Challenges

associated with

bringing high

fidelity

simulation to

rural campusesAmber Williams DNP, APRN, FNP

Ann Scott MSN, CCRN, CNE

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Disclosure slide

Ann Scott – University of South Carolina

Amber Williams – University of South Carolina

There is no conflict of interest and no sponsorship or commercial support was given to either author for the presentation today

Objectives

The learner will be able to name one challenge faced by rural campuses as they integrate simulation into their curriculum.

The learner will be able to name at least one resource used as a strategy for integrating a simulation lab on a rural campus.

Benefits of Simulation• Connects theory to practice

• Uses technology to mimic the

workplace

• Improves clinical competency

without risking patient safety

• High risk / low volume events

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• Faculty can select and tailor the

experience to specific learning needs

• Allows faculty to assess clinical reasoning

and prioritization

• Students can make mistakes and learn

from them

• Experiential learning in a safe

environment

Why do we need simulation at

USC Lancaster?

Didactic content and clinical experiences were not in alignment

Required in each clinical course

Rural areas

Limited patient care experiences

Limited specialty units

Limited high level acuity experiences

Limited access to a simulation lab

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Rural areas

44% of US hospitals in rural areas

Fewer nurses

Fewer nurses with higher degrees

Lower salaries

Generalists

Less access to resources

Technology

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Challenges

Kotter’s change model 1. raise urgency

2. build the guiding team

3. create a vision

4. communicate the vision

5. empower action

6. celebrate short-term wins

7. leverage wins to stimulate more

8. make it part of the culture

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Transformational Leadership

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Charismatic

Trustworthy

Inspires others

Empowers team

Creates vision

Effective leadership could establish

direction, align, and energize people

to overcome major political,

bureaucratic, and resource barriers

to produce change

(Kotter, 1996)

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1, 2, 3, 4…

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Need it now!

Leadership

support

Build a team

Create a vision of

‘what can be’

Champion the

vision

Building a guiding team

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Champion

Deans

Development

Experts

Faculty

Students

Without a good vision, a clever

strategy or a logical plan can rarely

inspire the kind of action needed to

produce major change

(Kotter, 1996, p71)

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A more detailed plan…

Where can we get funding?

Who will we ask?

Who will apply?

When can we apply?

What will we ask for?

What is the total cost?

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And more details…

Consultations

Design / specs

Travel and visits to simulation labs

Cost estimates

Engineers

Vendors

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Basic Logic model

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Logic Model: Simulation Plan

Regional:

-physical

space

-Money for

renovation or

building -money for

equipment

-IT support

Main:

-money for

simulators &

equipment

-simulation

experience

-simulation

scenarios

-IT support -consortium

Assess partner involvement &

new partnerships

-stakeholders

Administration

-simulation lab

director

-development

officers

-community

partners

-program director

-architect /

engineer

Seek funding

options

Inputs Outputs

Activities Participation

Outcomes

Short Medium Long

Determine

optimal

simulation space

Acquire simulators &

equipment

strengthened

partnerships with

community

Strengthened

relationship with partners

Assumptions

Simulation will enhance learning External Factors

Opportunities for

simulation

partnerships with other disciplines

and community

More research

data from

simulation

Strengthened

communities b/c

of:

-more competent

nurses

improved health

care

- improved health

outcomes

-a better educated

workforce

-strengthened

position within the

state

More nurses

comfortable with

simulated

learning and

technology

Nurses capable

of working with

complex

technology in

complex

situations

More frequent &

convenient

access to

simulation for

distance students

lab coordinator

Determine

timeline

Simulation Lab Timeline

2007 2011 2012 2013 2014 2015

Completion August 2015

University approval, bid process, construction begins

Hired Architects to design lab

Ordered simulators

Ongoing support approvedReceive

d grant funding

Funding applications began

Consultations with potential partners, supporters, funders

Vision for simulation lab on rural campus

BSN program started in rural area

Space, consultation, estimates presented to stakeholders

Stakeholders changed on both campuses

Built team & timeline

More detailed plan

5, 6, 7, 8

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Team executes

plan

Celebrate wins!!

Wins generate

more wins

Follow through /

anchor change

into the culture

Before….

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ReferencesHandley, R., & Dodge, N. (2013). Can

simulated practice learning improve

clinical competence? British Journal

of Nursing, 22(9), 529-535.

Kotter, J. (1996). Leading Change. Boston:

Harvard Business Review Press.

Powell, F. A. (2013). Using simulation training

in a cardiothoracic intensive care unit.

AORN Journal, 97(6). 739-743. doi:

0.1016/j.aorn.2013.03.011

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