Photo of three nurses in the back of a simulated ambulance while a camera records

Critical care simulation lab for nursing students moves to online format

Imagine you’re a critical care nurse transporting a patient with a subarachnoid hemorrhage (bleeding in the brain) from a non-stroke community hospital to an acute care stroke center. Your patient’s condition is deteriorating rapidly. You need to stabilize the patient…and you’re in a helicopter.

That was one scenario presented to second-year Master of Nursing (MN) students in Donna Thompson’s critical care simulation lab. In the traditional lab, the students are the ones in the cramped, high-stress environment with faculty members and clinical advisors hovering nearby, assessing their response.

With the transition to remote learning due to the COVID-19 pandemic, Thompson, an instructor and clinical coordinator with the Frances Payne Bolton School of Nursing, rewrote the scenario using faculty and clinical instructors as the critical care team members. 

Prior to starting their work from home in March, faculty and staff filmed the lab in the nursing school’s Center for Nursing Education, Simulation and Innovation (CNESI) using both the ambulance and flight simulators. CNESI Simulation Manager Thomas Baum and Simulation Operation Specialist Jared Lee—both paramedics—filmed the exercise, controlled the ambulance and flight vehicles and managed patient vitals. 

Photo of a dummy being used as a patient in a simulated emergency flight with two nurses

The simulation actors—Thompson, lecturer Amy Lower, instructor and course coordinator Angela Arumpanayil and clinical instructor Shalyn Adams—are all critical care registered nurses and work colleagues. Thompson said all have worked together as nurses, but she will be interested to see the interaction between clinical instructors who do not normally work together. She’s submitting the simulation to the Quality and Safety Education for Nurses (QSEN) website as a teaching strategy so other schools can utilize it if needed.

“We created the lab to challenge our final semester critical care MN students to use their critical thinking skills,” Thompson said. “We used both the ambulance and helicopter simulators, focusing on providing high quality patient care using a team approach, while including multiple opportunities for effective handoff communication.”

Virtual clinical simulation labs were a bit of a culture shock to faculty and students, who were—prior to the pandemic—spending 16 hours per week in the critical care environment simulation labs.

“Our students went from soaking up new knowledge through hands-on experiences in the hospital setting to learning through online simulations, case studies and discussions,” said Arumpanayil. “The students are finding they need to reorganize the way in which they approach their schedules and workload.

“I am extremely proud of how our students are managing the abrupt change to an online learning environment,” she said. “As nurses, we pride ourselves in being creative problem solvers and adaptable in an ever-changing environment and that is exactly what our students are showing us they can do.”