SIM lab - Do you like it?

peppered · Nov 20, 2010

ccstudent,

I want to thank you so much for your post, yours, and the teacher reply made me feel alot better. I am in my second semester and just did a SIMs for the first time. It was awful. First of all we get to school and our instructor tells us that another clinical group's teacher is sick so her clinical group is going to sit in and observe us all day without having to participate. This is our first time doing this, and none of the other clinical groups had any outsiders there - it was just their clinical group, their instructor and a few other professors and they said even that was stressful. None of us liked this idea, then it turns out these other students are incredibly blunt with their criticisms. After each scenario, students come in for "de-breifing" in the other room where 20 people were sitting watching you on a huge projector with 4 camera angles. they were taking notes on every mistake they could find and then the attack began. Our clinical instructor, who is the only one who has ever seen us in real world situations, was told not to talk and give feedback. So the other instrucors start pointing negative things out and then ask the guest students to chime in and they really go for the jugular. Even on a good performance. I was scheduled to go last, so i sat through this all day and just kept thinking, ok I have to hit every point that they missed, and do everything they did correctly. So i had this huge laundry list in my head and 15 minutes to do it. I should have just gone in calmly, but i got in there and tried to rush and do everything in 15 minutes. apparently i looked really overwhelmed, and "had my hands on everything in the room, yet didn't do one task to it fullest" I made a total ass of myself because its a fake situation. But for me, I am shy normally - and i have gotten over alot of things since starting school, but this was like my worst nightmare come to life - my every action being scrutinized by 20 people in a room laughing. To top it off i did an education on spirometry use to the patient and back in "de-breifing" was told by an instructor that i did it all wrong, that you blow into an incentive spirometer. I argued that she was wrong and one other student stood up for me, but others agreed with her. But she was totally wrong and she made me look like even more of a fool. So today I took our textbook to her and showed her in the book how it says to inhale into a spirometer, not blow. She apologized, but I feel like crap. I made a fool of myself infont of my collegues, and that one instructor thinks i am completely incompetent, that i never learned the basics. But she has never seen me in real life. Anyway it made me feel so bad, i don't even want to do this anymore. And in clinical I was rotating and started 7 IVs, and the GI clinic in the hospital said i should be on their IV team. But when i was put in the role of being in charge as a nurse I totally blew it and panicked. It just makes me want to get a CNA job and not go back to school. :uhoh3:

CuriousMe · Nov 20, 2010

I really enjoy my Sim experiences. Each Sim experience is the same patient, at three different times as they progress through the disease process. Our clinical group breaks in to teams of 2 or 3, we get report on the patient and then jump in. All the while, the rest of our group is watching the scenario play out from another room (the sim lab has multiple cameras and mikes around the room). At the end of each of the three segments, the team that was in the Sim comes back in to the observation room, and we all debrief together.

The Sim isn't about doing skills correctly (although, if anyone didn't follow all safety steps just as it was a patient because they're in Sim, they'd have a lot to answer for) it's a place for us to be in a situation that is generally just a couple steps past where we are clinically. Then to come back and talk about it. So, first the folks who were in the Sim talk about what decisions they think worked well, which they could have done differently and why, then the observers join in with what they may have done differently and why.

It's one of the few times, I fele we can kind of stop action, and talk about the "why's" of everything.

The other way I benefit from Sim is that since they push us just a bit further in Sim than we've been in clinicals. It's been a real confidence booster. At some point during each year, we have a benchmark simulation that we need to participate in. This is not with our clinical group, but is just us in the room (no classmates watching, just our clinical Prof and the Sim team). One of these sims had a CHF patient go into respiratory distress. To be absolutely truthful...at that point in my program, if that had happened to me in the hospital, my first action would have been to call for help! But, what I learned in that Sim is that I could at keep calm while working the problem (raise the HOB, put their O2 back on them, put the pulse ox back on them so I could see what was happening, listen to lungs, coach them to slow breathing, turn up the O2, etc) that were able to de-escalate the patient's anxiety and raise their sats.

Our sim team is fantastic though. They really work hard to introduce as much realism as possible. Additionally, while we do have a lot of whiz-bang, high tech manikins (one gives birth!) not all our Sim labs are with the high fidelity manikins. For one of our Psych rotation Sims, they hire a local actor to play a Schizophrenic adolescent. Other class members play his different family members as they go through this process of getting diagnosed and all it means. The actor was VERY good and it was a really beneficial experience.

Sorry, this got longer than I expected :)