Medical surgical nursing students have cared for a variety of patients and have been beta testing Lippincott’s new Docucare Electronic Health Record.

"Marilyn Hughes" (aka 3G) awaits the arrival of nursing students.

Students taking a health education course were given teaching assignments. Community members were kind enough to volunteer to be the client who would benefit from working with a nurse educator.

An actor from the community volunteered to help nursing students practice their teaching skills.

Nursing students taking an assessment course were recorded as they performed a head to toe assessment. The recordings were placed on Blackboard (UNE’s Web-based Learning Platform) so that the students could review and evaluate their performance.

Nursing students in the simulation labs demonstrating their head-to-toe assessment skills.

Sophomore nursing students were introduced to simulation. Each student had the chance to feel pulses, count respirations and take the blood pressure of one of two mannequins (SimMan Classic or Gaumard’s Susie).

Susie joined SimMan Classic on the Biddeford campus to meet with sophomore nursing students.

Nurse Anesthesia students continued to practice induction and emergence during open practice lab time and designated simlab skills labs.

MSNA students practice "emergence" with their post-op patient.

Physical Therapy student teams practiced working with a client with mobility issues. Also pictured below is a team of PT students who came to the sim lab to take photos for a Physical Therapy skills textbook.

Physical Therapy student photo shoot.

PT faculty member plays the role of a client so students can practice their skills.

Nursing students are introduced to Hal.

MSNA students spend time with Hal practicing induction.

Susie is invited to COM.

Pharmacy students assess Hal and 3G's lung sounds.

Newborn Hal meets nursing faculty and participates in Maternity class simulations.

Nursing students with Pediatric Hal

PA student, with Ryan, practicing on her own time.

You can see there has been a lot going on around here but the activity is not all focused around the mannequins. Our volunteer actors (thanks to UNE staff, faculty and students from McAuley High School) were busy working with social work students participating in simulations that provided opportunities to practice counseling a “family” in crisis.

Don’t forget to check out our facebook page for week by week updates. See you next time!

Our new family: Suzie, Hal and Baby Hal

It is with great excitement that we share the wonderful news about our ever-expanding family of high-fidelity simulators.  Thanks to some capital funding, the Clinical Simulation Program was able to acquire three Gaumard simulators: Advanced Airway Hal, Susie and Newborn Hal.  This new equipment will allow our labs to serve more students and faculty, and brings diversity to simulation scenarios.

The Susie simulator is our first female high fidelity simulator.  No more unconvincing, broad shouldered “lady” in lab: we now have a real fake woman.  Major features that Susie brings to the table are: interchangeable breasts with a variety of tumors and growths; multiple palpable pulses, auscultation sounds and reactive eyes.

Advanced Airway Hal is our first non-white simulator; it is so great to see simulator manufacturers helping educators to bring ethnic and cultural components to simulation.  In addition, Hal has a greater level of control with his airway and lungs: he has adjustable inspiratory and expiratory times, as well as a greater range of lung compliance.  Soon to be tested will be his drug recognition system: here’s hoping it works flawlessly and allow learners to get rapid feedback on their treatment.

And, of course, the baby.  Newborn Hal is a perfect little bundle of cuteness, if you think robots are cute.  As a smaller and wireless baby simulator, he adds realism to scenarios: mommy and daddy can hold and care for him, along with student learners.  He has a replaceable umbilical that can be cut, pulses (umbilical, brachial, fontanael) and chest rise.  By far the coolest feature, though, is his muscle tone: his arms will move, go limp or spasm.  It is pretty wild to hold a robot baby that cries and wiggles in your arms.

With all these new members to our family, we want to invite you all to a Baby Shower:

Come by on February 14th to say hi to our new simulators and catch up with some of our veteran manikins.

Hope everyone has a great start to the spring semester.

To improve their diagnostic skills, RN to BSN students in Professor Carol MacLeod’s class spent some time with Gene (3G) as part of their assessment course. They listened to Gene’s heart and lung sounds, identifying the characteristics of  a variety of normal and abnormal sounds.  At the end of the semester they returned to the simlabs for their final exam. Pairs of students performed assessments on each other while their instructor observed, via video feed to our adjoining debriefing room. Each assessment was recorded and uploaded to their Blackboard class platform. Students viewed their own assessment and evaluated their performance. They submitted their comments to receive feedback and their final grade.

RN students practicing their assessment skills.

Gene provides opportunities for RN's to practice assessment skills.

