Special Delivery

High-fidelity simulation prepares future labor and delivery nurses to provide competent care

Every day, labor and delivery nurses help mothers welcome their new additions to the world. The majority of those deliveries occur without complications, as women’s bodies perform actions they have been doing for millennia. Yet nurses must be prepared for challenging deliveries that present threats to the mother and the baby.

Advanced training helps healthcare professionals face challenges head on. At Baylor University Louise Herrington School of Nursing in Dallas, Texas, state-of-the-art technology helps students gain the skills and confidence they need to handle various delivery room scenarios.

Before the advent of simulation training in nursing education, students learned through experience with live patients. It was a completely uncontrollable learning method, as a nurse could be in practice for a few years before seeing a high-risk situation. Today, hospitals have little tolerance for risk, so students have fewer opportunities to perform certain procedures.

Evolving Learning Environments
The burden of that training has been passed to classroom environment.  “We can use high-fidelity simulation to provide those experiences in a safe way,” explained Vivian Gamblian, MSN, senior lecturer and SIM lab coordinator at Baylor University.

The technology for simulation was introduced to nursing education about ten to twelve years ago, and it is rapidly evolving. Baylor nursing students learn from “Victoria,” a high-fidelity mannequin that can be programmed to replicate high-risk, low-frequency labor situations, such as shoulder dislocation in the infant or excessive hemorrhaging in the mother. Every student, then, can be exposed to those scenarios.

With maternal hemorrhaging, for example, the simulator can mimic the real-life subtle cues that mark the onset of bleeding, testing if the student knows what signs to look for. The instructor can also make the situation worsen until the student has an “a-ha moment” and takes the steps to correct it.  The lab can be configured like various real-world environments, so nursing students can train for home births versus hospital births.

High-fidelity stimulators are used to train teams. They teach students how to best communicate in high-risk situations and bring their collective knowledge together for the good of the patient. Gamblian said, “The earlier a problem is identified, the greater likelihood of averting disaster.”

“Victoria” also comes with a high-fidelity newborn simulator and instructors can extend birthing scenarios to feature complications with the baby.

Achieving Mastery
“These are experiential learning moments that are deeper than what we could provide in a lecture,” remarked Gamblian. “We can do it again and again until participants reach a level of mastery. “When we talk about birthing, that’s really important.”

Undergraduate nursing instructors use this high-fidelity mannequin to orient BSN students before they go the hospital for their OB-GYN clinical. The simulators are not just a teaching tool for life-or-death delivery room scenarios, but are also used to teach high-frequency, low-risk situations.

Gamblian explained, “They just need to see how a baby is born before they go to the hospital.” Previously, the university used low-fidelity mannequins to teach the technical aspects of labor and delivery. Students, though, had trouble putting together the whole picture. Gamblian continued, “Through hands-on learning, students are able to grasp concepts more quickly.”

Preparing for Practice
“Victoria” is wireless, so she can travel from the simulation lab to classrooms for lecture training. She’s connected to a computer, so nursing students can ask her questions and get answers, as they would with a live patient. She also speaks Spanish, which is an opportunity to create greater cultural competency.

Higher-level students also learn from the technology. Nurse-Midwifery DNP students at Baylor use birthing simulators to study both normal birth and complications of birth. Family NP students train on prenatal care using the simulator.

Although Baylor nursing students attend school in a major city with access to high-volume delivery hospitals for clinicals, not every nursing student has that training opportunity. Simulation technology prepares students for practice.

“We’re seeing a movement globally towards stimulation,” said Gamblian. It trains labor and delivery nurses in the latest advances and helps mothers and babies get the best care.

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