles” that they hear when auscultating lungs in a simulated case of pneumonia, and make connections to history of the patient and lab results. But, there is no haptic feedback, the interpretations of data and hypotheses are carefully defined. The system illustrates, graphically, the pathophysiology (disease) and students will see, for example, how uncontrolled hypertension will lead to end organ damage over time, how this will relate to long term health care problems. In pharmacology, Sentinel U enables students to have a context to deal with medication regimens. A clinical scenario of an increasing INR from a warfarin patient will involve learners to consider the risk of bleeding, the reversal agents, and discuss with the health team, in a scaffold way. This helps to promote not only drug awareness, but drug priority and drug safety awareness as well. There is a focus on cause and effect, this complements the integration of these three areas and helps to prepare students to make evidence-based, whole system decisions.
Evidence-Based Support and Case Studies
Slide 9
Results from numerous studies back the advantages of virtual simulation like Sentinel U in improving educational outcomes were a 30% increase for the students trained by virtual simulation over the control groups’ pharmacology exam scores. In a similar study, Cant and Ryan found an improvement in the accuracy of diagnostic reasoning of undergraduates in nursing of ¼ due to the use of virtual simulations. Comparative research showed that the critical thinking tests were higher for virtual simulation group than for conventional approaches group particularly in detecting gentle changes in patients’ state. In one of these case studies a student initially thought he/she had dehydration in a virtual case as opposed to sepsis, but upon receiving immediate feedback and reflection was able to correctly identify the systemic inflammatory response in subsequent cases. Safe Clinical Practice is built upon the iterative process of learning (learning to learn) that a learning model like “Sentinel U” exemplifies.
Evaluation Metrics
Slide 10
Short-term measures include student performance on simulation specific checklists, Pre/Post Simulation Quizzes and faculty rating the clinical judgment of debriefing. Completion rates, time spent per module, errors made in the modules and accuracy of decisions will be tracked on the LMS and Sentinel U analytics platform. Student engagement will be assessed by the perceived usefulness, confidence and satisfaction scale surveys with five-point Likert scale, which will be administered to students, while long-term performance will be evaluated by benchmarking the NCLEX performance of the students, rotation evaluation score, and their OSCE (Objective Structured Clinical Examinations) pass rates. Students in the comparison group, from the previous academic year (pre-implementation) will serve as a baseline for the measurement of the pre and post clinical reasoning and application improvements.
Remediation and Continuous Improvement
Slide 11
A remediation plan will be developed for a struggling student who is not achieving his/her expected level of performance on a simulation. To get a score of less than 75% on any module, students will be required to attend a guided review session with tutor, re-work the scenario, and provide a reflective journal entry on what the student has made of the decisions they made in re-working the scenario. Student errors will be identified using assessment data and corrected at small group remedial lessons where common misconceptions, (i.e. Beta blockers in Asthma patients) will be identified in the students. The programme will be assessed every two years and decisions will be made on what sections to offer and the order of the sections based on stakeholder feedback, and on outcomes. This ongoing process of quality enhancement ensures they have the most up-to-date technology that meets the accreditation standards and evolving medical practice.
Budget and Resources
Slide 12
Roughly $28,000 is estimated to be required to implement Sentinel U for the 500 students in the entire school ( $18,000), to train the faculty ( $3,000), to integrate technical support ( $2,000) and to create student orientation materials ( $1,000), over a 3 year period. There will also be a request for funding of loaner equipment and Internet for disadvantaged students ($4000). The following additional funding sources will be pursued: The institution’s Innovation in Teaching Grant and extra funds will be raised through yearly technology funds from within the nursing program. Expenses will be billed from the Office of Academic Affairs, and their budget will be reviewed at the end of each quarter to ensure openness, and sustainability.
Timeline
Slide 13
The implementation time is eight months as from September when approval was given by administration, to April when integration takes place. Some key activities are vendor contracting, faculty training – 2 month period, student orientation – January, pilot launch –Fundamentals of Nursing – February, rollout to other courses – March and full deployment – April with evaluation. There will be support from champions, good IT support, and encouragement for participation to overcome potential barriers such as resistance from faculty members, technical issues or lack of participation. Progress will be kept under review and regular updates of progress will be shared with stakeholders to help maintain enthusiasm and accountability.
Conclusion
Slide 14
It has been a strategic move on the part of nurses’ education to include Sentinel U online simulation, which allows for the student to be equipped to manage the complexities of patient care in today’s world. This technology can be easily scaled and accessible to enhance cognitive and decision making functions by filling gaps in clinical thought and physical examination, and pharmacological use. Sentinel U is supported by evidence-based outcomes and proven implementation methodology, to complement existing high fidelity simulations and add to the educational experience. Its implementation will ensure that nurse graduates will not only be learned but kept assured and competent in practicing what they have learned to real-life clinical issues.
References For NURS FPX 6112 Assessment 4
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FAQs
Q. In what way does Sentinel U differ from high-fidelity manikins in terms of skills taught for physical assessment?
Sentinel U concentrates on clinical judgment and assessment interpretation skills through virtual patient simulation. High-fidelity manikins, on the other hand, offer training for physical assessment skills including palpation, auscultation, and psychomotor skills.
Q. What do you do if your students do not have access to the internet or a device?
Faculty members can arrange access to campus computer labs and loaners, allow more time to complete an assignment, provide flexible deadlines, and provide downloadable materials.
Q. Can Sentinel U help with remediation?
Yes, it can. Students can use Sentinel U to repeat simulation scenarios, practice clinical decision making, and identify their weaknesses.
Q. How much will simulation assignments affect faculty workload?
Simulation assignments can take extra time for setup, monitoring, grading, and giving feedback. Standardized virtual simulations can save time in the long run, as there would be less need for in-person simulations sessions.