Simulators Enhance Safety

Nursing education has become increasingly high-tech. One example is the growing use of human simulators. They resemble mannequins, but are computerized, making them much more complex and life-like. Northern Michigan University’s School of Nursing has acquired a complete set of these teaching tools: SimMan (pictured), SimBaby, and a pregnant female called Noelle.

“The driving force behind the simulators is safety,” said Kerri Schuiling (Nursing). “It used to be that patients were too often the first real test of a student’s skills. Simulators provide students with the opportunity of making errors without putting patients at risk, and of receiving immediate feedback. For example, if a wrong medication is given to the human simulator there will be a very life-like immediate reaction. This offers the student an opportunity to assess what is wrong and take the correct action. Many studies are demonstrating that patient safety is increased when students have practiced first using human simulators."

SimMan lies in a bed hooked up to his own monitor, as if he’s in the intensive care unit. He is capable of breathing, talking and producing 2,500 different heart sounds in addition to a variety of lung sounds. If he’s having some difficulty that students don’t pick up on, he gives cues so they respond appropriately.

“Students can perform basic nursing skills on him like taking blood pressure and pulse, inserting intravenous needles or catheters and performing dressing changes,” said Julie Dobson (Nursing). “We can also change various body parts to create different scenarios. For example, there’s an arm with a laceration and an arm with a severe burn. There’s a face mask that would indicate head trauma, and a chest plate that can be used for removing sutures or staples.”

Students can read a patient history on a computer and respond to that history by prioritizing and implementing nursing interventions. Faculty members can change the parameters on the touch-screen monitor and students have to respond accordingly. Debriefing sessions are held after each simulation to provide students with immediate feedback.  

Noelle gives birth with the aid of a mechanical apparatus controlled by the instructor. She provides opportunities for students to listen to fetal heart tones that can be altered, and assess labor status and the baby’s position. It is even possible for Noelle to mimic a cord prolapse, a condition that would require an emergency C-section. Contrary to human patients, it is also possible to stop midway through any process and discuss what is happenin. This is an advantage for students who otherwise might not recognize or absorb everything that surfaces during an actual delivery.

Maebelle Erickson (Nursing) has presented nationally on the use of simulation technology in nursing education. She became interested in the topic after attending a national conference six years ago and learning about the University of Maryland's success in using early human simulators for instruction.

“With simulation, you can put a lot of different skills together to effectively create a complex patient situation,” Erickson said. “There’s more timely data—like getting lab results back or seeing heart rhythms fluctuate. It also allows students to make mistakes and learn from them. You can’t allow students to make errors when they are caring for a real patient.”

Some faculty members have already received training on simulator assembly and care, as well as how to incorporate the technology into the curriculum. The entire School of Nursing faculty will participate in a workshop on use of the simulators in October.

“The training students receive with these is comparable to a clinical setting,” Schuiling said. “In fact, some states are using simulation in place of six hours in the hospital. The advantages are that instructors get quality time with one or two students. They can also identify specific outcomes and competencies students need and ensure they achieve them. Students are exposed to a wider range of scenarios than they might see in a hospital setting, where exposure to learning situations is dependent on the cases that are available at the time students are in the in-patient setting. 

“We also have a virtual reality device that trains students how to insert IVs correctly. You can literally feel the ‘give’ as the needle goes through the vein. The technological advances being made to support learning are amazing. They provide increased learning opportunities for students and increased safety for patients. These simulators will allow us to take our education to the next level. We are the only School of Nursing in the Upper Peninsula that has simulators for use as a teaching aid. The funding of a recent grant allowed us to obtain these devices and we are indeed fortunate."


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Updated: August 23, 2006

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