Nutrition and exercise physiology student Scot Webb
examines nursing faculty member Barb Richardson during a
simulated cardiac role-play scenario. (Photos by Doug
Nadvornick, WSU Spokane)
SPOKANE, Wash. – Jill Jones is walking on a treadmill at her cardiac rehab appointment. The exercise physiologist is evaluating Jill when she begins to experience tightness in her chest. He helps her sit down but her discomfort continues. Just a minute later she doubles over and falls in a heap on the floor.
That was the opening scene in a recent Saturday morning role-play scenario for WSU nursing, pharmacy and nutrition and exercise physiology (NEP) students and for University of Washington physician assistant (PA) students. The event was played out in the WSU Spokane nursing building.
The purpose was to group the students into interprofessional teams to see how they work together during a mock emergency.
Manikin aids simulation
Once Jones collapses, the scenario moves to the nursing simulation lab where Jones is portrayed by a high-tech manikin.
The student team turns Jones and slides a rigid board beneath her back. When a monitor connected to the manikin shows no pulse, NEP student Liz Anderson begins CPR, first from the side of the bed then from on top of the bed.
Nursing student Jamie Anderson uses a ventilation bag to
force air into the lungs of a manikin while nutrition and
exercise physiology student Liz Anderson waits to administer
CPR during a cardiac simulation exercise at WSU Spokane.
Nursing student Jamie Anderson uses a ventilation bag to force air into the manikin between compressions. She takes her turn performing CPR and then starts an IV. Pharmacy students Katie Ventura and Briana Robinson prepare vials of medication.
Overseeing it all is PA student Jeffrey Mitchell who keeps an eye on patient monitors and directs team members.
Within a few minutes, Jones’ heart is beating normally and a voice representing the manikin speaks through the room’s sound system. The voice complains that her chest hurts. The students talk with Jones, ask questions and reassure her.
Then simulation instructors stop the exercise and lead the students into another room for debriefing: “What went well?” they ask.
We worked well as a team, the students said. We did a good job of defining our roles. We communicated effectively during the CPR phase. We stayed calm. The patient didn’t die.
Then the instructors begin talking about what the students should have done differently.
“Why were you looking through all of the drawers?” Kevin Stevens, director for nursing’s Center for Clinical Performance and Simulation, asked one of the pharmacy students. “If you couldn’t find supplies, you needed to ask out loud for assistance. Maybe someone else would know where those supplies were located. Rely on the other members of your team to assist.”
When you’re in a room like that, you need to speak up so you’re heard and make sure you’re acknowledged, offered one instructor. You need to clear everyone away from the body before administering a simulated electric shock, advised UW physician assistant instructor Alicia Quella.
Students appreciate practice
Afterward, Barb Richardson from the Riverpoint Interprofessional Education and Research group, which organized the event, said the student response in follow-up evaluation forms was positive.
“They thought it was a valuable opportunity for them to practice a situation that simulates the real world,” she said.
“It was a great experience working with students from other programs,” wrote one PA student. “It helps to see everyone’s role and how to communicate effectively.”
“Please offer this experience OFTEN!” wrote another PA student.
Richardson said the simulation experience allows students to practice their newly learned skills in situations that won’t harm real people.
“I wish I had had the chance to do this,” she said. “I still remember the first time as a nurse that I worked with a real patient. My hands were shaking.”
Pharmacy clinical associate professor Brenda Bray said she saw several students experience “aha” moments during the simulation.
“Participating in these types of activities reinforces my commitment to push for widespread, meaningful adoption of interprofessional learning opportunities for all of our health sciences students on this campus,” Bray said. “It is important work.”