Author: Mary Franklin, DNP, RN, CNM, FACNM
Title: Assistant Professor
Institution: Case Western Reserve University
Skills or Simulation Laboratories
At the end of the experience, the learner will demonstrate the ability to perform physical assessment skills with sensitivity, empathy, and respect for the simulated patient
Low fidelity task trainers are a cost-effective tool to teach skills. However, practicing skills on task trainers focuses learner attention on the task to the exclusion of the other aspects of patient-centered care. It is difficult for faculty to integrate experiences such as talking to the patient, or maintaining patient dignity while doing tasks, when the task trainer is a disconnected body part.
Enhancing task trainers to resemble simulated patients reminds learners about the holistic nature of care while practicing physical assessment skills. Faculty facilitating the simulation skills lab for pelvic, breast, and pregnancy exams for advanced practice nursing students have used creative and inexpensive materials to enhance task trainers and integrate the skills of patient-centered care into physical assessment practice.
Task trainers were humanized with inexpensive materials to emphasize holistic care. Wig heads in various skin tones were purchased and outfitted with accessories such as hair, scarves, hats, glasses, and earrings. Pillows, gowns, and drape sheets were used to set the task trainers up as simulated patients. Name labels were used for the task trainers. During physical assessment skill practice, learners were expected to address the simulated patients by name and to explain the maneuvers they were performing, as if they were speaking to a patient. Using gowns and drape sheets helped learners practice maintaining the dignity of patients during exams. Faculty were able to discuss the principles of trauma-informed care during assessment practice with concrete examples of how a practitioner would perform an assessment on a patient who was wearing their own clothing rather than a hospital gown. Pictures of materials used and an example of an enhanced task trainer are attached.
Attached are an example of a standardized skills checklist. The highlighted areas indicate where patient-centered care is evaluated
Attached in a pdf are pictures of an un-enhanced task trainer, the materials used to enhance the task trainer, and an example of an enhanced task trainer
Using a standardized check list, faculty using enhanced task trainers observed the learner’s ability to include aspects of patient-centered care and trauma informed care into physical assessment practice. An example of a learner check list is attached.
Faculty have observed faster integration of patient-centered care into exams using live standardized patients and in the clinical area since the practice of using enhanced task trainers was introduced. Faculty have also reported an increased ability to demonstrate trauma informed care with the enhanced task trainers.
Students have reported a more life-like experience with the enhanced task trainers. They report a positive aspect of using the enhanced task trainers is the opportunity to practice the skills of explaining procedures to patients and maintaining patient dignity during exams.