Ebbs and flows in the need for nurses and the number of students entering nursing programs are common, but the COVID-19 pandemic caused a more severe nursing shortage than has been previously experienced. At the height of the pandemic, nursing schools suspended in-person classes and were essentially closed. At the same time, many experienced nurses chose early retirement. These factors came together to create the global nursing shortage we are currently facing.
Simulation, the use of mannequins that emulate either a specific body part or a whole patient for medical education, can help alleviate this nursing shortage by enhancing the learning experience of nursing students. The use of sophisticated patient simulators dramatically improves the students’ performance both in practical exercises and on certification exams.
The technology also provides an advantage to nursing schools competing for students:
– It shows that schools are at the forefront of a technological revolution in healthcare education.
– It demonstrates that the school values its students’ education enough to invest in premier technology.
– The enhanced performance of the students on certification exams attracts more students to the program.
– Improved learning leads to improved graduation rates.
Simulators can be used to teach specific skills as well as to help develop a nursing student’s critical thinking skills. For example, simulators are used for training nurses to administer intramuscular injections, allowing them to learn this vital skill without having to practice on a patient. More advanced simulators are used to allow students to practice scenarios they will encounter in more dynamic clinical situations. For instance, a realistic simulator can verbally converse with the student and present with a set of symptoms which the student would then have to quickly diagnose and treat, giving the student a chance to use critical thinking skills in a high-stress learning scenario so they will be able to react quickly and capably when they are patient-facing.
Today’s most advanced simulators can even incorporate mixed reality, using a digital or a simulated world in conjunction with a high-fidelity simulator. Combining a mixed reality headset, such as the Microsoft HoloLens 2, with a simulator, allows educators to merge digital educational content with the physical simulation exercise and help students bridge the gap between clinical theory and real practice.
An example of this is a simulator used to train both students and professionals in obstetrics, a field in which infrequent complications can be deadly to mothers and babies during childbirth. Mixed reality technology can prepare obstetric professionals to quickly and properly address conditions such as shoulder dystocia, a complication where the fetus’s shoulder gets caught on the mother’s pubic bone during childbirth. Shoulder dystocia is a high-risk complication. The baby is at risk for oxygen deprivation in the final moments of childbirth and the delivery room staff has a very tight timeframe in which to maneuver the infant around the mother’s pelvic bone. There are specific procedures, including the McRoberts maneuver, where the mother’s legs are moved into a specific position, to free the fetus’s shoulder.
With a live patient, the provider must make an educated guess about the position necessary for a healthy, successful delivery. However, a training system called Obstetric MR, in which the learner wears a Microsoft HoloLens 2 headset which makes the exact position of the fetus and pelvis visible, can provide students with the experience to deal with this complication. Using mixed reality, the user can see the location of the baby’s shoulder, while the patient simulator mimics the physical condition and orientation of the mother.
When the legs of the simulator are moved into the proper position, the pelvis, as viewed through the HoloLens, changes color to indicate that the baby’s shoulder is freed and can be safely delivered. The user has both visual and tactile feedback on how to position the mother, teaching them how to properly carry out this procedure when they encounter it in the clinic.
Using an alternative procedure, the provider presses just above the mother’s pubic bone to push the infant’s shoulder downward into the birth canal. In traditional learning environments, the practitioner must guess how much pressure to exert without causing injury. But with mixed reality technology, the Obstetric MR simulation program indicates when the learner has used the right amount of pressure that is needed to complete the delivery.
In addition to nursing schools, simulation training is also beneficial in cross-training experienced and skilled healthcare providers. This was common during the height of the pandemic when nurses of different disciplines were cross-trained in critical care.
An investment in simulation pays dividends to the learner, the educator, and the health system in general. As a society, we place a high value on training and education. We see this in aviation, for example, where pilots not only train early in their careers but continue to train on flight simulators. Athletes train throughout their careers as well, allowing them to remain extremely proficient.
Continuing education is vital in all disciplines, and it is even more important in healthcare because lives depend on the competency of medical professionals. In an article published by researchers at Harvard Medical School1, the substantial and quantifiable impact on outcomes when practitioners are trained using simulations was measured. Researchers found that more babies were delivered safely due to training with sophisticated patient simulators and that this reduction in harm to mothers and infants also resulted in a reduction in malpractice claims.
Simulation training is becoming increasingly common in medical education, and students, educational facilities, and, ultimately, patients, benefit from this important advanced technology.
About James Archetto
James Archetto is Vice President at Gaumard Scientific. He received a BS degree in biology from the University of Vermont and his MBC in marketing and international finance from the University of Rhode Island. He has more than 25 years of medical device, international business, and medical research expertise. Mr. Archetto currently leads Gaumard’s domestic sales team ensuring that each customer received the optimal simulation solution and best support in the industry.
1 Schaffer, A. C., Babayan, A., Einbinder, J. S., Sato, L., & Gardner, R. (2021). Association of simulation training with rates of medical malpractice claims among obstetrician–gynecologists. Obstetrics & Gynecology, 137(2), 246-252.