Judy LeFlore, associate dean at the UT Arlington College of Nursing, can supervise simulation assessments from hundreds of miles away. UT Arlington College of NursingA real-time video feed, a laptop and a computerized manikin baby are key components for a new simulation training initiative that allows UT Arlington College of Nursing educators to put Neonatal Nurse Practitioners (NNPs) and physicians through the paces of an emergency scenario from hundreds of miles away.

The "remote-controlled distance simulation" project was developed in partnership with Pediatrix Medical Group, the nation's leading provider of neonatal, maternal-fetal and pediatric medical and surgical subspecialty physician services. The goal is to allow Pediatrix clinicians, neonatal nurse practitioners and physicians to experience the value of competency assessment exercises with high-fidelity simulators, or electronic patients, in UT Arlington's Smart Hospital, without having to travel to campus.

Using Laerdal Medical's manikin baby SimNewB and a mobile system called SimView, Judy LeFlore, associate dean in the College of Nursing, has already run more than a dozen live clinical simulation sessions in Florida and Texas from her office at UT Arlington. All the exercises have focused on neonatal care emergencies. The providers suggested many of the scenarios based on their experiences.

The concept and its initial success are described in a paper published in the August issue of Clinical Simulation in Nursing. The proof-of-concept report is co-authored by LeFlore; Debra Sansoucie, vice president of the advance practitioner program at Pediatrix; Carolyn Cason, vice president for research at UT Arlington; Amy Aaron, NNP with Pediatrix; Mindi Anderson, UT Arlington College of Nursing assistant professor; and Patricia Thomas, clinical assistant professor.

Cason, a former College of Nursing professor and administrator, said the College of Nursing, Pediatrix and Laerdal recognize the value of assessing the competency of providers through simulation.

"We all know that if you're going to have a procedure done, you want the person doing it to have done it before," said Cason. "You want a health care provider with the ability, knowledge and the physical dexterity skills to be successful ... The whole point around this collaboration is that it's not only the knowing, but the doing."

The initiative is especially useful in a situation where nurses and doctors don't have a lot of opportunity to practice a procedure.

"It is critical for us to measure and validate the competency of clinicians in high risk, low volume procedures," Sansoucie explains. "If we can utilize the expertise and leadership of the team at UT Arlington to train in credible, valuable scenarios with their very own teams and in their own environment, we can not only offer an advantage to our patients, but also to our hospital partners as we enter this new era of Triple Aim in healthcare."

Originally developed by the Institute for Healthcare Improvement (IHI), the Triple Aim is a framework that describes improving the U.S. health care system by improving the experience of care, improving the health of populations and reducing per capita costs of health care.

Participants in the remote-controlled distance simulation project use Laerdal Medical's SimNewB to assess their preparedness for pediatric emergencies. Credit: UT Arlington College of NursingSansoucie also notes, "As we approach our second year of the regional rollout within Pediatrix, I can say that many of our practices would not have had accessibility to this training without the remote control distance simulation."

LeFlore coordinates work on the remote-control distance simulation project, with grant support from Pediatrix. She and colleagues in the College of Nursing design scenarios and she leads the exercise and debriefings with the health care professionals in other states. She said Pediatrix employees have responded enthusiastically.

"They love it," she said. "They ask for more training because the more practice in high-risk situations the better the outcomes."

In addition to being the maker of SimNewB, Laerdal is a partner in UT Arlington's Smart Hospital, a national demonstration center for simulation education and research with about 40 simulated patients. Laerdal also makes the SimView, a high-definition audio and/or visual capture and playback system.

The research paper "Remote-controlled distance simulations assessing neonatal provider competence" lists several advantages of the program, including that it can be used to assess the competency of nurses outside of metropolitan areas where simulation centers may be located, and notes this approach to competency assessment can be applied to other areas of nursing and medicine.

The paper states further: "The approach permits the assessment to occur in the HCP's (health care provider's) workplace. Using the employees' workplace with which they are familiar and comfortable may permit a more accurate assessment of the NNP's knowledge and skills. Additionally, the cost and time required to travel would be eliminated for the employee and the employer."

Original release: