Research – Completed Projects

Effect Of Collaborative Simulation Training For Pediatric Residents And Nursing Students On Team Work Skills In Patient Care

Researchers

Samrat Das, MD, Jessica Doolen, PhD, APRN-C, CNE, Shona Rue, MSN, RN, Necole Leland MSN, RN, Gigi Guizado de Nathan, BA

Abstract

In academia and clinical practice physicians and nurses work independently of each other. However, in professional practice they are expected to demonstrate teamwork skills. The literature suggests that collaboration between physicians and nurses can be linked to decreases in morbidity and mortality, reduced healthcare costs, and medical errors. Education on teamwork principles and skills of teamwork should be an important topic in the training of resident physicians and nursing students. The literature suggests that utilizing HFS and SP encounters is an effective teaching strategy for interdisciplinary education.

We hypothesize that the introduction of inter-professional education using HFS scenarios and standardized patient encounters with nursing students and pediatric resident-physicians result in improved teamwork skills resulting in improved performance of the health care team.

Specific Aims

  1. To determine whether inter-professional education on teamwork principles and skills with HFS scenarios and SP encounters has an impact on teamwork skills amongst nursing students and resident physicians. This will be tested by using a pre and post intervention questionnaire and completed by nursing students and resident physicians.
  2. To determine whether inter-professional education on teamwork principles and skills with HFS scenarios and SP encounters has an impact on the performance of health care team as determined by Standardized Patient Parents using a questionnaire developed by researchers.

Published

Journal of Investigative Medicine. January 2015;63(1):366 (abstract)

Presented

Western Society for Pediatric Research Annual Scientific Meeting; January 29-31,2015, Carmel, CA.


Use of Standardized Patient and High Fidelity Pediatric Simulation to Test the Effectiveness of Collaborative Simulation for Inter professional Education
Researchers

Samrat U Das, Jessica Doolen, Gigi Guizado De Nathan, Shona Rue, Chad Cross.

Journals

Journal of Inter professional Care, August 2015 (submitted)


Program Development and Evaluation of the Concierge Model of Simulation

Researchers

Coffman, S., Doolen, J., Llasus, L.

Journals

(2015). Online Journal of Nursing Informatics, 19 (2).  Available at www.himss.org/ojni


“Hearing Voices” at the Clinical Simulation Center of Las Vegas

Researchers

Amy Chaffin, PhD – Psychiatric Nursing Faculty – Nevada State College

Specific Aims

  1. To provide students with a real experience of “Hearing Voices” to better understand and empathize with patients who hear voices.


Simulating Teamwork and Observation for Procedural Safety (STOPS)

Researchers

Jessica Doolen PhD, APRN-C, CNE, Matthew Schreiber MD, Hiren Patel MD, Kartika Shetty MD, Kevin Gulliver MSN, RN, Rhigel Tan DNP, APRN-C

Abstract

A hallmark of safe systems within a hospital is development of teamwork competency. This includes organizational aspects such as 1) mutual performance monitoring, 2) supporting behavior, 3) effective leadership, 4) task-related assertiveness, 5) conflict resolution, and 6) closed-loop communication. The insertion of a central venous catheter (CVC) is a practice where implementation of safety strategies has had measureable effects on patient outcomes. Initiatives like the Comprehensive Unit based Safety Program (CUSP) for the prevention of central line associated blood stream infection (CLABSI) have focused on teamwork and simple, validated, effective measures like implementation of checklists. Effective execution of checklists relies on collaborative efforts from both the operator and observer on the CVC insertion team. To date, there is little evidence that the efficacy of the observer can be optimized through structured training.

We hypothesize that high-fidelity simulation of central line insertion focused on checklist utilization and team dynamics will, promote safety culture, improve physician and nursing competency for CVC insertion, and reduce the incidence of uncorrected safety risks (i.e. completed insertion of CVC without resolution of breaks in sterility or excessive venipuncture attempts). Our study includes:

  1. Pre-testing of operator and observer knowledge using a sample of questions from multiple Agency for Healthcare Research and Quality (AHRQ) surveys
  2. Didactic multispecialty sessions with evidence based education on CVC safety bundles
  3. High-fidelity simulation of CVC insertion assessing overall competency in CVC insertion, observation, teamwork, and conflict resolution
  4. Post-educational assessment of safety attitudes and procedural competency, and
  5. Follow-up testing to assess knowledge retention.

Specific Aims

  1. To test the hypothesis that a standardized training program of simulated central venous catheter (CVC) insertion with enhanced education regarding checklist utilization will:
    1.  Enhance team dynamics, improve physician and nursing competency for CVC insertion,  and reduce the incidence of uncorrected safety risks
  2. Assess the feasibility of developing an intensive training program for the development of “observation competency” in nurses and enhanced CVC insertion safety among physicians with plans to expand the project to a more extensive group (i.e. nurses at all stages of experience and practicing physicians who participate in central venous catheter insertion).

