Nurses, Students Practice Health Care Decisions with Interactive CD
The Institute of Medicine estimates that almost 100,000 patients die each year because of human errors in their care. This estimate is greater than the numbers of annual deaths from vehicle crashes, AIDS or breast cancer.
“Clearly, all health care professionals need more safe opportunities to practice decision making in emergencies,” said Dr. Angela S. Collins, associate professor of nursing at the University of Alabama.
The University of Alabama Capstone College of Nursing has completed its first interactive CD designed to give nursing students and nurses realistic but safe practice in making decisions that affect life and death.
“Nurses need to combine knowledge of chemistry, drugs and pathology and to think critically and rapidly,” Collins said. “We can use technology to increase the amount of realistic practice each student can have and make our mistakes in a safe, virtual setting rather than with live patients in the real world.”
The CD, developed with the help of Media Solutions from UA’s Center for Public Television and Radio, is entitled “Nursing Clinical Decisions: Patient Outcomes.” The video portions use nursing students, nursing faculty and staff and drama students as actors and were filmed at DCH Regional Medical Center in Tuscaloosa by Amy Eifler and Chuck Chambliss.
It contains video clips from nine cases in critical care and the emergency room. Viewers are shown a clip, provided relevant medical and nursing information, and prompted to decide on the next step in the patient’s nursing care.
Depending on the viewer’s decision, these virtual patients will recover, become increasingly unstable or die. The nine clips have 27 possible outcomes, depending on the decisions made by the viewer.
The need to make rapid, safe decisions is emphasized by the presence of a ticking clock and the provision of additional information about the patient’s deteriorating condition.
Senior nursing students in the course “Complex Client Systems” said they found the CD to be highly involved and realistic.
“Some were almost in tears when they realized they had made a wrong decision. Of course, it wasn’t real, and the CD then made them repeat the clip and rethink their strategy. This helps them understand where they went wrong and why,” Collins said.
Becky Edwards, director of technology and distance education at the College, said she knows of no other computer-based teaching tool that allows students to actually see the consequences of their decisions in such an interactive way.
“This CD makes an indelible impression on them,” said Edwards, who was also on the development team. “It’s powerful learning.”
Sigma Theta Tau International, the honor society of nursing, named the CD as the 2004 recipient of the Computer-Based Professional Education Technology Award for Region 8, consisting of Tennessee, Alabama and Mississippi. The Alabama League of Nursing named the CD winner of its Excellence in Teaching Award for innovation and commitment to nursing education.
Creation of the CD was funded by an Innovative Instructional Technology Faculty Grant from UA. These grants are designed to foster the development of cutting-edge uses of instructional technology.
Other faculty on the development team included Dr. Donna Gullette and Ann Graves. Thomas Little and Patrick McIntyre of the College’s computing support service contributed their technical expertise in computer programming and graphics. Collins also expressed appreciation to Dr. Sara Barger, dean of the Capstone College of Nursing, and to Dr. Sharol Jacobson, associate dean for research and practice, for their support of the project.
In addition to using the CD for the Capstone’s nursing students, the developers plan to market it to other nursing schools and to hospitals.
“Hospitals too have to provide nurses and other professional staff with opportunities to practice and improve their decision making skills, and this CD will be useful for them,” said Collins. “We have received suggestions for other topics from hospitals, and we are already producing a second CD. We think interactive technology like this can really help reduce mistakes in patient care.”
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