Tuesday, June 7, 2011

Lab Rat: The Final Episode - Freed from the Cage


This quarter started out quietly enough with the usual overload of teaching that we nursing faculty have been dealing with since we were hired last fall. Since my partner and I were unable to schedule a time and date to demonstrate our new Sim Man 3G during the winter quarter, we prepared for and demonstrated him early in this, the spring quarter. I must admit, even though I was and remain a bit of a skeptic about the use of simulated mannequins for nursing students, and the cost is staggering at $75,000 (!), he IS an amazing piece of technology.

You can dress them up - but you can't take them out!
We began by demonstrating our low-fidelity mannequins, which are capable of basic functions – they can have different breath sounds and respiratory rates, heart sounds and rhythms, blood pressures, they say certain phrases and can be male or female. The students can use them for intravenous and injection practice and for basic skill scenarios. There are four of them in our nursing skills lab. We allowed our fellow students to listen with stethoscopes and most of them appeared impressed with this first part of the demonstration.
The intravenous (IV) catheter insertion simulator was next on our demonstration agenda. 

As the one most familiar with the device, I performed this demonstration for the group. Now, this device, while it is fun and challenging, seems more like a video game with a joy stick than actually useful as a simulation tool for nursing students to learn how to insert an IV catheter. When searching for any research papers on the IV simulator, however, the research does seem to show, at least in one study, that simulation training did enhance the IV insertions skills of novice nurses significantly. Hmmm. Maybe not so useless after all. However, the study focused on inexperienced nurses and did not take into account crabby old nurses used to performing nursing skills the “old-fashioned” way. For me, the jury is still out on that device.
At any rate, the class seemed to also be impressed with the IV simulator, and then it was on to the mannequin affectionately known as “Mr. Big” – the SimMan 3G. He was rolled out from behind his curtain and lay there quietly. I was at the controls - the computer on the desk, and Sherleena was the “front man”. Or person, or whatever is the politically correct way to say this. She was the ringmaster – er, mistress or – I give up. All the students gathered around, and suddenly, there was a gasp as his eyes blinked and he began to breathe. We lead the students through the same exercises that we take our nursing students through – as the mannequin talked through his scenario, the students responded by taking pulses, listening to lung sounds, watching the oxygen saturation and pulse rates on the patient monitor and finally performing a head-tilt chin-thrust and using an Ambu bag to help Mr. Big breathe and then when his heart stopped, performing CPR on the mannequin. 







The students could actually see on the monitor how effective their chest compressions were and whether or not they “saved” Mr. Big so he could live to amaze and delight another day. And by golly, they did!
The SimMan 3G does have some good research to show that he can be effective teaching tool , however, faculty need to have time to plan and develop scenario s carefully and also allow adequate time for the simulation itself as well as time for debriefing. Time is, unfortunately, a luxury that we in the nursing skills lab have had virtually none of since we began this program. More on that later.
At any rate, the demonstration, I think, was a success, and actually the more I use the SimMan 3G, the more I can envision his value as a teaching tool. I am even not as shocked at his price tag as I was initially, considering how technologically advanced he truly is. He can bleed in different ways, urinate, talk, have seizures and is extremely programmable to different vital sign crisis. We really hope to have the time utilize him at some point. Perhaps when hell freezes over! Oh well.
 
Then we turned out attention to the SmartBoard!! Wooo Hoo!


The first task was to get it calibrated and working properly. After reading the manual, something I am loathe to do, I tried the different suggestions and finally wound up calling tech support. The first thing to do was find the serial number to register the board, which I did after searching the written materials that came with the board, and finding it actually on the side of the board. After that, calibrating was simple and I got our board working well. Then the fun of learning how very useful it will be for instructors and for students began – it is very interactive and truly fun to use. It can be a touch-screen for the internet, just like a computer screen, and also with the Smartboard’s own Notebook feature, it is similar to MS Office, in that you can create and save documents, create PowerPoints with links to websites and videos. There are many different drawing tools and creative tools as well to highlight the information on the screen. And students can easily get involved – students of all ages, really, can become captivated by the things that the board can do, and it is a nice change from sitting in their seats listening to someone else talk. They can easily create their own interactive presentations and become involved in learning. It is much more useful than I realized and am glad to have had the opportunity - mandated by the class, so no one could accuse me of playing!
We actually had to demonstrate the board to a class conducted by professor from the College of Education. .  Sherleena prepared a brief overview of the capabilities of the board, and I developed a Powerpoint that utilized the capabilities in an actual presentation to the class. We also developed a brief pre- and post-survey, and the results, although they were not submitted to statistical evaluation, were quite positive. Success! A very enjoyable one. The Smartboard in our skills lab will definitely be utilized – and much sooner than the SimMan 3G.
 Check it out!SmartBoard in action - set to some jazzy tune - dorky but informational!


And so we end. The lab rat is freed from her cage, and leaving is actually a bit sad. I do enjoy technology very much – my house is steeped in it, my husband uses a lot of technology for his livelihood and my son works for Apple and they both live and breathe it. I feel a bit like that is a cage for me, and while I will always love and incorporate it into everything I do, perhaps I just will not actually breathe it in and out all day!
Thank you Dr. Franklin, and who knows? Doctoral students, I am told, switch majors a lot, and anything can happen. I will certainly see you again!



