Minnesota Health Educator’s Conference 2013

Posted on April 24, 2013 by

Once again I had a wonderful time at the Minnesota Health Educator’s Conference.  This year we went to Brainerd and stayed at Madden’s on Gulls Lake.  It was a nice resort but they should have ordered better springtime weather. =) We got 10 inches of snow April 18/19!

Here are the tweets from this year’s conference #MnHEC13.  Unfortunately they never announced the hashtag, nor was it in the conference material.  The only place I saw it was in a last minute e-mail that I’m not sure many people received.  Once again, it was mostly me and one other person tweeting.  But it was fun!

I encourage you to join in next time!

To read the tweets in order go from bottom to top

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Mini-SUN conference, St. Paul, MN

Posted on November 10, 2012 by

I was lucky to attend a 1 day mini Simulation User Network conference sponsored by Laerdal and hosted by Regions hospital yesterday.  What an amazing day!

The conference brought together simulation experts from industry and academia, and attendees included nurses, physicians, paramedics, medical assistants and more.  Sessions included topics like debriefing (including an actual simulation and debriefing), creating a sustainable simulation program, and a panel discussion.

Breakouts included opportunities to learn about controlling and running high-fidelity mannikins, bringing realism to simulation, moulage for realism,  integrating simulation into a curriculum, etc.

I volunteered (read: was roped in) to participate in a simulation demonstration at this event in front of all of the participants.  I had no idea what was coming, and as a midwife I’ll admit I was worried about how I would do in a medical scenario.  I was reassured when reminded that if I made a mistake the conference attendees wouldn’t know if it was on purpose or not!

The biggest reason I volunteered, though, was that in 4 years of running simulation I had never been a participant myself.  I’ve done plenty of demonstrations to students before, of course, but never been thrown in to the unknown just like I do to my students.  It was nerve wracking!  It was also eye opening as both a life-long learner in nursing and an instructor who puts her students in these situations on a daily basis.  I recommend anyone who facilitates debriefing to do this whenever possible!

There were tweets from several attendees including me and my notes from the conference.  I share all of the conference tweets with you here.  For chronological order start at the bottom and work your way up!

I hope to see more SUN conferences in MN in the future!

Thank you Laerdal & conference planning committee for an awesome conference! #SUNRegions12

Minnesota Simulation Consortium (Linked In) #SUNRegions12

Objectives can be broad to help guide learners but leave the specifics off #SUNRegions12

Giving objectives in advance: literature divided. Many choose to give, and many choose to keep secret #SUNRegions12

Sell simulation to staff, don’t make it mandatory. Bring the manikins out and about and bring them to life! #SUNRegions12

Help in sim center: find people on limited duty, get new grads to help who’ve done sim in school #SUNRegions12

Don’t forget to plan for storage! #SUNRegions12

Don’t be afraid to run sims. It’s the best learning opportunity to learn to facilitate. #SUNRegions12

Ehr options for academia: Docucare (Lippincott), SimChart (Pocketnurse), using quiz function within LMS, Neehr Perfect#SUNRegions12

Deb filer at St. Kate’s: ehr via excel #SUNRegions12

Question for someone from Laerdal: can logs from simpads be printed somehow? #SUNRegions12

Behavioral expectations for students: 5 P’s participation, prep, professionalism, pt safety, performance. #SUNRegions12

Evenf for self-authored, Sim store has sound files, diagnostic pictures, etc. #SUNRegions12

“Handler”: similar to simpad ‘states’, allows for multiple variables to change over time #SUNRegions12

“Trend”: setting a change to occur gradually over time#SUNRegions12

Scenarios from sim store can be downloaded and trialed for 24 hours for free #SUNRegions12

“Instructor mode” has a base scenario but instructor can jump in and take control. “auto mode” is fully automatic. #SUNRegions12

On the fly vs preprogrammed: pre-programmed scenarios advantages: consistency from sim to sim #SUNRegions12

On-the-fly vs preprogrammed scenarios: otf offers control, customizability #SUNRegions12

Regions simulation med dispensing system (for sale!)#SUNRegions12 pic.twitter.com/EIKoKcOG

Enhancing realism: never throw away old iv arm skins. Use for moulage #SUNRegions12

Enhancing realism: crayola washable paint for bruises. Barriers for other moulage: petrol jelly; sticky Saran wrap #SUNRegions12

Enhancing realism session: place tattoos on manakins and make students start ivs and have students start ivs through them#SUNRegions12

