Spotlight
   

Wanda Goranson, 
MSN, RN- BC, CHSE
 

HOW DID YOU GET INTO HEALTHCARE SIMULATION?

I have been a “staff development” educator at UnityPoint Health System. In my earlier days, I taught CPR, ACLS, and a variety of critical care courses for the nurses. The classroom sessions were long and the participants had difficulty maintaining focus on the learning objectives. I enjoyed teaching small groups, using interactive and hands on leaning opportunities. In 2009, the opportunity arose to centralize all of the simulators in the hospital, create a two-room simulation lab, and name a full-time simulation educator. I accepted the challenge.

WHAT DO YOU LIKE MOST ABOUT HEALTHCARE SIMULATION?

I love working with the participants to improve their performance in an interactive, non-threatening, collaborative manner.  As healthcare providers’ performance improves, the patients’ outcomes and the patient experience also improve.

WHAT IS THE MOST CHALLENGING ABOUT HEALTHCARE SIMULATION?

Securing resources and developing expertise are the most challenging aspects of simulation education. Being a pioneer for simulation in my organization, I had many obstacles to overcome. 

Simulation equipment is expensive. Employees’ time to complete simulation is expensive. The ongoing challenge is to demonstrate the value of the education and the impact on patient’s outcomes. As managers recognize the benefits of simulation education, I have gained their support in allowing providers to attend simulation sessions. I still struggle with costs and have worked with our hospital’s foundation for funding to expand our center and add equipment.  

Local educational resources are limited, so I found it crucial to join the Society for Simulation in Healthcare (SSH).  The annual meetings, special interest groups, and SimConnect have allowed me to network and learn from experts from around the world.

WITH THE KNOWLEDGE GAINED THROUGH BECOMING CERTIFIED, HOW HAS THIS TRANSFORMED AND BENEFITED YOUR WORK AS A HEALTHCARE SIMULATIONIST?

I am amazed at how much I learn every year. The knowledge and research in healthcare simulation continues to grow. In preparing for the certification examination, I found several areas on the blueprint where I needed additional knowledge. The post-graduate Simulation Education Courses at Bryan Health Sciences College covered aspects of theory, implementation, and evaluation. I changed my simulations to start with the needs of the participants, and then develop objectives, scenarios, evaluation tools, and outcome measures. I made a deliberate effort to improve the feeling of “safety” for the participants in the simulation session and to provide non-judgmental debriefings. In my organization, the value of simulation education has increased and so has the number of requests. 

In 2012, I completed and passed the CHSE exam. I feel this validated my abilities as a simulation educator. Although I am now certified, I still feel there is always more to learn. I attend the IMSH conferences, which provides the evidence based practices and advances in simulation education. I am hoping to complete the CHSE-A in the near future.  

CREATIVE LICENSE

What do you do in healthcare simulation? 

The Dorner~Villeneuve Simulation Education Center serves nurses, physicians, residents, students, and other healthcare providers. One of our primary focuses is effective communication.

Communication issues are a major part of adverse events and poor patient outcomes. In the last year, in collaboration with the Internal Medicine Program Director, we have developed simulations for the medical residents on giving bad news, disclosing medical errors, providing informed consent, counseling on advance directives, and conducting family meetings. Each of these sessions was videotaped, allowing residents to critique their own performance and learn from others.

Nursing staff participates in simulations specific to their department’s needs. ICU nurses complete a massive blood transfusion simulation as an annual competency. The nurses on the stroke unit complete simulations on swallow screens. Multiple patients in a single simulation as well as patterning simulations are created for newly licensed nurses in the nurse residency program. Research nurses complete simulations to demonstrate competency on obtaining informed consents for studies. The nurse leaders complete patient rounding simulations. 

The health system uses simulation education to meet some of the requirements for certifications - Chest Pain Center, Stroke Certification, and Level 1 Trauma Center. As the organization started our ECMO (Extracorporeal Membrane Oxygenation) program this year, selected staff spent several days in simulation education. 

Our major inter-professional simulation education is the annual mock codes for all of the code team members—physicians, nurses, respiratory therapists, technicians, transporters, and clergy.  We’ve started Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) training in our organization. The goal is to add inter-professional simulations with TeamSTEPPS® training next year.

Last year, Simulation Education Center growth doubled. Our ongoing challenge is to provide simulations that have measurable educational and patient outcomes. 

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