High-Tech Simulation: Manikins Enhance Critical Thinking and Assessment Skills

By Holly Miller, MS, RN

You enter the room and the patient says “I don’t feel good.” This isn’t your usual patient environment or your usual patient. This patient is SimMan, and he is in the critical care area of the Fay W. Whitney School of Nursing at the University of Wyoming.

Simulation has always been a part of nursing education. For many years, there have been specific task trainer simulators for such skills as urinary catheterization, central line dressing change, intravenous catheter insertion, blood pressure measurement, nasogastric tube insertion, tracheostomy care, and many more. Male, female, pediatric, and geriatric full-body manikins also provide numerous opportunities to practice clinical skills. However, times are changing!

The nursing world has now become “high tech” in supplementing the teaching of new health care providers. Several companies are manufacturing high-fidelity and medium-fidelity manikins. High-fidelity simulators are run by a computerized system which allows the instructor to pre-set the lung sounds, heart sounds, and bowel sounds. The instructors can develop a specific scenario, use a preprogrammed scenario, or run a scenario “on the fly” by changing the vital signs and other parameters on the computer as the students progress through the scenario. Amazingly, the manikins can even speak! The medium-fidelity simulators are run from a hand-held remote control connected to a VitalSim device. They are not as sophisticated as the high-fidelity manikins but still have programmable heart, lung, and bowel sounds, a few pre-programmed scenarios, and can say a few words.

The Fay W. Whitney School of Nursing has high-fidelity simulators like SimMan and medium-fidelity simulators like Nursing Anne, Nursing Kid, and Nursing Baby. SimMan is a very popular guy across the country and worldwide. He is one of the most sophisticated manikins on the market. He is a full-body, anatomically accurate patient simulator who can be programmed to simulate a wide range of illnesses as well as signs and symptoms. He can even react to the medical interventions performed by the  students.

With SimMan, mistakes can be made and the student can see the consequences of their actions without harming a human patient. However, he makes the students feel like they are in a real-life situation. He can enhance the critical thinking and assessment skills of the students. High-fidelity simulations are the latest trend in nursing education. The Fay W. Whitney School of Nursing is including simulations into our clinical courses. This is an excellent way to supplement the clinical learning experiences in the actual clinical settings.

The Fay W. Whitney School of Nursing moved into the renovated College of Health Sciences Building in the summer of 2005. The Clinical Simulation Center (CSC) includes an assessment lab, skills lab, clinical FNP lab, reception area, demonstration classroom, media lab, and a simulation lab.

A small conference room breaks off into six state-of-the-art, fully-equipped exam rooms. Each exam room has a state-of-the art observation area where instructors can observe and record the events within the exam room. Two-way communication is possible between the exam rooms and the observation area. The skills lab is equipped with six state-of-the-art beds and headwalls from Hill-Rom.

The headwalls have functional suction, air, and oxygen. There is also the capability to record at the bed stations in the skills lab. Outside of the skills lab is a nursing station which is also used as the reception area. The clinical FNP lab houses the microscopes and other equipment for the FNP students.

The demonstration classroom is the ultimate in state of-the-art audiovisual equipment. It is equipped with three cameras, computer projection system, two large screens, 24 laptop computers, Hill-Rom power column, and other capabilities. The cameras make it possible to record the classes. The computers allow students to access the Internet during class. The media lab allows the students to work on a computer or view a videotape or DVD. The simulation lab is a multi-use area and has a community health area, a critical care room, an obstetrics room, an observation room between the critical care room and the obstetrics room with the same audiovisual capabilities as in the assessment observation decks, a pediatrics room, and another acute care area. Clinical learning has never been so
realistic, safe, or fun!