Amazing sim center up here on the 7th floor. I’m jealous!!!#SUNRegions12

Thanks Laerdal for a great lunch! #SUNRegions12

Does anyone have any photos to share? Great stuff today at#SUNRegions12

Ideal: debriefing expert & clinical expert together. Debriefer facilitates discussion, clinical exprt engages in clinical part #SUNRegions12

Debrief: how was comm? (Closed-loop) Shared mental model (were u sharing thoughts w/to)? Resource mgmt: is expertise utilized?#SUNRegions12

Key competency of debriefer: encourages reflection #SUNRegions12

Sim scenarios being used for medical credentialing #SUNRegions12

Debriefing can be effective toll for curriculum development & student learning #SUNRegions12

Good debriefing needs to be goal-driven & responsive to the learners#SUNRegions12

#SUNRegions12 we will be posting the presentations onhttp://Laerdal.com/sun  hopefully on Monday.

Consequential vice: what would pt outcome be if this happened in real life #SUNRegions12

Debfrief: Start with “what went well” #SUNRegions12

Exploring questions: “what made you make that choice?”. Learner focused #SUNRegions12

Leading questions in debriefing: “everyone looked lost in there. Does anyone know who was in charge? #SUNRegions12

Clarifying questions in debriefing: how do we do x, y z#SUNRegions12

Errors should be viewed as puzzles to be unpacked and learned from. Discuss this upfront. Help them know it’s safe. #SUNRegions12

Debriefing: learners come w/neg feelings & can feel shame. Seek safety: “unrealistic” or “i would never do that in real life”#SUNRegions12

Emotional state is strongly linked to learning #SUNRegions12Experiential learning is risky. Assumptions r challenged.

Book : Clinical simulation: operations, engineering, & management (Kyle) #SUNRegions12

Clarify: 2 to 1 time ratio @NursingTheIssue Debriefing: 2 to 1 ratio ideal #SUNRegions12

Debriefing models: it’s about having a tool kit not just one tool#SUNRegions12

Idea for tracking education hours in sim : 1 learner 1 hour = 1 Ed hour. 5 learners 1 hour = 5 Ed hours #SUNRegions12

Faculty development check-off list /syllabus for new sim faculty.#SUNRegions12

Faculty development: focus on needs assessment. Small, frequent training opportunities. Standardized competency tools#SUNRegions12

Barriers: identify ext and int barriers (survey organization 4 better results). Partner w/risk managing for areas of org need#SUNRegions12

Loma Linda University experts on policy & procedures for sim centers#SUNRegions12

#SUNRegions12: Wow LomaLinda willing to share their policy manual.

Means for organizational buy-in: data collection (ROI & ROE). QI – evaluations: did learning occur? (Kirkpatrick model) #SUNRegions12

4 areas of focus for keys to sustainable program: org buy-in, overcome barriers, faculty development, curriculum integration #SUNRegions12

SSH: certifies educators as Certified Healthcare Simulation Educator#SUNRegions12

Who’s accrediting sim centers? ACS, ASA, SSH. Society for simulation in healthcare doesn’t need an MD as med director#SUNRegions12

Sustainability: are sims written down so someone else could facilitate them? #SUNRegions12

Sustainability: Policies should be documented: such as “no live meds will be used” #SUNRegions12

Great educators may not intuitively be great sim facilitators. How are they orienting? #SUNRegions12

Sustainability: would your sim program survive if any 1 person left?#SUNRegions12

Establish a mission & vision for your sim program specifically#SUNRegions12. This will help guide your decisions.

#sunregions12 Thanks again Gail and great job!

I’d love to discuss collaboration between academia and industry#SUNRegions12

At the #SUNRegions12 conference doing some networking and learning more about #simulation ☺

Make sure we get a date for the HeartCode meeting! #SUNRegions12

Getting ready for a great meeting with some great folks!#SUNRegions12

At SUN conference Regions hospital. Excited to be with my sim peeps at #SUNRegions12

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MANE Faculty Development: Maintaining Momentum for Change

Posted on November 8, 2012 by

Last Saturday I went to the first conference held by the Minnesota Alliance for Nursing Education.  This group is a collaborative effort of several community colleges and one university nursing program who are putting together an entire nursing curriculum.  It will begin at member colleges in Fall 2013 (for general education requirements) and Fall 2014 for nursing courses.

There was an initial discussion of the current state of the curriculum, then the conference speaker was Diane Pestolesi.  She spoke about teaching for salience, building on prior learning, and bringing meaning to the current client situation.

Here are my tweets from the conference.  Though I had to leave a bit early, from what I’m told there wasn’t much I missed.  Chronologically start with the last tweet and read up.

