In previous issues of the Journal for Nurses in Professional Development, this column has explored use of simulation to integrate the nursing professional development (NPD) specialist intertwined elements of practice of educator/facilitator, researcher/consultant, and educator/academic liaison. Continuing on this theme, the focus of this column is on the change agent/team member intertwined element, and how the NPD specialist can employ simulation modalities to enhance the tasks associated with it.
The Nursing professional development: Scope & standards of practice (ANA and NNSDO, 2010) delineates several elements of practice, including the change agent/team member element. Each of the intertwined elements has various activities associated with it that encompass a broad range of actions. The activities related to change agent/team member element include incorporating changes into educational activities, supporting organizations as they go through change, collaborating with intraprofessional and interprofessional groups and facilitating team building, and problem solving where identified changes are needed (ANA and NNSDO, 2010).
The change agent/team member element lends itself well to simulation learning, as simulations can readily incorporate changes into scenarios and thus act as a reinforcement of organized education. For example, rolling out a new hospital-wide defibrillator requires a significant amount of coordination and staff education. The NPD specialist can support change by scheduling targeted simulations in the weeks after the initial education that incorporate the new defibrillators. In doing so, the NPD specialist can assess for knowledge or performance gaps and address them immediately. These targeted simulations can also serve as follow-up to the initial education, and help identify any systems issues with the rollout that needs to be fixed.
Simulation can also be used to help identify user-acceptance issues during the prechange phase. For example, if a hospital is considering buying new code carts, the NPD specialist could design simulations that help test different code carts and configurations. Presenting staff members with the opportunity to try out new equipment in the in situ environment to see how it fits, can provide excellent information on its appropriateness. The NPD specialist could evaluate how easily the proposed code cart rolls, how well it fits into different rooms and areas, how it is internally and externally configured and other user-oriented issues that might arise, which otherwise would not have been identified without in situ simulations. Positioning key stakeholders, such as frontline staff, at the beginning of the change process can help to increase adoption and sustain commitment as they are actively part of the change process.
Integrating stakeholders early in the change process is an essential part of organizational change management principles. Clayton (2014) suggests developing a stakeholder engagement culture that permeates throughout all levels in an organization by seeking to increase communication; facilitate feedback from stakeholders; and provide the correct tools for change including policies, procedures, and processes. Embedding respectful, proactive, and ethical processes to facilitate this culture leads to organizational excellence. Debriefing after simulations can provide an excellent forum for discussing specific changes, how they relate to practice, and emotional issues related to the changes.
NPD specialists can serve as influencers of change, as they have expansive organizational relationships with individuals at all levels. NPD specialists are integral to the change team and can serve to champion change, create positive emotions about change, and influence others to adopt and adapt (Atkinson, 2014). As simulation brings different people and professions together to learn, NPD specialists can focus on the people side of change and foster the atmosphere, relationships, and dialogue necessary for effective change to occur.
In addition to the change agent element, the team member element is intertwined and focuses on collaborating with teams and facilitating positive teamwork behaviors. Simulation is used in both academia and the hospital environment effectively to train interprofessional team members to better communicate and perform (Weaver et al., 2014). As part of the activities of this element, NPD specialists can design, develop, and deliver simulations that focus on many aspects of team building. Team building simulations can be used in varied areas for code blue response, rapid response, psychiatric emergencies, trauma, and others. The NPD specialist is in a prime position to bring different teams and team members together to optimize practice and patient care.
In future issues, the other intertwined elements will continue to be explored as they relate to simulation. What have you experienced with integrating the elements of practice with simulation in the hospital-based setting? How have you documented your NPD specialist practice as it related to your simulation work? Do you have any suggestions to share with others? Please email me at mailto:[email protected] to continue the discussion.
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