Educational Innovation

Interprofessional Online Simulation in COVID-19 Response

Preparing the future healthcare workforce is critical as the world experiences the COVID-19 pandemic. Simulation education must pivot to online delivery and expand to meet clinical training needs resulting from limited face-to-face learning for the foreseeable future.

In rapid COVID-19 response, the University of Minnesota M Simulation team has mobilized to deliver healthcare simulation education online. This ongoing series will share what we have implemented and tested including:

Leading the field: snapshots of innovations in simulations and clinical skills education

M Simulation’s team of simulation professionals collaborates with faculty across the health sciences (and beyond) to develop innovative and effective simulation strategies to address emerging needs, including:

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Identifying common curriculum across professions to improve health care training

Because we work across the health professions, our staff has a unique vantage point to address common clinical challenges. Learners across the health sciences need to practice having difficult conversations so that they can be prepared to communicate effectively with their patients on topics ranging from domestic violence to medical errors to end-of-life issues. Our staff makes interprofessional connections so that faculty across schools can work together to improve practitioner preparation for challenging conversations. 

Strategically integrating simulation into limited class time

Our staff collaborates with faculty across professions to develop simulation strategies that allow for clinical skills to be taught and assessed at multiple points in their curricula. An ongoing challenge is to ensure that learners at every level can participate in meaningful simulations within their limited available course time. We address this by ensuring the efficient utilization of resources. The School of Nursing has large numbers of learners at all levels who participate in simulations multiple times over the course of their educational programs. We ensure efficiency by pairing their students for team-based simulations, which require half the resources and time, and allow for faculty to include important concepts related to teamwork in their scenarios.

Using hybrid simulations for teaching and assessment

Our staff implements creative solutions to maximize realism and enable learners to practice a broader spectrum of skills. By combining real people with simulators or task trainers, we transform teaching and practice. In collaboration with faculty we conduct hybrid simulations for learners in the University of Minnesota’s Nurse-Midwifery program. Their learners participate in simulated scenarios with standardized patients wearing birth simulators, allowing them to practice managing the stages of labor and delivery while also providing patient support and practicing communication. Hybrid simulations provide learners the opportunity to improve and demonstrate both affective skills and psychomotor skills in patient care.

Meeting changing accreditation standards

Our staff works collaboratively with faculty to design simulations that address rapidly changing accreditation standards. Through the implementation of a six-station objective structured clinical exam (OSCE) for OB-GYN residents, we are helping faculty meet new requirements to document performance in different competency areas, including patient care, medical knowledge, communication skills, and systems-based practice. Our simulations also address other accreditation requirements, including interprofessional education and collaborative practice.

Training standardized patients to facilitate physical exam instruction as patient educators

Our staff provides training to a subset of standardized patients to prepare them to facilitate instruction in physical examination, clinical interviewing, and small group learning. These specially trained laypeople - known as patient educators (PEs) - fill the dual role of patient and educator as they facilitate workshops with health science learners at the University of Minnesota. In workshops with the patient educators, medical students practice their exam skills and the patient educators facilitate team-learning on the utility of each exam maneuver in assessing patient health. Clinical faculty oversee and provide support to patient educators, but no longer need to facilitate each small group, which allows them to use their expertise more strategically. This model also helps learners better understand how patients themselves are a critical component of the health care team.

Utilizing standardized patient methodology to enhance educational programs of non-medical professions

In collaboration with faculty, we prepare members of the standardized patient (SP) pool to portray individuals other than patients. The University of Minnesota Law School utilizes SPs as standardized clients in a unique curriculum designed to teach law students how to interview and counsel clients. We prepare SPs to be effective standardized clients by drawing on key parallels in practice between medicine and law. Both standardized patients and standardized clients need to be prepared to work with learners who need to gather information, make decisions, and provide counseling and support. The successes we have had collaborating with the Law School since 2008 demonstrate that standardized patient methodology is useful across a wide range of professions.

Developing simulations that can be conducted anywhere

In situ simulation – simulation that takes place within actual health care settings –allows us to support team-based learning in highly realistic environments. Our staff works to make it easy and cost-effective to conduct simulations in a wide range of environments and locations. In collaboration with School of Dentistry faculty, we conduct in situ simulations in University of Minnesota dental clinics, utilizing both standardized patients and patient simulators. Using B-Line Medical’s SimCapture® Ultraportable, we are able to record simulation video, audio, and data during off-site simulations. These recordings are immediately available for debriefing and review. We also serve other regional areas across the state, including our campuses in Duluth and Rochester, by developing standardized patients outside the Twin Cities.