Issue link: https://tmcpulse.uberflip.com/i/912991
t m c » p u l s e | d e c 2 0 1 7 /ja n 2 0 1 8 37 This is where you want them to make mistakes. You don't want them to make them in the real world, so let's catch them here. The whole idea is to really push the team, everybody on it, and find out what do you really know and what do you not. And then deal with the real-world consequences of all that, because that's what's going to happen in a hospital. — ANDY FOSTER Former astronaut instructor whose input shaped TWU's program decision-making opportunities and the opportunity to make a mistake and learn from that?'" Foster explained that multiple teams and organizations were involved in each space mission, in addition to the astronauts who were trained exhaus- tively on all parts of the shuttle system and orbital stations. All those people and organizations needed to learn to work together before blast-off, so the group always had a comprehensive dry run. "You picked the most critical 72-hour part of the mission where your primary mission objectives are being executed and you ran it around the clock, just like you would for the real thing," Foster said. "That integrative simulation where you have all the dif- ferent facilities is the one that gives you the really big picture." Ayers took the idea and ran with it. It was a time-consuming project with an overwhelming number of moving parts, but with help from Foster and Teresa Maharaj, Ph.D., RN, an assistant professor at TWU's College of Nursing, Ayers created an entire hospital ward from scratch, and designed patients, too. Amid real hospital beds, IV pumps, wound care carts and the incessant beep of monitors, nursing students immersed in the simulation treat fellow students acting the parts of patients—a homeless man in need of a toe amputation, a patient with PTSD, an individual going into hospice care, a drowning victim, a woman with a postpartum hemorrhage, patients with varying religious beliefs that impact treatment decisions and ethical conun- drums, all with competing demands to mimic real life. The team also created accompanying medical records to support the scenarios, complete with full histories, medication information and diagnoses. "It has all the characteristics of the hospital environment—patients come and go from surgery, they get admitted, they get discharged, they have orthope- dic surgery, family members are here," Ayers said. "We've had chaplains, social workers—everything that would happen happens. It's 24 hours a day and it gives them that reality of being on their own in a hospital environment." The students acting as patients get their direction from more than 100 pages of intricate scripts crafted by Ayers and her team. Contingencies are written into the pages like an if-then flowchart and are determined by the treatment decisions the nursing stu- dents make in real time, including any mistakes. Sometimes, Ayers and her colleagues have to whisper into the ears of the students playing patients to tell them their nurse made an error and to proceed with a certain scenario. (continued)