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Why You Should Consider Hybrid Simulation to Teach Labor and Delivery

Simulation is often used as a blanket term, not allowing for nuances in the training modalities and learning objectives. The reality is that simulation can be adapted to many different styles, needs, and expectations. In labor and delivery departments, where two patients means double the risk, hybrid simulation (probably the most frequently overlooked modality) is worth considering.

Adverse obstetrics events occur in 9% of all deliveries in the United States.
50% of these events are preventable.1

Hybrid simulation involves a task trainer or partial simulator being realistically affixed to a standardized patient. This allows for the proper teaching and assessment of clinical treatment and communication skills in an integrated fashion.2 For maternal and newborn healthcare providers, the blend of hands-on and interpersonal skills can make all the difference in terms of patient outcomes.

Here are some reasons that you may want to turn to hybrid sim:

1. Hybrid Simulation Is Often Lower-Cost

First and foremost, task trainers and partial simulators come at a significantly lower cost than a full-bodied, high-fidelity simulator. Though there are certainly training situations that require a full-bodied simulator, it’s important to note that not all do.

Keep in mind your learning objectives. Are you teaching your learners how to read a patient’s body language? To perform an invasive procedure while offering reassurance to the patient? To develop strong communication skills?

If you answered "yes" to any of these questions, you are likely an ideal candidate for using hybrid simulation. The standardized patient can exhibit pain, emotion, stress, and converse in a way that a full-bodied simulator simply cannot. Learners can benefit from the human dialogue, while still gaining the necessary skills training through the use of the task trainer or simulator. And, the cost-savings makes reaching your learning goals all the more attainable. Consider also that hybrid simulation can be excellent preparation for more advanced simulation later. You’ll be saving now while creating a pathway for success if you advance to higher fidelity simulation later.

2. Hybrid Simulation Offers Effective In Situ Training Opportunities

In a labor and delivery room, the team of healthcare providers cover a wide range of disciplines from nursing to medicine to anesthesiology and more. The sheer number of people involved in treating a mother and her baby can lead to a lack of clear leadership, miscommunication, or confusion – all of which are capable of bringing harm to a patient.

These types of human factors, along with systemic factors, can be identified and corrected through the use of in situ simulation (simulation that takes place in the real clinical environment). And, because of its ease of use and portable nature, hybrid simulation lends itself well to an in situ simulation environment.

Experts argue that hybrid simulation provides better insights into the real-life system as it allows you to assess problems from various points of view.

The use of a standardized patient with an attached birthing simulator can effectively teach the complexities associated with birth, while ensuring that learners monitor the patient and communicate with one another. By holding simulations in the real-life setting, learners can also help to identify unforeseen hazards before they pose a risk to a real patient.

3. Hybrid Simulation Sets the Stage for Enhanced Patient Interactions

Simulation can certainly prepare students for the obstetric and newborn setting prior to their transition to practice. But it can also prepare practicing healthcare providers to give safer patient care and promote quality outcomes during low-frequency, high-risk emergency situations. 3

Eliminating the need for extensive storage, set-up, and breakdown, hybrid simulation can be quickly set up to allow physicians and nurses hands-on practice of the most important delivery skills. And, if a recent sentinel event in a hospital warrants a full staff training, a scenario can quickly be brought to life.

Healthcare providers, just like providers-in-training, can reap immense benefits from hybrid simulation’s mixture of procedural and interpersonal skill practice. The difference is that practicing healthcare providers can immediately apply their learnings to real patient interactions and emergencies.

The result of easy-to-operate, small scale hybrid simulations done right:
  • Improved learner knowledge
  • Competent clinical performance

Ultimately, these results can lead to improved patient outcomes and satisfaction.4

How to Meet the ACOG Standards: Best Practices in Hybrid Simulation

The American College of Obstetricians and Gynecologists offers resources and guidelines to healthcare providers, promoting emergency preparedness, patient safety, and patient counseling.
 
If you are currently using or would like to use hybrid simulation to teach these skills, use these recommendations to steer you in the right direction.

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References

  1. Institute for Healthcare Improvement. (2012, May 30). Expedition: Preventing obstetrical adverse events. Retrieved from http://www.ihi.org/education/WebTraining/Expeditions/PreventingObstetricalAdverseEvents/Pages/default.aspx
  2. Lopreiato, J.O. (2016). Healthcare simulation: Dictionary. Rockville, MD: Agency for Healthcare Research and Quality.
  3. Jeffries, P., Bambini, D., Moorman, M., Washburn, J. & Hensel, D. (2009). Constructing maternal-child learning experiences. Journal of Obstetric, Gynecologic, & Neonatal Nursing. Retrieved from https://www.academia.edu/24499934/Constructing_Maternal-Child_Learning_Experiences_Using_Clinical_Simulations
  4. Sun-yeun, H. & Mi-ye. (2015). Effect of application of hybrid simulation for delivery nursing care. Advanced Science and Technology Letters, 116, p. 70-73. Retrieved from https://pdfs.semanticscholar.org/4f79/63b7657c43b04c92ef3b25f1d1b5ee06071f.pdf

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