There is little doubt that simulation technology is the way forward in providing holistic health care education.

But how do we best utilise this new breed of simulator in order to ensure the greatest impact on the clinical area. If we take heed of Watson (1996) then ‘it is the environment that shapes our behaviour, and that what we learn is determined by the elements in the environment and not the individual learner’.

Watsons beliefs are certainly founded as I have learnt recently. Nurses undertaking a scenario quoted that they did not feel like nurses without their uniforms on. They also stated that the Skills laboratory environment within which the simulator resides did not feel like real life, the O2 was not where it should have been, the defibrillator was not the same as there ward based machine etc etc.

This leaves with undeniable evidence that in order to provide maximum educational benefit to our student s that we must provide a familiar and safe environment to ensure that the student remains motivated and that continuity is maintained.

 

So how do we get hold of a realistic simulation environment, I reckon £200,000 should just about do it, first the building work then the equipment costs, not bad eh , well I suspect that for you like myself the bottomless pot of cash does not exist, I certainly haven’t seen it in my NHS organisation (but I have heard tell of special room decorated in gold and diamonds , only kidding).

 

Well for us mere mortals there may be an alternative right under our noses. My Skills lab sits smack bang in the middle of a Large general Hospital containing an A&e, ITU, HDU, Maternity, Theatres, Wards etc.
So If I cant afford to bring clinical reality to me then I’ll go to it.

I will not begin by telling you how easy it is to close down a clinical area of a busy hospital and take 4-8 staff out of there clinical roles to train, because it's not.
It is pure unadulterated logistical hell, If any of you manage to do this without questioning your will to live, then please write and let me know.

It is however with a bit of forethought and hard work, an achievable proposition, that with your Hospitals support will provide you with the most realistic clinical area of them all.

A few words of warning before you all go out and take over your respective clinical areas.
Try and use a side room if at all possible or some where that can be secluded from prying patient eyes. There is no nosier species known to man than the hospital patient. Imagine it, sat in bed for days on end then a trolley is wheeled past with a pair of strangely life like feet protruding from under the blanket. In no time at all you will have a bay full of patient’s ghoulishly baying at the door trying to steal a peak at the poor poor patient who looks oh so pale (I am not exaggerating on this one either).

A side room is ideal as all wards have them, A&E will have them for aggressive or contaminated patients a theatre is perfect as it is stand alone already and most women’s units are made up of side rooms and delivery rooms also.

So now you have your room all you need is your staff.
Firstly there is no point in training teams to work together that aren’t going to do just that.

You must ensure that the team consists of a realistic skill mix and that the members of the team would ordinarily work together on a day to day basis. One of the main objectives of clinical environment simulation is to improve the patient outcome if that particular scenario should manifest itself in real life. Therefore role allocation is a major factor as the old adage goes “when you ask for someone to phone for an ambulance at any accident, either everybody will or nobody will” (Birch 2002).

It is essential that each member of the team is aware of his or her individual role, for example, following a recent major haemorrhage scenario and during the teams de-brief. I asked the team members who’s role it was to get the I.V’s from the store room and from a team of six people four hands went up. This just goes to show that although as individual practitioners we are all highly skilled individuals, but when it comes to working effectively as a team our role delegation leaves a lot to be desired. It is not acceptable that ineffectiveness is highlighted during a real life emergency as health care education providers we need to utilise simulation now ……………………………..

 

Coming soon Part 2… If you liked the above then let me know and you’re comments good or bad will motivate me to hurry up and provide you with the next thrilling instalment of  “Utilising simulation in your clinical area “

 
Best wishes for those of you who try out the above and please share your experiences on this site.

Regards

Neal.