Professor Mariann Mankowski’s Social Work students taking Advanced Clinical Theories for Practice with Individuals, had the opportunity to conduct a therapy session with an actor client who played a role based on a case study. Each student from the class spent 20 minutes with the client, using interventions based on a specific clinical theory. Classmates in the adjoining classroom watched the live video feed.  At the conclusion of the session students were able to obtain feedback from their instructor and the actor.

Practice in Medicine & Health students also came to the simulation labs to practice meeting with a family members in the hospital setting. Professor Cindy Tack developed scenarios the allowed her students the opportunity to gather assessment information, provide interventions and build rapport with various family members, while navigating space, equipment and distractions in a busy hospital intensive care room.

Honing counseling skills in the Sim lab

Social work students meet the "client" during debriefing session.

A clinical case was presented to Physician Assistant students during weekly Integrating Seminars held in the simulation labs. One student was assigned the role of the patient while teams of two students took turns practicing their assessment and interview skills. Four teams of students systematically completed a head to toe assessment of their “client.” They took a history and performed a physical exam on the “patient” based on his/her chief complaint. Each team received feedback from their fellow students and faculty.

PA students Integrating Seminar debriefing session.

Nurse Anesthesia students spent many hours in the skills lab (Blewett 203) this semester. Besides practicing a variety of task training skills, they also had hands on practice on the anesthesia machine. Prior to coming to the machine check lab, they watched a video filmed in the simulations labs, starring MSNA Director Maribeth Massie. The video provided information about how to perform a comprehensive check of the anesthesia machine.

MSNA students task training practice lab session.

Cynthia and Ryan were delighted to host aspiring health professions students from Westbrook Regional High School who had the opportunity to see what goes on here at CSP and to practice some of the skills that they have been learning in their Introduction to Health Professions course. Students were enthusiastic and looked very professional in their scrubs.  They were an impressive group of young people and several expressed the desire to attend UNE. We hope they do!

Westbrook Regional students visit with SimMan 3G.

Nursing 201 (Medical Surgical Nursing II) students, under the direction of Professor Dawne-Marie Dunbar, continued their weekly visits to the simlab. They were always enthusiastic learners and appreciative of the opportunity to practice caring for a variety of different simulated patients here in at CSP. We saw fewer nursing students this past semester because of the transition from our ADN program to our new BSN program. We look forward to next fall when the first class of BSN nursing students (currently sophomores in Biddeford) will arrive on this campus and begin learning clinical skills in the simulation labs.

Nursing students meet their post operative patient.

We’ve had a great semester and are already busy collaborating with faculty and planning for a busy spring semester. Check back with us next month to learn all about the newest members of our simulation family. Very exciting!

Happy Holidays to All.

Happy Holidays from our family to yours!

See you in January!

P.S. Don’t forget to LIKE us on our Facebook page so you can keep up on the weekly happenings here at CSP.

The lab’s time this summer was split up between simulation sessions, special projects and reorganizing.  First-year Physician Assistant students were fortunate to be the first program to use our new SimMan 3G.  Cynthia and I brought him to the Alexander 07 lab for several assessment sessions.  We focused on pulses, eyes and auscultation (listening to heart, lung and belly sounds).  The students were fabulously fun to work with: so great, in fact, that I let them name the new simulator.  Say hello to Gene and the students who named him:

PA students feel the pulses on SimMan 3G ("Gene")

MSNA students came to lab for their capstone simulation experience: Crisis Resource Management (CRM).  They participated in several intense operating room scenarios with our METI simulator.  Each student gets their turn putting METI to sleep and adapting to a variety of emergencies.  These scenarios always stand out for me because the MSNA faculty put forth a lot of energy into creating a realistic case: the lab is filled with multiple actors and lots of equipment.  It was great to have them come to lab.

MSNA student care for patient while surgeon prepares to cut.

Amongst cleaning and organizing our many rooms, two projects came to fruition: doors and air!  Our two original simulation rooms (Blewett 116 and 117) now connect directly into our debriefing room (Blewett 107).  This will keep the learning environment contiguous and allow students to share their initial reactions to a scenario.  Additionally, it will allow equipment to be easily moved between rooms (the doors are extra wide).  The benefit for me, however, is that I can now see sunlight in my office.

Though, it goes through three windows and has to travel 100 feet.

So it’s not that bright.

Still, I can see trees!

Door from 116 to 107, with Gene and METI.

As for the air project, Facilities was kind enough to set up an air compressor in the basement that feeds to the gas room.  Our two METI simulators suck up a lot of air when they are running.  For the past 7 years, the lab has been paying to rent and lease canisters to provide this air.  But now we get it for free!  Yippee!

