Authors

  1. Holtschneider, Mary Edel MEd, MPA, BSN, RN-BC, NREMT-P, CPLP

Article Content

[horizontal ellipsis](T)he focus on interprofessional continuing education and collaboration is further transforming NPD practice. While the need for Nursing Professional Development (NPD) practitioners to use their expertise in the educational process to create change and promote quality in the practice and learning environments remains, the prior focus on nurses has expanded to encompass the entire healthcare team. (Harper & Maloney, 2016a, p. 3)

 

For the past year, my colleague Dr. Chan Park and I have written about how nursing professional development (NPD) practitioners can use simulation to promote interprofessional education (IPE), with the end goal of improving patient outcomes. We have touched on a variety of aspects of IPE, including how to design and deliver interprofessional (IP) simulations that are targeted and relevant to all the participating professions and focused on both the learner and patient points of view. We challenged readers to think about ways to move their debriefing strategies away from only focusing on how the learners felt and/or perceived how they performed during a simulation, to whether the patient outcome improved because of excellent IP teamwork. If the simulated patient outcome did not improve or, worse yet, the patient was adversely impacted by the team actions taken during the simulation, how could IP teamwork be enhanced to better the outcome?

 

Earlier this year, as we anticipated the pending release of the updated 2016 Nursing Professional Development: Scope and Standards of Practice and its emphasis on IP, we culminated our series with an eye on how future NPD practitioner roles will unfold over the next few years with regard to IPE and simulation. IPE is and will continue to be emphasized in the practice environment, and it is now solidified with the new Scope and Standards of Practice release. I encourage all NPD practitioners to delve into this new document and consider ways to use it to optimize NPD practice, as it offers us an unprecedented opportunity to propel us forward in a manner that we have not had in the past. Leading the charge for IPE is not an option anymore. Rather, it is essential for all NPD practitioners to embrace and integrate IPE into educational programs and offerings.

 

Beyond IPE, how else can NPD practitioners employ simulation modalities to optimize their practice moving forward? The updated roles of the NPD practitioner are learning facilitator, change agent, mentor, leader, champion for scientific inquiry, advocate for NPD specialty, and partner for practice transitions Harper and Maloney (2016b). Simulation, as one of many different educational approaches, can provide an intriguing venue for NPD practitioners to experiment with these updated roles and link simulation scenarios to workplace competencies. If you are already using high-fidelity simulators for some educational endeavors such as nursing orientation and/or life support courses, now is a great time to consider expanding your use of different simulation modalities to maximize the updated NPD practitioner roles. For example, the use of standardized patients (SP) is one specific way to enhance simulation offerings and move beyond the use of computerized manikins.

 

Below are some thoughts on developing simulation scenarios, optimizing and expanding simulation modalities, and elevating the use of simulation in NPD practice that are relevant to each of the updated roles.

 

Change Agent

In this role, the NPD practitioner seeks to transform processes that are often suboptimal and can negatively affect quality of care. In situ simulations that test systems from beginning to end can be quite effective at identifying latent threats and engaging frontline staff to help fix problems. Rapid response team (RRT) activation simulations can be very helpful at pointing out knowledge and process gaps. Use of an SP to portray a patient on a medical/surgical floor who displays difficulty breathing would trigger an RRT response from the floor staff. To optimize the simulation, document the initial actions and response times of the first responders and the RRT team, and note any systems issues that appear to hinder optimal response. These systems issues could be related to equipment, supplies, the paging system, location, environment, and so forth. Engage the staff to help identify better processes, and follow through with appropriate action items.

 

Mentor and Partner for Practice Transitions

The mentor role focuses on helping others to professionally develop and grow in the workplace setting. Although this is an important role, NPD practitioners often do not have much formal training on how to mentor, nor do they have formal training on how to help and support others as they move into different professional roles. Using an SP to help role-play some key scenarios can be quite helpful. Some of the situations the SP could portray include a new nurse who feels unappreciated in her current unit and is seeking a job change, a seasoned nursing assistant who would like to return to school to earn a nursing degree, or a healthcare professions student who is searching for professional direction.

 

Facilitator of Learning and Leader

In these roles, the NPD practitioner influences the IP healthcare team and the healthcare environment. Ensuring that IP simulations are targeted and relevant to the involved professions is essential. Looking at simulating issues beyond clinical topics, such as interpersonal conflict resolution, difficult team dynamics, and handling challenging patient situations, can help clinicians and others develop skills relevant to all aspects of health care and the practice setting.

 

Champion of Scientific Inquiry and Advocate for the NPD Specialty

One of the ways an NPD practitioner can embrace these roles is to ensure that all educational activities, including simulation-related offerings, are congruent with evidence-based practice. In addition, the NPD practitioner can champion scientific inquiry by seeking ways to evaluate outcomes of simulation education beyond only learner satisfaction or Kirkpatrick Level 1 (Kirkpatrick & Kirkpatrick, 2009). Moving to Level 2 evaluations, where there is some documentation that the participants learned the targeted material at the end of a session, can help show how simulation makes a difference in the work environment. Striving for Level 3 and 4 evaluations, called Impact Metrics by Kirkpatrick and Kirkpatrick (2009), can help the NPD practitioner document the value and real results of educational efforts for the learners and the workplace as a whole. Ultimately, this can serve as an advocacy for the NPD specialty.

 

These ponderings are meant to provide a start for ongoing discussions on ways that NPD practitioners can use simulation modalities to further enhance the updated NPD practitioner roles as outlined in the Nursing Professional Development: Scope and Standards of Practice. In future columns, we will continue to explore innovative uses for simulation and link them back to the revised document.

 

How have you started to implement the new Scope and Standards of Practice as it relates to simulation? Do you have any suggestions for other NPD practitioners as they embark on this journey? Please email me at mary.holtschneider@va.gov.

 

References

 

Harper M. G., Maloney P. (Eds.). (2016a). Nursing professional development: Scope and standards of practice. Chicago, IL: ANPD. [Context Link]

 

Harper M. G., Maloney P. (2016b). Nursing professional development: Revisions of the scope and standards of practice. Journal for Nurses in Professional Development, 32(3), 171-173.

 

Kirkpatrick J., Kirkpatrick W. (2009). The Kirkpatrick four levels: A fresh look after 50 years 1959-2009 [white paper]. Kirkpatrick Partners LLC. Retrieved from http://www.kirkpatrickpartners.com/Portals/0/Resources/Kirkpatrick%20Four%20Leve[Context Link]