Tweets

Clinical rounds Pestosoli: 1. Papers, trouble shooting 2. SBAR with coaching, clarifying 3. Review, reflect, reinforce #MANEMMC

4 clinical expectations spiraled through a curriculum: apply nursing process, practice safely, comm effectively, act professionally#MANEMMC

The experiences that make students “feel like nurses” r not usually things that make students “think like nurses” #MANEMMC

Reflective Practice: transforming education& improving outcomes (Sherwood & Horton-Deutsch) #MANEMMC

Keep it salient: limit to 3-5 objectives. What would you tell someone about your topic on a 5 floor elevator ride? #MANEMMC

Keep it salient: what is it? How will they know it when they see it? What will they do about it? #MANEMMC

Take 5: 5 mins to talk about last week- what did we cover, salient/ important points. Review, transition into this week’s topic. #MANEMMC

ICARE: stdnts 2 b intrstd, comfrtble, connctns, actvties, applctin, relevant, respnsble, reflction, reptition, engaged & emotional#MANEMMC

In order to “think like a nurse”, students must engage with patients or patient care situations. #MANEMMC

In order to “think like a nurse”, students need to be coached to recognize, reason, respond, & reflect #MANEMMC

Benner via Pestolesi: 1. Teach to salience 2. Integrative teaching 3. Develop clinical judgment 4. Emphasis on trnsfrmtn to nurse#MANEMMC

Course teams can work together throughout MANE schools. An amazing opportunity for collaboration. #MANEMMC

Sources of financial aid found in industry with Oregon consortium. Will be seeking sources for students to pursue FT study. #MANEMMC

Evaluation plan will be worked on #MANEMMC

Admission requirements being worked on. Do students come in as NA’s? Unknown at this point. #MANEMMC

Clinical is going to be quite different. Interviewing/ wellness experiences includes a diverse group of patients. #MANEMMC

OB, peds, and MH are incorporated throughout. OB is a state of wellness! #MANEMMC

75 credit AS program approved (5 sems) #MANEMMC

At MANE’s first faculty Dev Day #MANEMMC

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Consumer Reports on Pregnancy and Birth?

Posted on May 14, 2012 by

As a blogger about nursing, parenting, birth, teaching, etc… I never really thought I’d do a blog post about Consumer Reports, but here goes.

Consumer Reports (CR) is:

an expert, independent, nonprofit organization whose mission is to work for a fair, just, and safe marketplace for all consumers and to empower consumers to protect themselves. The organization was founded in 1936 when advertising first flooded the mass media. Consumers lacked a reliable source of information they could depend on to help them distinguish hype from fact and good products from bad ones. …To maintain its independence and impartiality, CR accepts no outside advertising and no free samples and employs several hundred mystery shoppers and technical experts to buy and test the products it evaluates.

Imagine my surprise, then, when Consumer Reports started writing about pregnancy and birth related care.  The organization probably most famous for its automobile ratings is now rating birth interventions.  I was skeptical.

Imagine my further surprise when what I read was one of the best written and factual pieces on pregnancy and birth care, entitled “What to reject when you’re expecting: Top 10 procedures to think twice about during your pregnancy”.  What’s more, this was not written by midwives, obstetricians, nurses, or anyone else with a spin or bend.  It was written by independent researchers, accustomed to looking at “products” from a consumer’s perspective, looking past the hype and with an eye on safety, quality, and value.

They start by pointing out that the US ranks 42 in maternal mortality in the world.  42nd, and maternal deaths continue to rise in the US.

They go on to list 10 overused procedures, including Cesareans, inductions, and routine rupture of membranes.  

They then list 10 strategies for best outcomes, including choosing a midwife,  a doula, and… *GASP*… “Listening to yourself” and doing those things that feel best in labor, like walking and changing positions.  

They recommend being prepared for pregnancy with some tips on being as health as possible before hand.

Finally, they end with 2 “success” stories, though I think they would have been best labeled VBAC succes stories.  My only regret is they didn’t include positive first birth stories, or any out-of-hospital birth stories.

This is truly an amazing article, and one that EVERY person in America should read.  Remember, every human being is born one way or another.  Birth effects everyone, and everyone should stand up and demand better than 42nd in the world.  American families deserve better, and if nothing else, Americans deserve a better value for their money.

Thanks Consumer Reports!

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Not about extended breastfeeding or Attachment Parenting

Posted on May 12, 2012 by

Yep, here we go.  Another blog post about THAT magazine cover.

This one’s not about so called “extended” breastfeeding (or I should say, the opposite of the socially normal breastfeeding in the US which is abbreviated when compared to the rest of the world).

