Simulation lab is getting out of hand

[aeris99]

We've been doing simulations in lab. The scenarios usually involve a nurse, a wife and sometimes family.

It's turning into a total mess.

The clinical groups are ganging up on each other. If the "nurse" is from the other group, the wife/family have been being loud and mean to the "nurse". Then the next group goes and there's even worse behavior in retaliation.

I thought the professors would reign it in but that's not happening. The professor from the other group has been showing her students the lab answers. And our professor sort of instigates some of the goofing around.

I feel like it is a waste of time to be trying to do sims when it turns into this.

How would you handle this?

[HouTx, BSN, MSN, EdD]

HORRIBLE. This is exactly the reason that simulation is not equivalent to actual clinical training with real patients. A recent article by National Council of State Boards of Nursing uncovered the fact that very few nurse faculty are adequately trained to teach via simulation. This teaching method is different - and requires very specific skills and knowledge for the instructor. If they can't even control the scenario, it would seem to indicate that they are not well prepared.

[nurseprnRN, BSN, RN]

It's "rein," as in, to control a horse by using the reins. But I take your point.

HouTx makes a better one-- simulations aren't just for playacting. I cringe to remember one of the first times I taught ACLS a hundred years ago and made up a scenario that was not very good, completely flummoxed the learners (bad idea), and really had no good resolution. I never did that again.

Feedback to your faculty could be a gift to next year's class. Look up some of the refs on sim learning, especially the ones that emphasize better specialized skills and how to acquire and apply them, and share it c your faculty dean. She spent a bundle of money on those gadgets and will be interested in seeing they are used to best advantage.

[aeris99]

Apologies for using the wrong term. Though I do wish my instructors would reign over our labs! 😙

I will research as you suggested and speak with the Lab professor.

We have one of the programmable simulation mannequins whose vitals and actions were changing during the lab. It would be a great experience if we were able to focus on the simulation instead of the theatrics.

[smf0903]

Well, my gut reaction to this is to say to step up and take control as you would in a hospital setting. I know the sim labs are for learning protocols and reactions to situations, but in "real life" you could have a family going crazy, a wife who is belligerent, etc. What would you do? Learning to deal with patient and family situations is also a part of the learning. Try approaching it as an opportunity to show off your therapeutic communication skills Perhaps after a couple of times reining in the "families" the instructor will take notice. Do you do post-sim conversations? If so I would make a point of saying something about the behavior, not like "wow Suzie was a real piece of work!" but rather something like "what could I do to help calm the family?" That way you're bringing up the behavior without bringing up the behavior, if you know what I mean And I agree totally about putting it in the eval at the end! Good luck! I hope it goes better!! :)

[dah doh, BSN, RN]

I don't agree with the professor giving out answers or instigating. That behavior needs to be addressed with the dean.

As to the sim scenarios that "get out of control"... we do that deliberately for the medical residents at our facility so they know how to deal with various emergency situations including "difficult families" that are up in their face or hysterical spouses. Some of our staff are pretty good actors! We try to make it fun, but the doctor is usually nervous. After the scenarios, we review & critic the Interactions. We try to give suggestions as to how they can improve so they are better equipped to deal with real situations both in the medical decision making area and in dealing with families. Hopefully, your sim lab sounds like ours!

[bellini]

HORRIBLE. This is exactly the reason that simulation is not equivalent to actual clinical training with real patients. A recent article by National Council of State Boards of Nursing uncovered the fact that very few nurse faculty are adequately trained to teach via simulation. This teaching method is different - and requires very specific skills and knowledge for the instructor. If they can't even control the scenario, it would seem to indicate that they are not well prepared.

Agree. There are entire courses that address how to properly conduct a simulation scenario. And, I will add that the instructors seem to be unaware that simulation scenarios are at least as useful for practising non-technical skills such as effective communication, leadership, etc. These students seem to be learning unprofessional behaviour, and not much else.