Finally, in the first week of August, I was lucky enough to travel to Las Vegas for the first annual Gathering of Technicians (GOT), a conference focused on the technical side of all things simulation.  The conference was hosted by the University of Nevada – Las Vegas (UNLV) and their entire staff was absolutely delightful.  The facility at UNLV is fantastic and, thankfully, air conditioned.

Capt. Wilkinson speaks to the crowd of 85 simulation technical staff.

We had two very full days of workshops and lectures.  Topics included moulage (the “making up” of wounds and physical props), video technology and vendor-specific training.  My favorite session, though, was the talk by Captain Steven Wilkinson.  A former airline pilot trainer, the Captain taught us a few lessons about how simulation came about in the airline industry.  The success of making simulation a natural part of a pilot’s training and continued certification, is an inspiration to me.  Medical simulation will most likely follow the same route, where standards are set for simulated work time before board certification and during one’s career.  It’s very exciting to think about the places we will be going!

Ryan rocks the apron while preparing a bloody emesis (AKA vomit) at GOT.

Here’s to another exciting year at UNE CSP!  See you soon!

Students from most all of our health professions departments spent time with us in April and May, including: Physical Therapy students and Nursing students, highlighted below.

Physical Therapy students were welcomed back in to the simulation labs this spring.  As part of their Physical Therapy Management of Adults with Disorders of the Neuromuscular System class, the students had the opportunity to conduct a physical therapy treatment session for a patient with a traumatic brain injury (TBI). The patient’s behavior (agitation, confusion, lethargy etc) was the focus of the session.

Ryan filming Physical Therapy students practicing in the simulation lab.

Nursing students ended their busy year in the simulation labs practicing their medical surgical, psychiatric, pediatric, teaching and maternity nursing skills.

Medical surgical nursing students collaborating on the care of their patient.

Nursing students practicing their teaching skills.

Ryan plays role of psychiatric patient needing reassurance from nursing student.

Nursing faculty member, Marge Aube, is "Mom" to Pediatric Hal.

Our senior nursing students were a bit sentimental as they commented on their last sim experience before graduating from UNE.

• Experience was wonderful!
• Always a pleasure, allows us to put our brains to work.
• I love Sim!!
• Bye bye sim, it’s been swell I will miss you.
• I love sim lab! Sad it’s the last one!

3G Arrives!

It is always hard to say good-bye to our graduating students but it was fun to say “Hello!” to our new high fidelity wireless simulator, Laerdal’s SimMan 3G. Ryan wasted no time unpacking our new mannequin and  has already put in many hours discovering how easy 3G is to operate. We are happily imagining the variety of new environments and patient cases that will be available to us as we integrate our newest member of our mannequin family into our simulation learning experiences.

SimMan 3G meeting other "family" members.

That’s all for now, but we’ll be back with another update in July. Happy summer to all.

Anywho, this month’s tech-focused blog post deals with four little pieces that have been of note during the month of April.  Enjoy!

Decapitation

An exciting little project: removal of a METI HPS head.  The HPS being used in our simulated operating room has a very messed up face: a tear from the corner of his mouth, some stains and lots of general grime.  While it is still under warranty (just a few more weeks…no renewal possible for this old unit), I decided to get his face replaced.  This requires a trip to Sarasota, FL and some tender care from METI Customer Support.

Ryan performs a decapitation on a METI HPS.

While I was a little apprehensive before starting the task, it turned out to be fairly simple.  All the tubes have quick-release connections and are clearly labeled at both ends: esophagus, bronchi, eye control, etc.  The only trick was disconnecting his spine: I got a tip from METI’s Ben Walker to detach the spine at the base of the skull, not the neck.  I did need to hunt around campus for the correct size allen wrench; thanks a bunch to Elaine and the good folks in ITS.  Then, with time and patience (the close quarters only allow for about 120 degrees rotation before you have to reseat the wrench), I was able to perform a successful Mortal Kombat finishing move.  Get Over Here!

Ryan poses with the liberated cranium.

Control Room

One of the joys of being the technical head of the simulation program here at UNE is the opportunity to reassess our operations and then go about refining our lab’s systems.  For the past year, I have felt frustration with the layout of the control rooms; in particular, the control room that doubles as my office.

It gets crowded easily in here.

