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• W2000160741 abstract "For multiple reasons, I attend a lot of simulation conferences. One of those dedicated to nursing is the WISER Center conference, in Pittsburgh. In the interest of full disclosure, I was asked to speak, at this past December's conference, about writing for publication. WISER is one of the only conferences run by a major simulation center dedicated to nursing simulation. I thought you might like to see some of my notes from this really neat conference. Many nurses say that there is no proof to support the costs associated with full-blown adoption of simulation. I would argue that there is evidence but that it is scattered in multiple venues. One must attend many conferences and read widely and deeply to find this evidence. Some of that scattered evidence appeared in several presentations at this conference. Connie Lopez of the Kaiser Permanente system reported on the outcomes of its patient safety program. After implementing perinatal team training, the program experienced a 44% drop in its malpractice claims over 7 years. This perinatal team training is based on the work of Tim Draycott's group, which experienced similar outcomes in Britain. Pam Jeffries spoke about her recent study in which students who had to take care of three to four simulated patients critiqued the experience as totally unrealistic, as they would never have four patients in the real world. The “take-home” of this study was that we are not providing students with preparation for what their work world is really going to be like. A risk management director for a major hospital system suggested that NOT saving any videotapes or digital recordings of simulations forestalls potential legal problems. No recordings, no subpoenas for “evidence.” This risk manager also suggested that video releases should state that all videos are peer reviewed, making them potentially undiscoverable in any future potential litigation. The take-home from this talk was that there is no current litigation by a patient or a disgruntled simulation attendee. It is possible that there have been simulation evidence cases that have been settled in lower courts, but they have not been appealed to the next higher court, appellate court, where case law is made and cited. Simulation is on its way to becoming a standard of care in hospitals, and by default, perhaps, schools of nursing. It may also become an expectation that undergraduate and graduate health care provider students of all kinds will train together. The observation was made more than once during the conference that professional sports team members do not train individually and then get together only on game days; they train together day in and day out so that they are prepared for the real thing. Hmm, an interesting thought! Hospitals are using simulation more and more for orientation of new nurses and other health care providers. Simulation is being used for performance assessment, as well as remediation. A new twist on simulation is its use in orientation of new unit managers to deal with such incidents as doctors writing inappropriate orders, the counseling of employees, and the management of unruly patients. Hospital educators would also like to compare new nursing graduates who have learned with simulation with those who have not. Laura Fero, a nurse researcher from the University of North Carolina–Greensboro, presented her study evaluating students in simulation scenarios. She suggested elegantly that paper-and-pencil exams represent proposed actions, not actual clinical practice. In her research, soon-to-be-graduate nurses could not anticipate doctors' orders and could not provide rationale for nursing actions. (This could be a whole editorial in itself!) Drs. Paul Phrampus and Ben Berg provided examples from their own experience of working with management to get what you need for simulation. They suggested talking about costs in terms of efficiencies and demonstrating that you have thoughtfully planned for what you are asking. Approach it from a WIIFM (what's in it for me) perspective—with “me” being the administration. Use the term ROI (return on investment). Alice Blazeck, from the WISER Center, presented an excellent model for introducing neophyte faculty to simulation. She described simulation anxiety syndrome, experienced by many faculty who are suddenly tasked with teaching students with simulation. She starts by sending e-mails to new faculty members 6 weeks ahead of their scheduled simulation date, with detailed directions for bringing students to the facility, along with scenario-preparatory reading and objectives. Her liberal use throughout her e-mail communications of NYR (not your responsibility) for just about everything related to the experience allays fears of new faculty members. They show up with their students, and Alice models everything else. This approach has proven very successful. I was privileged to watch her work her magic for an hour with a group of first-semester nursing students. Suffice it to say, I learned many interesting things and, scattered throughout the conference, found bits of supportive evidence for the use of simulation." @default.
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• W2000160741 date "2010-03-01" @default.
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• W2000160741 title "Notes From the WISER Nursing Simulation Conference, December 2009" @default.
• W2000160741 doi "https://doi.org/10.1016/j.ecns.2009.12.010" @default.
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