Health Sciences Simulation Policies and Procedures

Mission

The Blinn College Health Sciences Clinical Simulation Labs (BCHSCL) provides simulation tools to aid in the development of curricula that encourages learners to develop procedural skills and enhance their clinical decision-making process.

Vision

Provide opportunities for outstanding healthcare education and scholarship that lead to improved safety and quality of patient care using simulation.

Goals

• Provide student-centered learning opportunities for the development of clinical skills and the promotion of life-long learning.
• Support all learners in meeting standards in their professions in order to promote safe, high-quality patient-centered care.
• Create a shared learning space where students can develop an appreciation for the many disciplines in today’s healthcare environment and the skills needed for effective interdisciplinary teamwork.
• Embrace technology in all aspects of education, scholarship and clinical practice.

Facilities

The Simulation and Clinical Labs occupy approximately 16,000 square feet on the second and third floors of the RELLIS Academic Complex Building I, across the street from Blinn’s Walter C. Schwartz Building. This space includes:

• an emergency medical services skills/simulation lab with a simulated ambulance system that operates in and around the complex,
• 21 mid-fidelity, semi-private hospital rooms,
• six low-fidelity, private hospital rooms with a central teaching space,
• six high-fidelity emergency/intensive care unit rooms, including two mother/baby suites,
• a physical therapy lab,
• two radiologic technology x-ray suites,
• one apartment/home setting space with a functioning environment to use in conjunction with the Texas A&M Cybersecurity Program,
• an Anatomage Table active training space,
• a virtual IV training room,
• 10 simulation activity debriefing spaces,
• and future space for a trauma environment within the high-fidelity space.

Terminology

Deliberate Practice

A goal-oriented approach used to develop and/or improve all levels of skill acquisition utilizing scaffolding principles to attain clinical judgment and mastery leading to expert performance (modified Ericsson, 2004). The experience must be monitored with immediate personalized feedback provided by faculty, coaches, standardized patients, or electronic devices capable of documenting the performance.

Feedback

A critique of a participant’s performance provided to assist the individuals in developing competency.

Fidelity

The degree to which a simulated experience approaches reality. The level of fidelity (high, mid, or low) is determined by the environment, simulators, the tools and resources used.

Independent Practice

Practice outside of scheduled curriculum experiences that do not include monitoring or feedback.

Skill

The ability to safely perform technical and/or non-technical tasks while upholding speed, efficiency, and accuracy. Skills and tasks are more than the ability to perform or cite; they include the ability to perform and communicate proficiently, therapeutically, and consistently within appropriate time limits.

Skills Experience/Skills Lab

Activities designed to promote or to assist the development, efficiency, and accuracy of technical and or non-technical skills. These activities are designed to uphold professional comportment with respect for the development of intra/inter professional knowledge, skills, attitudes, and behaviors.

Simulation

A pedagogy using one or more typologies to promote, improve, or validate a participant’s progression from novice to expert. A simulation based activity is based on a patient experience and requires learners to demonstrate clinical judgment while performing technical and non-technical skills.

Simulation-enhanced Interprofessional Education (Sim-IPE)

Simulation-based activities in which participants and facilitators from two or more professions are placed into a simulated healthcare experience in which shared or linked educational goals are pursued, while the individuals involved learn about, from and with each other to enable effective collaboration and improve health outcomes.

The Debrief Process

An activity that follows a simulation-based experience led by a facilitator in an effort to promote reflective thinking.

Typology

Classification of types. In simulation it refers to the classification of different educational methods and/or equipment used to provide a simulated experience.

Definitions for Current Simulation Typology

Utilization of Simulators and Equipment

Purpose: This BCHSC simulation program policy is to ensure that all users receive the appropriate training to promote effective learning.

Review: The simulation program OP will be reviewed by September 1 of each even-numbered year by the Director of the Simulation Center.

Policy

Due to the cost of simulators and equipment, special considerations must be taken before utilization. Users, both internal and external, are required to attend orientation/training prior to using designated simulators and/or equipment. The training will be tailored according to the specific features of individual simulators and/or equipment.

Procedure

1. The simulation centers’ faculty and/or staff will provide simulation in-services throughout the year. The dates and registration information will be publicized. In-services will be held at the beginning of each fall and periodically throughout the year.
2. Instruction on specialized equipment (simulators, haptics) requires individualized orientation sessions prior to use. These orientations must be scheduled with the simulation center’s designated personnel. Please schedule at least one week in advance to ensure your needs can be met. Notification must be via online reservation form.
3. Failure to comply with policy may result in the simulation event being postponed until user has obtained the necessary orientation/training.
4. Following is a list of specified equipment requiring orientation/training prior to use:
   • High fidelity: For example, SimMan3G, SimMan Essential, SimNewB
   • Mid fidelity: For example, Harvey, Vital Sims
   • Low fidelity: For example, Partial Trainers
   • Haptic: For example, Virtual IV
   • Specific Medical Equipment
   • AV Equipment and Digital Audio-Visual Recording System
   • Radiology: For example, Portable X-Ray

Maintenance of Simulators and Equipment

Purpose: This BCHSC simulation program policy is to ensure that all users receive the appropriate training to promote effective learning.

