Preparing for practice

The School of Nursing and Midwifery's Simulation Lab provides a fully immersive hospital experience, allowing students to put theory into practice

It’s last-minute checklist time. Kate straightens her blue shirt and glances at her reflection. Hair tied back. Name badge on. Non-slip shoes, watch, no jewellery, no nail polish. Check. She takes a deep breath as she enters the ward, searching the room for Jennifer, the midwife, who will provide her with a handover.

“Excellent, you’re here,” says Jennifer, briskly. “I need to get to my other client in the ward next door, so let me tell you about Casey. She’s 30 and was admitted two hours ago in established labour. She is now contracting 4:10 at 50-60 seconds.”

Kate diverts her gaze to Casey, who is too preoccupied with breathing through a contraction to notice.

“I was able to complete an abdominal palpation, vaginal examination and listen to the fetal heart before she moved into left lateral,” continues Jennifer. “Her previous birth two years ago was normal. We have discussed that her labour has been quick, and Casey has consented to active management of the third stage with oxytocin. Oh, and that’s her partner there with her.”

“I don’t think she will be long now,” she adds. “I have set up the trolley and just brought in the oxytocin. I can check that with you now before I go next door.”

Kate nods. Her Friday shift has begun, but not exactly where you may think.

This is not a real ward in a real hospital, with a real patient, or a real outcome. Instead, it’s a controlled scenario, carefully developed by academics and executed in La Trobe’s Nursing and Midwifery Simulation Lab. This hands-on training plays a vital role in developing the clinical and soft skills that nursing students need to prepare them for placement and practice.

Enhancing skills

So what does a simulation lab look like?

“It resembles a normal hospital clinical environment,” explains Dr Monica Peddle, Undergraduate Course Coordinator in the School of Nursing and Midwifery. “It’s got the sights, smells, sounds, equipment, colleagues, patients and families. Intravenous volumetric pumps are whirring, cardiac monitors are beeping, there’s overhead announcements and the smell of alcohol-based disinfectant on the floors and surfaces.”

The result: a fully immersive experience that allows nursing and midwifery students to put theory into practice. A technical skills area provides students with the opportunity to simulate administering medication or wound care.  A ward area – complete with beds, patients and equipment – can be adapted to resemble a birthing room, accident emergency room or high dependency unit.

Mannequins provide the patient perspective, including Fidelis Lucinda Childbirth Simulator, which offers a realistic learning experience of birth, and Sim Man, which has breathing sounds, heartbeats and changes colour. Full mannequins are supplemented by part task trainers, including true-to-life abdomens, arms and cervixes.

“Simulation offers students an opportunity to question routine habits and learn how to work together in a team environment,” says Sharon Mumford, Course Coordinator of the Bachelor of Nursing and Midwifery. “They attend lab classes in uniform, complete the required hygiene procedures and are expected to behave as if they were in practice. The sessions develop their soft skills including how to communicate with colleagues and patients, and their dexterity. And we debrief after the simulation is complete, reflecting on the theories, policies and critical thought processes behind their performance.”

Most importantly, says Peddle, “simulation takes away student anxiety about knowing what to do in practice, what it’s going to feel like, and how to have conversations with patients.”

“We can teach students to take blood, for example, but taking blood while you are explaining the process to a patient is complex,” she explains. “Simulation allows students to integrate their theoretical, cognitive and soft skills before they encounter these situations in real life.”

Fourth-year Bachelor of Nursing/Bachelor of Midwifery student, Jessie Cameron, agrees. “Entering a healthcare setting as a professional in training can be challenging,” she acknowledges. “The Simulation Lab allowed me to practice my critical thinking and clinical skills in a safe and supportive environment. The post-simulation discussion enhanced my learning and has benefitted my training beyond measure. As a result, I feel far more confident on placement.”

New lab

The School of Nursing and Midwifery Simulation Lab has recently been refurbished, providing students and academics with a larger, more realistic and technologically enhanced facility.

Four wards with six beds and two single-bed rooms, control and observation capabilities, and video equipment is supporting 1200+ undergraduate and postgraduate students, and facilitating skills development and group learning in a range of health contexts.

Professor Lisa McKenna, Dean and Head of the School of Nursing and Midwifery, believes that the new high-tech facility enhances teaching innovation and the student experience. “The new facility will provide an environment that is more realistic, enables new learning and teaching approaches, and increases student competency on placement and in practice,” she says.

“Teaching spaces are larger and more adaptable, allowing staff and students access to a range of learning settings.”

“Multiple video recording units are a feature of each skills area, providing new opportunities for students to record themselves and develop their capabilities as reflective practitioners,” adds Mumford. “And facilitators are able to place further emphasis on debriefing, feedback and student-directed learning.”

“Online education has been transformed in recent months but, for nursing and midwifery students, developing a professional skillset in a practical setting is critical. Simulation labs help nurses and midwives in training to increase their competency to, ultimately, support an outstanding patient experience.”