Rapid Curricular Innovations During COVID‐19 Clinical Suspension: Maintaining Student Engagement with Simulation Experiences

Abstract

Health care education programs were faced with the need to quickly adapt to a new reality during the coronavirus disease 2019 pandemic. Students were temporarily suspended from campus and clinical sites, requiring prompt changes in structure to their didactic and clinical learning. This article describes the rapid adjustments that one midwifery and women's health nurse practitioner education program created using both synchronous and asynchronous simulation experiences to promote student learning and ongoing engagement. Flexibility and reflexivity were needed by faculty and students alike in the face of the multiple changes wrought by the pandemic. Curricular changes were made simultaneously in many courses. Objective structured clinical examinations simulate telehealth experiences that assess knowledge, clinical reasoning, and professional behaviors via a scripted scenario and an actor patient. On‐call simulations mimic telephone triage and provide students the opportunity to build listening, assessment, and management skills for prenatal and intrapartum scenarios. Students are provided equipment and virtual instruction in an intrauterine device insertion session, which promotes skill acquisition and self‐confidence. Trigger films are used to visualize real‐life or scripted clinical encounters, leading to discussion and decision‐making, particularly in the affective domain. Bilateral learning tools, similar to case studies, provide students an opportunity to demonstrate their knowledge and critical thinking with a mechanism for faculty feedback. Web‐based virtual clinical encounter learning tools using patient avatars prompt additional student learning. Suturing skills introduced in live remote group sessions are augmented with video‐guided individual practice. This article describes each of these adapted and innovative simulation methods and shares lessons learned during their development and implementation.

Shifting to Delivering Simulation Virtually Within a Healthcare Education Setting

“…The coronavirus disease 2019 (COVID-19) pandemic has created a necessary shift in healthcare-education strategies from in-person to virtual modalities [ 1 ]. Various virtual-simulation approaches have been adopted into healthcare education, each with beneficial applications to undergraduate, graduate, and ongoing professional levels of education in nursing, medicine, and midwifery.…”

“…This approach focuses on the cognitive and behavioural skills by critically considering why actions are performed and the education provided to patients and families about the interventions, as opposed to the hands-on technical skills of performing the action [ 2 ]. Another approach using telesimulation focuses on assessing skills and clinical competencies [ 1 ]. Telesimulated Objective Structured Clinical Examinations (OSCEs) are conducted to evaluate student learning, clinical judgement, and professional conduct; during OSCEs, students demonstrate competencies in obtaining and assessing clinically relevant information, providing patient education, communicating important information, and developing a care plan [ 1 ].…”

“…Telesimulated Objective Structured Clinical Examinations (OSCEs) are conducted to evaluate student learning, clinical judgement, and professional conduct; during OSCEs, students demonstrate competencies in obtaining and assessing clinically relevant information, providing patient education, communicating important information, and developing a care plan [ 1 ]. While each educational institution may implement telesimulations differently, many have chosen to approach this experiential learning with preparatory information; for example, learners may be provided with the history and background of the simulated patient before entering the simulation [ 1 , 2 ]. Using online platforms such as Zoom, learners enter the virtual simulation where they are able to engage with the simulated patient [ 1 , 3 ].…”

“…While each educational institution may implement telesimulations differently, many have chosen to approach this experiential learning with preparatory information; for example, learners may be provided with the history and background of the simulated patient before entering the simulation [ 1 , 2 ]. Using online platforms such as Zoom, learners enter the virtual simulation where they are able to engage with the simulated patient [ 1 , 3 ]. Similar to in-person modalities, the simulation ends with a debrief that promotes self-reflection and critical thinking that can be applied to ongoing learning [ 1 ].…”

“…Using online platforms such as Zoom, learners enter the virtual simulation where they are able to engage with the simulated patient [ 1 , 3 ]. Similar to in-person modalities, the simulation ends with a debrief that promotes self-reflection and critical thinking that can be applied to ongoing learning [ 1 ]. Variations of this approach include permitting the learner or facilitator to “time-out” during the simulation for feedback, in order to debrief and/or dissect important information and dialogue being captured during the session [ 3 ].…”