A new strategy in neurocritical care nurse continuing stroke education: A hybrid simulation pilot study

Abstract

IntroductionHigh-fidelity simulation is frequently utilized in medical education. Its use in the neurosciences is limited by the inherent limitations of the manikin to simulate neurological changes. We report here the use of a hybrid simulation – a combination of lecture and high-fidelity manikin – in the education of neurosciences nurses, involved in care of neurocritical care patients.MethodsNeurosciences nurses from at the University of Missouri, Columbia, MO, USA, which is an academic, tertiary-care medical center participated in the simulation during Spring of 2016. The simulation involved a patient presenting with acute intracerebral hemorrhage (ICH) who neurologically deteriorated to brain death. Pre- and post-simulation questionnaires were administered using a questionnaire with five-point Liker scale.ResultsSeventy-two responses were returned. The majority had 0–5 years of nursing experience with 83.8% having prior critical care experience. Pre-simulation, the majority of nurses (85.7%) agreed or strongly agreed with managing patients with ICH. When the responses of “agree” were compared to “strongly agree”, a significant improvement (p<0.001) in all responses except confidence in speaking with other healthcare providers was found.ConclusionNurses reported significant improvement in understanding and managing patients with acute ICH and neurological deterioration after participating in a neurocritical care hybrid simulation. This study shows the benefit of using hybrid simulation in the education of neurocritical care nurses.

Assessing Outcome Measurements and Impact of Simulation in Neurocritical Care Training: A Systematic Review

“…Hocker et al 13 evaluated the confidence in performing apnea test for brain death determination using a 1- to 5-point scale questions where a score of 1 indicated “novice,” 3 indicated “competent,” and 5 indicated “fully confident.” They reported a significant increase in the mean score by 1.49 (maximum score was 5), P = .001. Newey et al 15 used a Likert scale questionnaire to assess confidence among nurses. They reported a statistically significant improvement in the percentage of nurses who felt confident after the simulation compared with before simulation.…”

“…The JBI quasi-experimental critical appraisal tool was used for the remaining 8 studies. [11][12][13][14][15][16][17][18] The overall quality of the relevant studies was moderate to high, with a range of 61.1% to 77.8%. We did not exclude any study because of methodological quality issues.…”

A hybrid simulation-based workshop improves knowledge and confidence in the management of hemorrhagic conversion of stroke among interventional neurology trainees

“…First, in the current study participants were primed with a short, high-yield didactic session delivered prior to the simulation scenario; a hybrid approach consisting of a traditional lecture combined with simulation has previously been shown to be effective in teaching the management of patients with intracerebral hemorrhage and neurological deterioration. 15 Second, in this study participants managed the patient as part of a group, whereas participants worked individually in our prior study. Finally, our prior study included mostly neurology residents whereas the current study was focused on fellows.…”

The Effects of Video Instruction on Neuroscience Intensive Care Unit Nursing Skills in Case Presentations and Neurological Examinations

“…Although acute and critical care are important components of undergraduate nursing education, 7 nurses who work in critical care settings may benefit from specialized training, as exemplified by robust educational interventions for cardiac intensive care unit nurses. 8 Recent studies of NSICU nurses have focused on improving learners' knowledge in identifying and managing acute intracranial hemorrhage and neurological deterioration, 9 reading bedside continuous electroencephalogram, 10,11 and managing acute stroke. 12 Others have described efforts to teach critical care nurses nonclinical skills such as in communicating bad news 13 and providing palliative care, 14 especially relevant during the current coronavirus 2019 pandemic.…”

“…12 Others have described efforts to teach critical care nurses nonclinical skills such as in communicating bad news 13 and providing palliative care, 14 especially relevant during the current coronavirus 2019 pandemic. Educational formats have included simulation training, 15 hybrid modules combining lecture and high-fidelity manikin-based simulation, 9 and traditional didactics, 11 among others.…”