The Affordable Care Act goals are to increase quality of care while decreasing spending. In alignment with these goals, there is an increase in patient care being moved from inpatient to outpatient (American Academy of Pediatrics, 2013). We see these trends also reflected in our pediatric population as see more of their care being provided in community and primary care settings.
Moreover, the Institute of Pediatric Nursing (IPN) identified challenges for undergraduate nursing programs in providing pediatric didactic content and clinical experiences (McCarthy & Wyatt, 2014; IPN, n.d). While the role of the nurse in primary care is evolving, there is currently a gap in undergraduate training that is essential for success in this environment. Top challenges include competition for clinical sites, limitations in qualified faculty, and limited opportunities for medication administration and reduced exposure to safe practice. Topics that are under-represented include: behavioral issues, mental health, nutrition, infection control and prevention (McCarthy & Wyatt, 2014).
Methods:
In this presentation, we discuss our implementation of pediatric simulation scenarios where encounters are in a primary care setting. Multiple international studies have demonstrated that simulation improves clinical knowledge and problem-solving (Cant & Cooper, 2017; Mather, Jensen & Cummings, 2017). “Simulations offer low-risk, complex experiences that can be used to educate nursing students around the world, while also exposing US nursing students to global nursing issues and increasing global competencies” (Baumann, Sharoff, & Penalo, 2018, p. 374). Specifically, our students are challenged to address universal issues of bullying, nutrition, diabetes, vaccine hesitancy, autism, child abuse, anemia, and obesity. Each encounter requires student interaction with a pediatric patient and adult family member, with an emphasis on family centered care.
Results:
The curricular goal of our simulation experiences is to follow the recommendations to strengthen the undergraduate curriculum (McCarthy & Wyatt, 2014). Expected student performance outcomes include age-appropriate assessment, use of standard screening tools, medication administration, and proficient use of the patient’s electronic chart. The student’s ability to effectively communicate with a healthcare provider and accurately educate families about these primary care topics are what determines student learning success.
Conclusion:
In summary, our primary care pediatric simulation scenarios can be used globally by students and nursing faculty to enhance pediatric learning, education, and experience.