Review: The simulation program OP will be reviewed by September 1 of each even-numbered year by the Director of the Simulation Center.

Policy

Due to the cost of simulators and equipment, maintenance and care of the equipment must be performed after utilization and as needed by the Centers’ Simulation Staff. Users, both internal and external, are expected to inform the Simulation Centers’ staff or faculty of all equipment or simulator malfunctions as soon as it occurs.

Procedure

See policy and procedure manual related to preventive maintenance schedules and vendors specific to each simulator and equipment.

Expectations of Educators Utilizing Space and Simulators at the BCHS Simulation Center

Purpose: This BCHS Simulation Centers’ policy is to define the expectations of external faculty/educators utilizing BCHS Simulation Centers’ simulators and equipment.

Review: The simulation program OP will be reviewed by September 1 of each even-numbered year by the Director of the Simulation Center.

Policy

External faculty/educators must be properly instructed on the use of simulators by BCHS Simulation Centers’ staff. If the faculty/educator is not properly trained, the activity will be postponed until orientation is completed.

Expectations for BCHS Simulation Centers Personnel

1. Reserved rooms will be ready for occupancy by the external users, with all extraneous supplies and equipment removed from the room and requested simulators on and ready to be used.
2. Requests for simulator programming can be completed by BCHSC simulation personnel with an additional request process from the website. A meeting will be scheduled to discuss the details.
3. Requests for BCHS simulation personnel to assist with the activity can be accommodated for an additional charge.
4. Requests for AV recording assistance by BCHS simulation personnel can be accommodated for an additional charge.
5. Requests for moulage by BCHS personnel will be accommodated by adding to the scheduling request.
6. Troubleshooting of equipment and simulators will be provided by BCHSC simulation personnel during the experience.
7. BCHSC simulation personnel will turn on and off all simulators at the beginning and completion of the experience unless other authorized arrangements are made.

Expectations for External Faculty/Educators

1. Reservations for simulators, equipment, and space must be received two weeks prior to the event. Any late or emergent reservation may be subject to additional charges and availability.
2. External faculty/educators must provide a list or roster of attendance in order to meet requirements for future SSH accreditation.
3. External faculty/educators must provide a description of the educational learning activities conducted within the BCHSC simulation center.
4. Faculty/educators who access the simulation center are expected to attend an in-service related to proper usage of simulators, haptics, and other equipment.
5. External users are expected to bring all supplies, equipment, and other materials needed for the simulation-based experience unless other arrangements are made prior to the activity.
6. External users are expected to follow all BCHS Simulation Center policies and procedures.
7. External users are expected to comply with the dress code policy:
   • HSC identification badge or agency badge must be worn visibly.
   • While participating in a simulation-based experience, appropriate attire includes clothing that is professional, neat, clean, and not distracting or offensive to others.
   • Appropriate attire in an effort to promote professional role-modeling will be either business casual, uniform, or clinical attire defined by program policy and procedure.
   • Closed-toe shoes are required in all areas. Shorts are not appropriate.
8. External users are expected to comply with the food and drink policy:
   • No food, drinks, candy, or gum are allowed throughout the simulation center. Individuals with identified medical conditions should discuss this with their faculty/instructor and the simulation center personnel.
   • Language must be professional with simulator experiences and standardized patients. Respectful and professional attitudes are expected behavior.

Check-Out of Equipment, Simulators, and Supplies

Purpose: This BCHS Simulation Centers policy is to explain the loaning procedures of simulators, equipment, and supplies.

Review: The simulation program OP will be reviewed by September 1 of each even-numbered year by the Director of the Simulation Center.

The Blinn College Simulation Program Operating Policies and Procedures (OP) have been reviewed and accepted by Sami Rahman, MEd, MSN, RN, Director of the BCHS Simulation program. The BCHS Simulation program OP will be reviewed by September 1 of each even-numbered year by the Director of the Center.

Appendix

Use of Real Drugs or Medications for Simulation Based Experience in the Simulation Program

Purpose: BCHS Simulation Program policy is to ensure that faculty, staff, students, and external users do not bring or use real drugs or medications for use in a simulation-based activity into the simulation center.

Review: The Simulation Program OP will be reviewed each September by the Simulation Director and Dean of Health Sciences.

Policy

No real drugs or medications are to be used for simulation-based activities. No real drugs or medications are to be brought into the simulation center by faculty or other customers for educational purposes.

Exceptions to this policy may include over-the-counter drugs such as fleets enemas and suppositories that are currently not available as a simulated product, IV solutions that can be used with a partial trainer or advanced patient simulator, and commercially prepared first aid kits in each center.

Procedure

1. Real drugs or medications for use during a simulation-based education activity are not allowed in a simulation center.
2. All crash carts are to be inspected, restocked with new simulation emergency drugs, and locked following inspection after each use.
3. If any real drugs or medications are discovered in the simulation center, they will be immediately disposed of appropriately in sharps containers.
4. If simulation center personnel discover a real drug, they are to notify the simulation center director immediately. The simulation center director will contact the potential source and initiate appropriate action.

