Simulation doesn't have to be expensive: Moving forward with low-tech solutions

Tuesday, 19 November 2013: 10:00 AM

Melanie Chichester, BSN, RNC-OB
Labor & Delivery, Christiana Care Health System, Newark, DE
Terri L. Wyatt, MSN, RNC-LRN, GC-C, CNE
Margaret H. Rollins School of Nursing, Beebe Medical Center, Lewes, DE
Nicole J Hall, MSN, MBA, RN
Margaret H Rollins School of Nursing at Beebe Medical Center, Lewes, DE

Learning Objective 1: The learner will be able to identify opportunities for direct care nurses to demonstrate leadership.

Learning Objective 2: The learner will be able to describe 3 methods to help make low-tech simulation exercises more realistic.


Simulation training has become an integral part of nursing students’ education, permitting team drills in a safe setting. But not all nursing education programs can afford a large simulation laboratory with electronic manikins. We sought to develop a postpartum hemorrhage simulation training module with very basic equipment, using creativity to produce an atmosphere of urgency.


Using scenarios developed by a nurse clinician in conjunction with instructors at a small nursing school, we created a comprehensive education plan. After an evidence-based didactic, the "hemorrhage" was created by an enema bag filled with "blood," changing vital signs were indicated on a flip chart, and fundal assessments were done with a small ball under an elastic band on the manikin’s abdomen. Time intervals were compressed to create urgency by giving the students less time to react to each change in the patient’s condition. A debriefing was conducted post-simulation to assess students’ perceptions, provide reflection time, and discuss clinical reasoning.


Twenty-four students participated and evaluated their experiences. All agreed they experienced a feeling of panic as the "patient’s" condition deteriorated, yet felt the review beforehand gave them the tools needed to act. All concurred that this was a valuable experience which should be included in the next year’s curriculum. The faculty appreciated the "real-life" scenarios brought by a practicing clinician. The direct care clinician received the opportunity to "look forward" to other career options as a nurse educator.


Effective simulation training can be carried out without a large budget, using creativity and ingenuity in any setting, whether a small program in the United States or in a rural setting globally. Direct care clinicians willing to share their expertise through specialty topic presentations can "give back" to those who are the future of nursing by collaborating with faculty at nursing programs.