The goals of this study are to provide pilot feasibility data of an intensive training program for the development of “observation competency” and culture of safety enrichment in nurses and physicians as facilitated by a team approach to CVC insertion. Completion of this project will provide the basis to expand the project throughout a hospital system with incorporation of all medical and nursing staff.

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Communication Simulation Flip
Presented at Elsevier Faculty Development Conference, Las Vegas Jan 3-5, 2014

Researchers

Beverly Canfield, MSN, RN and Roxann Green, MSN, RN

Download the Poster


Objective evaluation of skill acquisition in novice microsurgeons
Researchers

John Brosious, Shawn Tsuda, John Menezes, Richard Baynosa, Linda Stephenson, Adnan Mohsin Wei Z Wang, William Zamboni

Journals

Journal of Reconstructive Microsurgery, Poser presentation/ ASPS


Program Evaluation of Simulation Using the Kirkpatrick Method

Presented at Elsevier Faculty Development Conference, Las Vegas Jan 3-5, 2014

Researchers

Dr. Sherrilyn Coffman, EdD, RN, Interim Dean and Professor at Nevada State College

While high fidelity simulation (HFS) is a widely accepted learning strategy in nursing education, there is little research on the best way to implement simulation programs. When our School of Nursing implemented a new simulation program, the Concierge Model, we also developed a plan for program evaluation. Our goal was to evaluate how simulation contributed to student learning and how faculty, students, and staff perceived its effectiveness.

Background: The common definition of concierge is a “doorkeeper,” or a “staff person who uses special resources to control operations.” In our simulation laboratory, a concierge is a faculty member who is trained in simulation methodology and whose role is twofold–to facilitate and to debrief undergraduate BSN students on their clinical simulation day.

Method: We selected the Kirkpatrick method as the basis for program evaluation. This method is well established as the standard for training program evaluation in business, industry, education and government (Kirkpatrick & Kirkpatrick, 2007).

Results: To date, we have evaluated Levels 1 (reaction) and 2 (learning). Kirkpatrick Level 1 evaluation consisted of analysis of questionnaires administered to students, faculty, concierges, and simulation technicians. Descriptive statistics were used to analyze quantitative rating scales. Simple content analysis summarized qualitative open-ended questions. Level 1 evaluation revealed overall positive ratings by students, faculty, concierges and staff. Comments provided justification for re-aligning simulation topics with course content to improve students’ experience.

Kirkpatrick Level 2 evaluation involved a quasi-experimental study. Three faculty reviewed the video recordings of HFS scenarios to determine if student performance improved from session one to session two, as the scenario was repeated. Researchers had expected student performance in session two would reflect learning from session one. Although this hypothesis was not supported, there were significant differences in two sub-scores related to medication administration and patient identification.

Conclusions: We have used program evaluation data to identify gaps in student learning, improve the way simulations are scheduled, and improve the implementation of the Concierge Model. Satisfaction with the new simulation program and positive student learning outcomes are the result.

Reference

Kirkpatrick, D. L., & Kirkpatrick, J. D. (2007). Implementing the four levels. San Francisco, CA: Berrett-Koehler Publishers.


Coffman, S. (2012). From static lab to simulation lab: Students reflect on their learning. Clinical Simulation in Nursing, 8(8), e335-340.
Researchers

Dr. Sherrilyn Coffman, EdD, RN, Interim Dean and Professor at Nevada State College

Conclusion

Dr. Sherrilyn Coffman, Interim Dean and Professor at Nevada State College, used the phenomenological method to study students’ perceptions of learning in different skills lab settings. She compared students’ reflections on learning after (1) a static lab using low-fidelity task trainers and (2) a simulation lab incorporating high-fidelity manikins. Students’ comments indicated a progression of learning from the “what, when, how and why” of psychomotor skills in the static lab to more complex concepts such as “assessing, prioritizing, relating information, and formulating therapeutic interventions” in the simulation lab. Findings confirm the added value that simulation contributes to learning in the skills lab setting. The study is published in the October 2012 edition of Clinical Simulation in Nursing.


An Interdisciplinary Approach to Learning and the Development of Communication/Collaboration Skills Using High Fidelity Pediatric Simulations
Researchers

Daniel Heintz: University of Nevada School of Medicine
Lori Candela, Alan Jauregui, Jessica Doolen: University of Nevada, Las Vegas School of Nursing

Conclusion

  1. Nursing students demonstrated higher perceived collaborative practice at posttest.
  2. Nursing and medical students showed stronger agreement and perceived importance of active learning, diverse ways of learning, and high expectations at posttest.
  3. With respect to simulation design, both groups of students showed greater agreement and perceived importance of simulation design at posttest.
  4. Students also demonstrated higher perceived learning and self-confidence in learning at posttest.