Healthcare Simulation Standards of Best Practice

Blinn College Health Sciences Simulation Program has been a member of INACSL since 2011. The Healthcare Simulation Standards of Best Practice are designed to advance the science of simulation, share best practices, and provide evidence-based guidelines for the practice and development of a comprehensive standard of practice.

The Healthcare Simulation Standards of Best Practice provide a detailed process for evaluating and improving simulation operating procedures and delivery methods that every simulation team will benefit from. Adoption of the Healthcare Simulation Standards demonstrates a commitment to quality and implementation of rigorous evidence-based practices in healthcare education to improve patient care.

Standards Areas

• Professional Development: Initial and ongoing professional development supports the simulationist across their career and helps provide high-quality simulation experiences.
• Prebriefing: Prebriefing is a process involving preparation and briefing so learners are prepared for the educational content and aware of the ground rules for the simulation-based experience.
• Simulation Design: Simulation-based experiences are purposefully designed to meet identified objectives and optimize achievement of expected outcomes.
• Facilitation: Facilitation methods vary and depend on learner needs and expected outcomes.
• The Debriefing Process: All simulation-based educational activities must include a planned debriefing process.
• Operations: All simulation-based education programs require systems and infrastructure to support and maintain operations.
• Outcomes and Objectives: All simulation-based experiences originate with the development of measurable objectives designed to achieve expected behaviors and outcomes.
• Professional Integrity: Refers to the ethical behaviors and conduct expected of all involved throughout simulation-based experiences.
• Simulation-Enhanced IPE: Enables learners from different healthcare professions to engage in a simulation-based experience to achieve linked or shared objectives and outcomes.
• Evaluation of Learning and Performance: Simulation-based experiences may include evaluation of the learner.

Citations of the Healthcare Simulation Standards of Best Practice

• Watts, P., Rossler, K., Bowler, F., Miller, C., Charnetski, M., Decker, S., Molloy, M., Persico, L., McMahon, E., McDermott, D., Hallmark, B. (2021). Preamble. Clinical Simulation in Nursing.
• INACSL Standards Committee, Hallmark, B., Brown, M., Peterson, D., Fey, M., Decker, S., Wells-Beede, E., Britt, T., Hardie, L., Shum, C., Arantes, H., Charnetski, M., & Morse, C. (2021). Healthcare Simulation Standards of Best Practice Professional Development. Clinical Simulation in Nursing.
• INACSL Standards Committee, McDermott, D., Ludlow, J., Horsley, E., & Meakim, C. (2021). Healthcare Simulation Standards of Best Practice Prebriefing: Preparation and Briefing. Clinical Simulation in Nursing.
• INACSL Standards Committee, Watts, P. I., McDermott, D. S., Alinier, G., Charnetski, M., Ludlow, J., Horsley, E., Meakim, C., & Nawathe, P. (2021). Healthcare Simulation Standards of Best Practice Simulation Design. Clinical Simulation in Nursing.
• INACSL Standards Committee, Persico, L., Belle, A., DiGregorio, H., Wilson-Keates, B., & Shelton, C. (2021). Healthcare Simulation Standards of Best Practice Facilitation. Clinical Simulation in Nursing.
• INACSL Standards Committee, Decker, S., Alinier, G., Crawford, S. B., Gordon, R. M., Jenkins, D., & Wilson, C. (2021). Healthcare Simulation Standards of Best Practice The Debriefing Process. Clinical Simulation in Nursing.
• INACSL Standards Committee, Charnetski, M., & Jarvill, M. (2021). Healthcare Simulation Standards of Best Practice Operations. Clinical Simulation in Nursing.
• INACSL Standards Committee, Miller, C., Deckers, C., Jones, M., Wells-Beede, E., & McGee, E. (2021). Healthcare Simulation Standards of Best Practice Outcomes and Objectives. Clinical Simulation in Nursing.
• INACSL Standards Committee, Bowler, F., Klein, M., & Wilford, A. (2021). Healthcare Simulation Standards of Best Practice Professional Integrity. Clinical Simulation in Nursing.
• INACSL Standards Committee, Rossler, K., Molloy, M., Pastva, A., Brown, M., & Xavier, N. (2021). Healthcare Simulation Standards of Best Practice Simulation-Enhanced Interprofessional Education. Clinical Simulation in Nursing.
• INACSL Standards Committee, McMahon, E., Jimenez, F. A., Lawrence, K., & Victor, J. (2021). Healthcare Simulation Standards of Best Practice Evaluation of Learning and Performance. Clinical Simulation in Nursing.
• INACSL Standards Committee, Molloy, M., Holt, J., Charnetski, M., & Rossler, K. (2021). Healthcare Simulation Standards of Best Practice Simulation Glossary. Clinical Simulation in Nursing.
• INACSL Standards Committee. (2021). Healthcare Simulation Standards of Best Practice. Clinical Simulation in Nursing.

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