An Interprofessional Branching Simulation to Introduce RN First Assistant Students to Their Role in the Perioperative Setting

Abstract

Simulation can be an effective tool for educating health profession students and can enhance interprofessional education by involving roles across multiple disciplines. Perioperative nurse educators at one institution used a five‐part branching simulation of preoperative, intraoperative, and postoperative events for a single patient undergoing a procedure to introduce RN first assistant (RNFA) students to their role in the perioperative environment. The simulation participants included student RN anesthetists, a surgeon, an RN circulator (played by an actor), and a standardized patient. The objectives for this simulation were to assess the implementation of the didactic RNFA curriculum and to enhance the RNFA students’ transition into their role in the perioperative setting. The simulation and multiple debriefings reinforced the concepts of role acquisition, surgical conscience, closed‐loop communication, and interprofessional collaboration. Perioperative nurse educators can use this type of educational activity to teach these concepts to their students.

Surgical Conscience: A Concept Analysis for Perioperative Nurses

“…It includes not only an awareness of what is right or wrong with a surgeon’s technique, 32 but also the morals that guide them 32,38 . Because of the positive ethical nature of the surgical conscience, 54 some authors have suggested that perioperative personnel use self‐examination 50 or self‐inspection 53 and consider their moral obligation to the patient when providing care 35,50,53 …”

“…Perioperative team members should employ an effective surgical conscience when advocating for patients 35,41 . Personnel should use their knowledge of sterile technique, 31,41 attentively avoid and recognize breaks in technique, 41,45 and immediately begin to mitigate breaks in technique when they occur 41 .…”

“…Duplicate articles were removed and the full‐text versions of the remaining articles were analyzed for relevance; those articles that only mentioned surgical conscience and did not define features of the concept were removed. The searching and screening process (Figure 1) resulted in the 27 articles 1,26,28,31‐54 included in this concept analysis. Supplementary Table 1 shows the data extracted from the articles during analysis.…”

“…Perioperative team members should employ an ef fective surgical conscience when advocating for pa tients. 35,41 Personnel should use their knowledge of sterile technique, 31,41 attentively avoid and recognize breaks in technique, 41,45 and immediately begin to mitigate breaks in technique when they occur. 41 In 1990, academic nurs es designed a baccalaureate perioperative nursing pro gram and defined surgical conscience as "the process of introspection for client advocacy;" 52(p107) this is especially true when patients cannot advocate for themselves.…”

“…32,38 Because of the positive ethical nature of the surgical conscience, 54 some authors have suggest ed that perioperative personnel use self-examination 50 or self-inspection 53 and consider their moral obligation to the patient when providing care. 35,50,53 Awareness of and accountability toward self and others Described as a 360-degree awareness of all activities occurring within the perioperative environment, 34 sur gical conscience requires that perioperative personnel monitor their own practice 33,51 as well as the practice of others 33 to ensure patients are provided with safe envi ronments and care. A key characteristic of surgical con science involves the skill of performing constant personal and interpersonal evaluations of practice.…”