By Petra Duncan
Sure Dolly, let’s dance! A mother and her daughter receive a visit from a front line health care team at the long term care facility that has become the mother’s home in recent years. It is the job of the students to handle all the daughter’s challenging questions and take care of the mother’s deteriorating health from middle-stage dementia. Today mum wants to dance and as I peak through the glass observation window, I can see that the students definitely have their work cut out for them, as a male physical therapy assistant guides the senior in a waltz across the floor!
This is just one of the 22 scenarios written for “Save Stan Saturday” (SSS), an event developed for interprofessional experience. On Saturday, March 2, 2013, more than 200 students entered the Edmonton Clinic Health Academy (ECHA) at the University of Alberta, to take part in our 3rd Annual SSS. They came together from various health care educational facilities around Edmonton and the surrounding area with the intention of practicing their communication and teamwork skills. Students from hugely diverse medical backgrounds, such as nursing, medicine, pharmacy, physiotherapy, occupational therapy and respiratory therapy, sign up in advance for the simulation experiences they feel will benefit them the most. Each simulation is designed to work with three to five different disciplines, and students from all levels are encouraged to participate.
As I venture into the “On Call” Room, where all the students gather during the day, the atmosphere around me is electric. If you needed a natural jolt of energy you just had to go and stand in the middle of this room where students anxiously awaited their call for duty.
On the floor below, facilitators set up for the ER Mash Up, a simulation lab that has five different emergencies happening at the same time. The expectation here is that the students work together to handle the situation in an efficient and effective manner to help the patients needing immediate attention.
SSS grew out of a need for more interprofessional activities and was originally piloted by the Interprofessional Health Education Partnership (IHEP), comprised of the University of Alberta, MacEwan University, Northern Alberta Institute of Technology, NorQuest College and Alberta Health Services. The name of the event came about when the Health Sciences Education and Research Commons (HSERC) received their very first high fidelity mannequin, the METI i-Stan. He became affectionately known as Stan around the office. Hence the name “Save Stan Saturday,” and the rest, as they say, is history.
This once a year event incorporates mannequins, standardized and simulated patients, hybrid and Second Life activities. Each scenario is followed by a debrief session. The students seem to really appreciate the opportunity to practice in a safe controlled environment and learn from each other. Likewise the facilitators seem pleased to give of their precious time to support and encourage the new generation of health professionals. These kinds of events are so valuable, but become absolutely priceless when preparing our health care students to participate in team patient care. I often hear a senior health care professional saying that they wish these kinds of events had been available to them when they were attending University.
Our Hospital to Homecare activity is split into 2 scenarios. Part 1 involves a senior by the name of Stanley Moorhouse being discharged from Hospital. In Part 2, we see him being visited in his home. Both times his wife is present and he is a most difficult patient with many health complications. There are five-plus students conducting the discharge interview and trying to make Stanley’s hospital discharge as comfortable as possible. The team have to introduce themselves and come up with a plan for the Moorhouse interview. They usually select a lead person who has the team introduce themselves and then each student gets to ask questions and speak about their concerns, with the lead tracking time, so that everyone gets a turn. It is interesting to see the light go on when they realize what each one of them does and how each contributes to the success of Stanley’s return home. When Stanley asks some difficult questions, the students support and help each other. Sometimes they don’t have an immediate response and say they will get back to Stanley with the answer, but the main thing is that Stanley gets the help and support he needs for the transition home. It is also important to assess Mrs. Moorhouse’s able to handle Stanley and include her in every step of the way. Each time the scenario takes place there could be a different set of health care students in the room, ranging from Doctor, Nurse, RT, OT and Pharmacist or a technician.
Usually each group sees a brief description of what they are about to walk into, and has a pre-planning meeting with one of the facilitators. Not all the students will enter at the same time, as certain health care staff might be needed at different points throughout the scenario. Or they may be asked to participate in an unusual situation that may not come up in their professional line of duty. In our palliative care role, the paramedic does the hand off, but sometimes ends up helping the doctor and nurse if there is no other staff about. The great thing about SSS is that anything can happen, presenting the unanticipated challenges of real life!
In the scenario Help My Baby, sometimes the mother hands the baby to a health care student and runs out and other times, depending on the composition of the team members, the mother just leaves the baby on the waiting room chairs and walks out. There is usually much discussion over who will take charge, whether they should run after the mother or tend to the baby first, and what would you do if a young mother did this in your clinic?
At the end of the day’s events, in the “On Call” Room, a huge role of paper posted on the wall for student feedback is full of comments and quotes from students, including the following:
“I feel intimidated sometimes, but SSS showed me that everyone begins at the beginning sometime in their careers,” Respiratory Therapy Student.
“I had never worked with (a Respiratory Therapist) before–they are crucial to our situation–I didn’t really know what specific things they did, I didn’t know where they would fit and then I got to see that,” Medicine Student.
“We don’t meet other health professionals or know what their roles and responsibilities are. You kind of figure it out as you go in clinical but we’re never really taught that. In SSS we learned about these areas with the context of a team,” Nursing Student.
It takes many staff members to put on a program like SSS: facilitators who work with the planning part at the beginning; instructors who guide the scenario’s, some 10 minutes, some half an hour; and those who guide the feedback and debrief. Much work and time goes into the different ways each group will run their feedback and debrief–the most important part of the simulation event and where the learning really takes place! It is important to add that the staff and facilitators are volunteers who give up their Saturday to help further the education of a new generation of health professionals who are working together to create better understanding, communication and service to their patients.