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Tuesday, May 17, 2022

UC Davis nursing students enhance interpersonal skills, clinical practices in intimate simulations

Three different simulation spaces at the Betty Irene Moore School of Nursing provide a plethora of real-life scenarios for nursing students to prepare and apply their clinical knowledge

By BRANDON NGUYEN — science@theaggie.org 

From tears and grief to newfound intimacies and growth, students at UC Davis’ Betty Irene Moore School of Nursing are placed into authentic, complex simulations to apply clinical practices learned in the classroom. As part of the nursing school’s curriculum, these dynamic simulations are created by faculty — sometimes even involving them as actors — to create potential real-life scenarios that nurses may encounter. 

Terri Harvath, a professor at the Betty Irene Moore School of Nursing and a nurse educator for over 20 years, is the mastermind behind developing simulations for the nursing students and has guided countless nursing students toward applicable real-life practices. 

“Clinical practice of tasks has always been a part of nursing education, but I would say in the last 20 years, we’ve really been looking at how to introduce simulation, and we’ve gotten more and more sophisticated over time with how those simulations can emulate real life situations,” Harvath said. “What we know about the research that’s been done in simulation as a part of nursing education is that the more authentic the experiences are, the more students learn and the more they grow in both their psychomotor and their interpersonal skills.” 

To reproduce real-life experiences, faculty have focused on creating an environmental atmosphere in which nurses would most commonly find themselves. In Moore Hall on the UC Davis Sacramento campus, there are three different simulation spaces. The first involves a setup similar to that of the inpatient hospital unit that looks like an eight-bed hospital ward. The second simulation space comprises a 15-room primary clinical care space that patients typically enter to see their primary care providers. Unique to the UC Davis campus, the last space has been deliberately set in a one-bedroom apartment that emulates the home environment as health care shifts more into the community to tend to elderly patients, according to Harvath. 

Megan Hansen, a communications and marketing specialist supporting several departments at UC Davis Health including the UC Davis Health Center for Simulation and Enhancement, has played the role of the partner of a dying patient in a simulation and reflects on the powerful experiences that simulations offer for both the students and herself.

End-of-life care and death can be such a taboo topic in American culture, so I’ve been impressed by how this training session handles those discussions while imparting valuable knowledge and information to the students,” Hansen said via email. “I was so impressed with the students’ reactions. They were so soothing and kind, one even asked if she could hold my hand. I felt cared for and their sincere care and concern was so evident to me.”

How the nursing students handled the simulations impressed Hansen, and she emphasized the importance of empathy in the health field.

“This [simulation] exemplified for me the types of warm, sensitive, caring and incredibly capable students we have at the nursing school,” Hansen said via email. “These are just the types of people we want out in the real world caring for our loved ones and us.”

The simulation Hansen volunteered to partake in involved a two-part end-of-life care situation that two nursing students immersed themselves in as the other students watched. The first part involved a woman in the hospital who decided to end treatment for cancer and go on hospice care. She was supported by her partner, which was the role that Hansen played. During this training, the two women discussed next steps with the care team. 

In the second part of the simulation, which was held in the one-bedroom apartment environment, a woman who was ill was in her final moments and died while the nurses were visiting. It was up to the nurses to tell the partner that she had died.

Emily Boone, a second-year graduate nursing student, was one of the nursing students in this same simulation who had to deliver the news of the recently passed patient to Hansen. 

“I had a lot of nerves going in, and I wanted to be someone who could provide a therapeutic space for a person going through a difficult time,” Boone said. “I went all in and was completely immersed. There’s a reason I want to be a nurse, but after this experience, I’m more sure of my purpose. I know how to be present and helpful, without being overwhelmed by emotion. I feel much better prepared when that moment inevitably comes.”

After simulations, students are led by faculty in intimate group debrief sessions to discuss their experiences and learn from each other. 

“The debrief sessions are where the magic really happens,” Hansen said. “These take place after the simulations are done and we discuss what worked and what didn’t work and how to make improvements. This is where faculty, staff and students share their experiences and knowledge, and in this session everyone was so willing to be vulnerable, to cry, to discuss those difficult topics in a safe, nonjudgmental environment.”

With countless scenarios instrumental to students’ growth as nurses, Harvath has high hopes for the impact simulations can have on students not only in the nursing field but also various medical fields.

My hope is that we expand the use of simulations, and what we know from the research is that students can actually use 50 to 75% of their clinical learning and simulation and they do just as well or better than students who are in traditional clinical experiences,” Harvath said. “And again, it’s because these are such potent and well-designed learning experiences. The pandemic is especially helping us understand that we need to be able to engage students in clinical learning outside of the clinical setting, and I think simulation really allows us to give that potent clinical learning experience, so my hope is that we use more of it because it’s a very intentional approach to curriculum and clinical design.”

Written by: Brandon Nguyen — science@theaggie.org 

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