{Did you really just link to Wikipedia Carrie?  Yes I did.  Its a pretty good article.  Mostly I love that Wikipedia has so many beautiful pictures of breastfeeding!}

This one’s not about “Attachment Parenting” or attachment theory, which is a no-brainer if you just look at the science.  If you think Attachment Parenting is about adhering to any sort of parenting “theory” then you’ve bought into the hype and misinformation.  I recommend you watch this brief interview with an AP leader and local (Twin Cities) mom Kristine Dorrain.

This one is about big business.  Yes, I’m going to get a bit political here even; not red and blue kind of political, but in the sense of relationships and power kind of political.  Its funny, really, because breastfeeding and parenting are my usual blog topics, while I avoid business and politics like the plague.

Here, though, business and the almighty dollar have gotten in the way of the second toughest job in the world: motherhood.

Do you wonder what I think is the toughest job in the world?  Being a stay-at-home dad (hmmm…. I smell another blog post).

A business ploy, a money grab has tried to threaten our value and self-worth as mothers.  Geez, is any amount of money worth that?

Why do so many people want to exploit mothers, pitting one against the other?  Why prey on people who are struggling day to day to do the best for their families?

Because they can, and because we let them.

By we, I mean society.  Where is the outcry and backlash against Time?  What about the reporter and photographer?  Why aren’t men and women alike standing up and saying “no”;  not about me, not about my wife, not about my mother.

When did it become acceptable to exploit those of lesser power?  Oh wait, I guess that’s the way its been all along.  I just thought things were getting better.  Maybe I’m wrong.

What do you think?

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Placenta pictures: a follow-up on an important social media case

Posted on May 2, 2012 by

It feels like the right time for me to follow-up on a previous blog posting about a group of nursing students who were kicked out of school for posting a picture of themselves with a placenta on Facebook.

The school’s position was that it was a privacy violation, disrespectful to patients, and unprofessional.  The students’ position was that because their instructor knew what their intent was and didn’t tell them not to, they had consent.  Also they argued that they didn’t receive due process from the school before they were dismissed from the program.

A federal judge ruled in favor of the students on this case and reinstated them into their program.  While I am not surprised that they were reinstated on grounds of a lack of due process, I am surprised that in the judge’s decision he specifically said that nothing in the picture could link the placenta to a particular mother.

I’ll say that again: he said nothing in the picture could link the placenta to a particular mother.

I believe we can learn a lot from our own and others’ mistakes.  I believe that as a nursing instructor I learned and am more prepared to handle student issues just from having read this story.  I’d like to read and hear more about what other instructors have dealt with and how I can handle or perhaps avoid the issues all together.  Because of privacy issues, however, I can’t learn from others and can’t share with others.  The only reason I know about this story is because a lawsuit was filed and it went to court.  How many similar issues like this have happened around the country that those instructors could have learned from?  Could this have been prevented if stories had been shared?

I believe we have to be diligent with privacy: patient’s, student’s, etc.  I believe we have to err on the side of caution and NOT share even if we’re pretty sure it would be ok.  But I believe we lose out on a lot.

Technologies are changing faster than we can keep up, and lifestyles are changing rapidly around these technologies.  What would have been unheard of or unthinkable before is easily possible now.   We have to think hard about where/how/with who we share information.  Additionally, we have to think hard about what we do when new technologies put people in situations they’ve never experienced before.

What would you have done with these students?  What do you think of the judge including as part of his basis for the ruling that the placenta was not identifiable?

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Tweets from MN Health Educator’s Conference

Posted on April 20, 2012 by

There weren’t a lot of tweeters there, but several people learned!

Here they are, from newest to oldest:

Had a great time at #MNHEC12. Great to see old friends & make new ones. Hope for more tweeting & back channel convo next year!

#mnhec12 good conference!!

Glossary: http://bit.ly/JdbRTI #MNHEC12

Iggy: Download the glossary from the accreditation criteria!#MNHEC12

Lab/sim faculty should be Master’s prepared RNs in order to teach/ evaluate/ supervise #MNHEC12

Overview the the common problems with accreditation standards by Iggy. #mnhec12

Credentialing of nursing faculty is another area that gets schools in trouble #MNHEC12

If you are the administrator of your program, you must be no more than 20% teaching #MNHEC12

Iggy: now for NLNAC you have to be “perfect”. Also it can take 6-8 months before you know for sure how you did. #MNHEC12

Beginning the final morning session #mnhec12

Looks really interesting! Free course through UPenn on Health Care policy https://www.coursera.org/course/healthpolicy #MNHEC12