The difficulty comes with the multi-function nature of the space: sometimes it is just an office where I program, cut video and eat lunch; other times it is chock full of people running a scenario (myself, faculty, actors, etc).  When being shared by multiple people, we are constantly getting in each others’ way: a beverage blocks the mouse I need to use, I have to squeeze past someone to get a microphone, everyone’s backpacks/purses are tripped over.  So I wanted to figure out a way to consolidate my systems and create a separation of “tech space” and “guest space.”

Luckily I had the time to rearrange my multiple computer systems and the money to purchase a wall mount for a monitor.  By moving stuff up and over, I was able to make my technician space and a public space clearly defined.  Now, bags can go under the desktop or on the hooks mounted on the wall and faculty notes can be organized on top.

Ah, much better. Cleanup creates space for our guests to occupy and Ryan can now run all systems from the far end.

Moulage

For UNE’s Annual Spring Symposium, CSP was called on to help create and record several video vignettes relating to veterans’ health issues.  One of the vignettes focused on a soldier with an IED-related arm injury.  Cynthia and I needed to doctor the actor’s arm up for the videotaping, but did not want to spend a long time on the project.  We chose to use a Laerdal rubber burn skin:

Does this gross you out? It grosses my wife out.

Intended for use on our SimMan, this piece easily slipped onto the actor’s hand.  We then wrapped the rubber hand and the actor’s forearm in gauze, securing everything in place and adding that clinical touch.  Here it is in action:

Uh, you might wanna have someone look at that...

3G

Lastly, exciting news!  We received approval to purchase SimMan 3G a month or so ago (which I believe Cynthia mentioned previously on these pages) but we have now learned that he is on his way!  While offering all the features of our current SimMan, 3G has several unique additions, the most obvious being his lack of wires…we get to go mobile with our adult simulation scenarios.  3G also brings a simple, quick to set up fluid system to our program: he’ll bleed, cry, foam at the mouth and sweat at the drop of a hat.  Look for an upcoming announcement of Mr. 3G’s welcoming party!

That’s all from the desk of the Wizard!

This month we welcomed newcomers from the School of Pharmacy. Ninety-seven students practiced their respiratory assessment skills to rave reviews. “Great experience to provide us with an idea of a real clinical setting and the possible role of the pharmacist.” “This was a great learning experience. I was very impressed by the facilities and the quality of the artificial environment.”

Pharmacy students positioning patient for respiratory assessment.

Not newcomers to simulation, but here for the first time this year, Occupational Therapy students returned to the simulation labs to demonstrate their skills for evaluating instructors. At one point, all four of simulation theaters were occupied as student pairs took turns playing the role of the therapist or the client. Each session was captured and uploaded to our sim server. Students can access the recorded sessions to review.

With left sided weakness, the client learns how to put on a shirt and button it up.

Actors and faculty gathered in the simulation labs for the filming of  vignettes that will be shown at breakout sessions during Spring Symposium on April 7th. Three brief scenes were filmed and edited by Ryan. Physician Assistant, Occupational Therapy, Nursing and Social Work faculty collaborated with actors from Adverb Productions to create compelling case studies for symposium participants to discuss.

Ryan the filmmaker with Kirsten Thomsen and Christine Hall

Interview at the Veteran's Clinic (Bill Croninger, OT faculty)

Shelley Cohen Konrad has developed unfolding case studies for her social work students and this month brought the return of  the actors to their roles of the pervious month. The students have been working with the same “clients” throughout the semester and have used their therapeutic skills to provide counseling and emotional support for this couple in crisis.

Session captured for admissions video production.

Cynthia and Dawne-Marie Dunbar were honored to be chosen to participate in the  Health Information Technology Scholars (HITS) program which is a faculty development collaborative partially funded by  the Health Resources and Services Administration (HERSA). The focus of the program is to expand integration of technology into the nursing curriculum. Cynthia and Dawne-Marie have developed a technology project, completed a series of online modules and recently went to Johns Hopkins to attend a workshop designed to provide an opportunity for HITS scholars from across the country to collaborate on technology projects.

In March Cynthia presented at the Drexel University Simulation in Healthcare Conference. Simulation Stone Soup: How to Create Rich Simulation Experiences

Nursing students from our Adult Medical Surgical clinical groups and specialty nursing courses (Maternity, Pediatrics and Psych) have continued to clock many hours with SimMan, Simbaby, Pediatric Hal and our volunteer actors.

What do you do if the power goes out during a surgical procedure? MSNA students had a chance to experience this occurrence during their weekly practice sessions and open labs offered throughout the month. “This experience gave me a feel for the OR and the flow of events during induction, emergence and power failure” “I think the sim lab was extremely helpful in preparing all of us for real life situations.”

Power is lost!