When you think of teamwork in a simulation, you think teamwork among students, right? In our 48- and 72-hour continuous integrated sims, there are many opportunities for teamwork and interprofessioinal collaboration. Students collaborate with actual providers, members of the healthcare team, and each other, for great experiences to prepare them for the real world. But, there's another important aspect of teamwork and collaboration in our integrated sims that is not often discussed. Teamwork among faculty.
Typically, for a 15-20 minute sim utilizing a high-fidelity human patient simulator or standardized patients, faculty use pre-developed simulations purchased by the nursing program or ones developed by individual faculty. Those work well for single issue simulations (e.g., pulmonary embolism, etc.). But, it takes a team to design and implement a 48 or 72-hour sim. While our expert team can develop evidence-based scenarios and implement them at the request of faculty in nursing programs, we prefer that we teach faculty this process. Here's why.
The process of designing, implementing, and evaluating a long, integrated sim has a tremendous positive impact on the faculty team. Once objectives for the integrated sim have been decided on, the faculty team begins scenario development. Our process is much more complex than a typical scenario because it is a multi-patient scenario, and it has a long, extended timeline. The final product when executed looks and feels just like a patient care unit in a hospital. It is a complex, dynamic document. Because there are many patients in the scenario, both for individual students to have their own multi-patient assignment, and for patients to be admitted, discharged, transferred, etc., individual faculty often have their own individual patients that they begin researching after the team has decided on patients, events, timelines, etc. But this is not a significant part of the process. When the faculty team comes together to begin the integrated script, they must work together to decide how and when patient care events and issues occur and how the timeline proceeds. One cannot just put in individual patients and expect to have an integrated timeline. The timeline of a multi-patient assignment is carefully crafted for each student to provide the best challenging experience at the right acuity level for this level of student.
This is where it gets interesting. Because a faculty team develops the scenario, the team brings the richness of different backgrounds, clinical experiences, and specialties to the process. So, as a med-surg nurse, I have experiences I bring to the patients in our scenario, maybe it's neuro, ortho, CV, or cancer. Other faculty members have similar or other expertise and experience to the sim. We all contribute. Perhaps a faculty member with mental health background suggests that we script in depression for one of our med-surg patients. Someone else suggests that there is a family issue to consider. Someone else says... "if the student doesn't turn this patient, he will develop a pressure injury." Another person says, "this patient has been losing weight because..." And so on. Faculty working together develop a much richer experience for the students. Providers participate and help with orders and other aspects of the medical care. Interprofessional team members such as PT faculty also add that discipline's perspective. The possibilities are endless for a creative team.
As we develop this scenario, we search for the most current evidence-base for the nursing and medical care for these patients, again based on backgrounds and expertise. So, this becomes a learning experience for the faculty team, not just the students who will experience this great product. Each aspect of every patient's care must be accurate, up to date, and evidence based. Everyone contributes and learns from that experience.
How is this accomplished in a busy faculty's schedule? Usually, faculty decide to meet one afternoon a week for several weeks leading up to the actual sim. One time, we met together for most of a weekend, and concluded with a multi-patient, long, integrated scenario. We now often meet on Zoom, at a mutually identified time, day or evening.
Once the team gets to the execution of the sim, each team member knows the scenario inside and out, has the expertise to conduct the sim, to debrief students, and to debrief with the team once the sim concludes. The benefits of designing an integrated sim extend well beyond the students' simulation experience. The benefits of a strong faculty team go on long after a major sim is concluded.