Nurses “notice” that there is a need to assess. #mnhec12

Dr. Jean Giddens, author on concept-based curriculum #MNHEC12

Never put together curriculum based on a book. Build your curriculum and find the best resources to support it. Iggy. #MNHEC12

From students: we don’t read because you tell us what we need to know. #MNHEC12

When we fragment information, students memorize. Iggy #MNHEC12

Make the classroom an environment of clinical imagination: Iggy#mnhec12

NCLEX tests nursing dx. NANDA does not use R/T, AEB in nag dx.”@NursingTheIssue: NCLEX has never tested NANDA #mnhec12“

We need to stop reviewing previously covered material (I.e. pathophysiology) #MNHEC12

NCLEX has never tested NANDA #mnhec12

We are not accountable for student learning, they are. #MNHEC12

Iggy: NCLEX is not a disease test- its a concept test. #mnhec12

Sim eval rubric from OCNE: 5 areas: Clinical judgement, safety, relationship-centered care, skillfulness, Team/comm: spiraled #MNHEC12

Preceptors who work with unlicensed: CTA’s (Clinical Teaching Associates). Must be supported by manager and attend training.#MNHEC12

Quality improvement project included as part of integrative learning time #mnhec12

OCNE Clinical Learning Model incorporates 5 areas. Case based, concept based, intervention skill based, focused care, integrative.#MNHEC12

Case studies are shared among consortium through commmon database #mnhec12

Concept based clinicals: students & faculty have a flyer in their pockets to explain concept based care & their role to nurses#mnhec12

It takes 10,000 hours to be expert at something. It takes min. 7 contacts with any given diagnosis for proper understanding.#MNHEC12

Book recommendation: Outliers. Author: Malcolm Godwell (sp?). Its about expert thinking outside of nursing. #MNHEC12

From ATI: knowledge < critical thinking < clinical reasoning < clinical judgement. #MNHEC12

OCNE clinical learning model: Focused direct clinical, intervention skill based exp, integrative exp, concept based, case based sim#MNHEC12

Discussion at our table: students need 2 hear early & often nursing is a knowledge profession not tasks #MNHEC12

A nice image on Zone of Proximal Development http://bit.ly/HVPm5G#MNHEC12

Important to keep students in the Zone of Proximal Development http://bit.ly/6bMpon #MNHEC12

Clinical education is to fill out, extend, deepen theoretical knowledge@@#MNHEC12

CERG: clinical education redesign group. You start from a blueprint@#MNHEC12

Its true, evolution missed the boat on this one. If only we burned calories by thinking! #MNHEC12

Leave your job to get your master’s degree, go into debt, then take a 30% pay cut: why we can’t recruit nurse educators. #MNHEC12

Main faculty concern about “mother duck” model: patient safety.#MNHEC12

OCNE study found new grad are very task oriented @#MNHEC12

#MNHEC12 no more mother duck clinical! In a great presentation with Paula Gubrud from OCNE!

Current clinical model in nursing ed can be described as “mother duck” model #MNHEC12

Focus on the clinical education redesign @#MNHEC12

Overview of the OCNE curriculum @#MNHEC12

Learning about the Oregon Consortium for Nursing Education. Being used by 8 comm colleges and 5 campuses at OHSU #MNHEC12

#MNHEC12 Looking at an EHR? Check out article by Donna Gloe(2010). Selecting an Academic EHR. NurseEducator

Am learning to tweet and tweet a conference. #MNHEC12

Reminder that we are educating students for minimal competency, not mastery @#MNHEC12

Nurse’s Touch focuses on the soft skills that are hard to teach@#MNHEC12

Good morning to tweeters from breakfast! #mnhec12

Starting breakfast session, Nurse’s Touch by ATI @#MNHEC12

Waiting to learn about EHR integration @#MNHEC12.

Discussion around program completion, required “prerequisites” and distance education @#MNHEC12

Professional standards vs student learning outcomes vs program outcomes @#MNHEC12

Good resources on the NLN-AC web site, @#MNHEC12

NLN-AC will have new documents up by June 1. Public comments are needed @#MNHEC12

Session on NLN-AC, Standard 4 with Marilyn Smidt @#MNHEC12

Banner: do away with curricular threads and implement 3 apprenticeships @#MNHEC12

Check out Sue’s web site at http://fieldsue.com (no www),@#MNHEC12

Next breakout session, Incorporating the New 2010 NLN Framework with Sue Field @#MNHEC12

Ann Jones gave update from Board of Nursing @#MNHEC12

Starting the annual Mn Healtheducators Conference #MNHEC12

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