PEORIA — Most nursing students will never witness a real patient go into a life-threatening code, but they need to. That’s were simulation comes in.
“Simulation is where they get to see complications — it’s a chance to see something they wouldn’t normally see,” said Mischelle Monagle, associate dean of nursing at Illinois Central College. “By the end of their second year we make sure all students have done a code, so all students at some level know how to handle a code.”
Simulation has always been a part of nursing education, but it has grown by leaps and bounds in recent years with the creation of high-tech mannequins. Illinois Central College is on board with the trend. At ICC’s north campus, students in health-career programs learn in environments that mimic real work environments and practice on mannequins that are lifelike in the most important ways.
Victoria is a simulation mannequin that can give birth. She can scream, push, cough and get sick, and she can say "the baby is coming" in English and Spanish. Victoria will also react to students' ministrations. If she is given the wrong medicine or dose she will react. If CPR is not performed correctly, she will get sicker. An IV will produce blood flow, and she can even hemorrhage.
“Victoria has given birth over 60 times,” said simulation skills lab coordinato Greg Love while pointing to Victoria’s removable cervix, which is little worse for the wear.
To make Victoria an even better teaching tool, ICC also has a newborn mannequin named Tori, which can be either male or female with the help of removable genitals. Tori is inserted into Victoria’s belly and students do sonograms and learn how to monitor the fetal heartbeat. After birth, Tori can display all kinds of frightening issues, including difficulty breathing, which forces babies to make a distinctive grunting sound.
“They can do hours and hours of clinical visits and never see a kid grunting,” said Monagle.
In simulation, bad outcomes provide teaching opportunities.
“The great thing about Victoria is that we can have a fetal demise,” said Love. “We’re not only teaching skills, we are teaching students how to manage their emotions as well. You can’t break down in tears — Victoria needs you.”
Many nursing instructors will allow students to make mistakes to see how they react when things go bad, said Monagle.
“In simulation many students slow down and start critical thinking,” said Monagle. “If it were a real person and things were going bad, they would stop and call for help.”
Research shows that a non-threatening environment is more conducive to learning. Though students get upset when things go south, they learn important things.
“I’ve heard students say, ‘I will never make that mistake again,’” said Monagle.
ICC has seven high-fidelity mannequins like Victoria. They are used not only in the nursing program, but also by the other health career programs at ICC. Students in the emergency medical services program use mannequins specifically designed to simulate trauma. The radiography program uses a mannequin which can be X-rayed. And the surgical technologist program has a mannequin that can be dissected.
“Nancy is a cadaver. You can actually cut her open and remove organs,” said Love. “After the school year is over she has to be rebuilt. She goes down to Florida, where she gets new skin, new mesentery (abdominal) lining, and new organs.”
In addition to the mannequins, ICC has built realistic medical environments. There’s an operating suite, an X-ray room, and an ambulance bay equipped with real ambulances. In the patient room where Victoria resides, the walls hold the same equipment as real hospital rooms.
At the end of every simulation, nursing students and their instructor review what happened. Students watch themselves on videos shot during the simulation so they learn not only from their own mistakes but also from the mistakes of their peers.
“They’re all assessing each other at the end,” said Monagle. “The debriefing is probably the most beneficial part of the simulation. It’s key.”
Simulation is well-received by the tech-savvy younger generation, said Monagle.
“They love this stuff,” she said. “They often ask for more days of simulation. They like it better than clinical visits.”
Clinical visits are dependent on which patients are being seen, and cases are typically routine. Simulation allows for drama — and great learning potential — every time.
Simulation, which is being done in addition to traditional nursing training at ICC, is likely producing better-trained nurses.
“Employers tell us our students come in very knowledgeable and ready to begin work at the entry level,” said Monagle.
Though the high-fidelity mannequins typically cost $80,00 to $100,000 and are expensive to maintain, ICC is expanding its program. The school is hoping soon to purchase a 5-year-old boy mannequin who has expressions: he can grimace and express fear when he’s about to get a shot. In spite of the cost, the value of simulation is proven, said Monagle.
“Everyone is into simulation now," Mongale said. "It’s where the learning happens. It’s the future.”
Leslie Renken can be reached at 686-3250 or firstname.lastname@example.org. Follow her on Twitter.com/LeslieRenken, and subscribe to her on Facebook.com/leslie.renken.