Measurement of Acquisition of Crisis Resource Management Skills Using Simulated Emergency Codes
Researchers

Cynthia Herrick, MD, Jessica Doolen, MSN, RN, Michael Nasiak, MD, Carolyn
Sue Witt, PhD, RN, Kevin Gulliver, MSN, RN, Aditi Singh, MD, and Sandhya Wahi, MD, MPH

Conclusion

  1. Interdisciplinary simulation enhances participants perception of team work.
  2. Participation in interdisciplinary simulation positively impacts participants attitudes toward collaborative education.
  3. Participant perception of CRM performance was significantly improved following the second simulation experience.
  4. Increased frequency of collaborative education could continue to build interprofessional relationships.

University of Nevada School of Medicine – Department of Emergency Medicine

Research and Scholarly Activities

Activity Title – Description Local/

Regional/

National

External Participants Total # Learners
3/18/2012 Society for Academic Emergency Medicine Annual Meeting – Resuscitation Skills workshop for the EM Physician (Pre-Conference Workshop) National National Audience 45
5/30/2012 Emergency Department Management of the Unstable Overdose Patient Local (EM) 24
9/12/2012 Bedside Managemenet of Unastable Tachyarrhythmias Local (EM) 26
1/30/2013 Eclampsia and other High Risk Emergent Deliveries Local (EM) 28
2/12/2013 American Academy of Emergency Medicine National Meeting – Pediatric Emergency Department Simulation: Critical skills from birth to the school bus! (Pre-Conference Workshop) National National Audience 40
3/20/2013 Neonatal Sepsis and Resuscitation – EM Simulation Course Local (EM) 27
5/22/2013 Management of the Traumatic Airway – EM Simulation Course Local (EM) 28
9/4/2013 Management of the Crashing Asthmatic Patient – EM Simulation Course Local (EM) 30
11/6/2013 Transfer of Care of the Pre-Hospital Patient – EM/EMS Simulation Course Regional LVFR 40
3/19/2014 Resuscitation of the Post-Arrest Patient – EM Simulation Course Local (EM) 30
5/14/2014 Physicians Orders for Life Sustaining Treatment (POLST): End of life care in the Emergency Department – EM Simulation Course Local (EM) 30
9/10/2014 Interfacility Transfer of the Post CVA and Post Cardiac Arrest Patient – EM Simulation Course Local (EM) 28
11/5/2014 Ebola Virus Disease Screening and Management – Simulation Course and Decontamination Workshop Regional USAF 41
3/25/2015 Recognition and Management of Occult Trauma in Severly injured patients – EM Simulation Course Local (EM) 30
5/13/2015 Doctor to Bed 5 – Core Resuscitation Skills for the EM Intern – EM Simulation Course Local (EM) 12
5/27/2015 Management of the Unstable Anticoagulated Patient and the Novel Anticoagulants – EM Simulation Course Local (EM) 30
7/8/2015 Advanced Airway Bootcamp – A Primer for the New Emergency Medicine Resident Local (EM) 12
*Each Simulation Workshop has a customized SSOT (Standardized Simulation Obervation Tool) that faculty complete for participating residents.
* Each EM Simulation Workshop has a resident evaluation process, where the educational activity is evaluated by Learners for feedback regarding the simulation exercise.

University of Nevada School of Medicine – Department of Surgery

Research and Scholarly Activities

A Checklist Improves Troubleshooting of Common Endoscopic Malfunctions by Surgical Residents in a Simulated Environment

Researchers

Kevin Grimes, Jenny Lam, Adnan Mohsin, Shawn Tsuda

Presented

Poster presentation/ SAGES


Can Residents be Trained to Perform Diagnostic ERCP During Their Training

Researchers

Matthew Johnson, Maris Jones, Cory Richardson, Charles R St Hill, Mariangela Rivera, Adnan Mohsin, Nathan Ozobia

Presented

Poster presentation/ ACS/SAGES


Augmented Reality Telementoring (ART) platform a randomized controlled trial to assess the efficacy of a new surgical education technology

Researchers

Angelina Vera, Michael Russo, Adnan Mohsin, Shawn Tsuda

Presented

Poster presentation/ Sages

Journals

Published Surgical Endoscopy


Portable self-practice laparoscopic box trainers underutilized by surgical trainees

Researchers

Michael Russo, Shawn Tsuda, Adnan Mohsin

Presented

Poster/ SAGES


The effect of a mandatory portable, self practice laparoscopic box trainer curriculum on home skills training and resident skills acquisition

Researchers

Michael Russo, Ryan Jones, Adnan Mohsin, Shawn Tsuda

Presented

Poster/SAGES


Randomized controlled trial of Laparoscopic partial tasks with a reversed camera view versus Surgical trainees in “warm up”

Researchers

Samaan Sattarzadeh, Adnan Mohsin, Shawn Tsuda

Presented

Poster/ Oral Presentation/ SAGES


Can Minimally Invasive Trauma be Taught?

Researchers

Tim Browder, Heidi Ryan, Shawn Tsuda