Educating faculty in working with simulated patients within undergraduate student nurse training

Background: The Francis report (2013) identifies concerns around the quality of nurses and other healthcare professionals ability to communicate in a compassionate and empathic manner with patients. Given the decreasing number of clinical placements, the use of manikins is increasingly common in nursing education. There are strong drivers for the use of manikin technology; financial, legal and technological (Dean et al., 2016) and there is a percieved high status lure of technology. Manikins can support learning in a controlled clinical environment, however, it is impossible for students to practice communication skills, authentically, with a manikin. Simulated patients (SPs) are individuals trained to portray a real patient (Lopreiato et al., 2016); in their role of patient advocate, their needs, circumstances and preferences can be explored.

Project description: We aimed to provide a three-stage training for Bachelor of Nursing university lecturers in effective engagement with SPs in person centred simulation. Over nine weeks, information was gathered from lecturers which shaped the content of the first-stage workshop. We ascertained lecturer awareness in sixteen areas of SP methodology and context.

One experienced faculty member presented the workshop; two SPs demonstrated roles and collectively presented sixteen areas of SP methodology and context, including role portrayal, their ability to deliver objective feedback and their role as patient advocate. The workshop was relevant, safe, meaningful and transferable, underpinned by the ASPiH standards.

Summary of results: The lecturers were asked to complete a sequential evaluation of the workshop based on a retrospective pretest-posttest evaluation. To reduce the ‘response shift bias’ of a conventional pretest-posttest evaluation, this was contemporaneous with the sixteen areas scored as each was covered.

All lecturers indicated increased awareness with every one of the sixteen descriptors. Pre-workshop, the average awareness level of each descriptor was: ‘no-awareness’/‘limited-awareness’, rising to an ‘awareness’/‘moderate-awareness’. It was not expected that participants would rate themselves as having ‘full-awareness’ as these topic areas are to be covered more comprehensively in future stages of training.

Discussion: Post-workshop, lecturers had ‘limited-awareness’ of:

• the background to SP methodology

• range of ways of introducing SPs into education delivery

• involving SPs in the debrief.

Content of future workshops has been determined by these results, to address ‘assumed knowledge’.

This is a highly transferable and replicable introductory workshop, which will be delivered to lecturers in the wider School of Health Science and Social Work faculty, enabling them to explore working with SPs within allied health professional undergraduate courses.