Friday, February 4, 2011

Week 5 - trying to figure it all out!

Click on the monkey for action!
Sherleena and I met this week with Dr. Franklin to figure out how to now pull all the threads of information that we've gathered into some semblance of order. Now the work of our course begins, creating manuals for lab - student, faculty and equipment!

We also began actually using the mannequins in lab for heart sounds and pulses! The students loved it and it was a good practice for learning about murmurs, rubs and thrills - and it was "thrilling"!

Saturday, January 29, 2011

Back in our own skills lab

A lot of thoughts after that visit to the amazing Sim skills lab in Cincinnati - one of the most interesting and concerning things to me was the lack of culture and ethnicity among the mannequins. There was one African-American mannequin. One. Dare I say "token"? When I asked how they might develop a scenario with a, say, Hispanic theme, the answer was, well they could dress the mannequin like a Hispanic! Really? Does that mean in a serape and a sombrero? Can we say stereotype? One of the most important areas in nursing is being sensitive to culture. However, no skills lab that I have yet seen, save for this one lone mannequin of color, have any culturally diverse mannequins. Yet more than 50% of the patients that nurses see identify as "other". They are not Caucasian. It seems we pay lip service to culture, while in our skills labs we see only whites. We say we are developing realistic scenarios with these new, incredibly expensive mannequins, but again, it's a whites only club. I call on the schools of nursing and the Sim manufacturers out there to change THIS scenario. This is not real life, and we need to reflect reality truthfully in our skills labs.


There. I'm getting off my soapbox for now.






Back in our skills lab, Sherleena decided we need to at least give our Sims a little more personality! Teri, Sherleena and I along with some of the students had a great time making them "real"! Check it out:










Applying eyelashes and makeup




Whew. That was tough, we need a rest.

Visit to a Sim Lab!

Last week, Sherleena and I went to Good Samaritan College of Nursing and Health Science in Cincinnati for a meeting of the Tri-State Nursing Skills Lab Consortium. This is a group of nurses from the three states (I have no idea which three - except for Ohio) who get together and share ideas and "recipes"(more about that later) for their Sim lab mannequins. The sales rep from Laerdal, the premier maker of these Sim people, was there and gave a demonstration of all the things the 3G Sim person can do. OU just purchased one of these guys for our skills lab and we wanted to see how he/she performed. Boy, was it impressive! I took a quick video with my iPhone - it's not very good, but if you loaok closely, you can see his eyes blink occasionally, and he's breathing. He also can bleed - arterial or venous - and he can have 2 kinds of seizures - tonic or tonic-clonic - his lips can turn blue, his tongue can swell, he can talk, scream, moan, puke, urinate, defecate, have edematous limbs, has all the pulses you and I do, he can cry real tears, have many kinds of heart rhythms, and on and on.... it's a bit weird and a lot cool. And then we took a tour of their skills lab.... Holy Toledo....er, Cincinnati! We had to pick up our chins from the floor. It is a lab to envy! Here are the pictures:

EKG monitor for the 3G mannequin

Showing us how he bleeds!

Sim control station

This is their HUGE skills lab - about 20 mannequins in electric beds, fully equipped.


Another view


Child mannequin

With 02 mask

Sherleena checking it out!

The one mannequin of color....more about that later

Bedside table and suction equipment

Headboard with gloved and sharps container

Using an old nylon - a  tattoo "sleeve" was made for this mannequin!

To practice tracheostomy care


They even have a storage room...

with a washer and dryer!

Monday, January 10, 2011

SimMan 3G

The New Man in town: or in the nursing lab! Awesome! Now, to learn how to take care of him... conference on Friday - we'll let you know what we learn!

Sunday, November 14, 2010

Setting up the SIM lab













So, for the past 3 weeks, Sherleena and I have been busily setting up the computers in the new nursing lab, and also setting up and activating a SMART board - a projector that acts like a computer touch screen for use in the lab, and finally, putting together and operationalizing (love that word - sounds so CIA) 4 adult SIM mannequins, one child and one infant mannequin. When turned on, they have heart beats, blood pressures, bowel sounds and make cool sounds - live vomiting! How fun is that? I think we must guard them carefully around Halloween. IV's can be started in their arms, injections into various sites on their bodies, and orifices can be explored and tubes inserted. We've taken several groups of nursing students on tours and they are excited about their lab and using the mannequins.


The hardest part for me is not calling these mannequins by the "D" word - D....mmy. This is not politically correct, and hurts their feelings. Sorry, guys.



These mannequins can be programmed for nursing scenarios so that the students can actually have as close to real patient assessments as possible before we turn them loose on the public.

Midterms

Weirdly quiet in here... only two people in the lab, no issues to solve. Hmm. So, cleaned the desktops, looked at the keyboards and EWWWWWWW! A word that I used to use back in junior high came to mind...."GROTTY" which I think was a word for grotesque or gross or ... anyway, disgusting. Stuff stuck to some of the keys. I don't want to know what it is or was. Just get me outta here....