The spring of 2020 is not a time that any of us will ever forget. Our professional and personal worlds went through unprecedented change as we entered the COVID-19 global pandemic. The tragic loss of life, long-term effects of the illness, disproportionate impact on communities of color, economic devastation, and secondary trauma to health care professionals cannot be quantified.
While midwives worked to protect our communities, our loved ones, and ourselves, midwifery students struggled with the same issues while trying to keep their education on track. Many were removed from the clinical setting due to inadequate personal protective equipment, social distancing requirements, and legitimate fear from preceptors and patients of exposure to one more individual. Several midwifery students who were newly licensed registered nurses (RNs) described feeling helpless that they were not able to be part of the essential worker team. They sought opportunities to be involved through testing sites, answering the COVID resource telephone line, and most importantly, continuing their midwifery education. Program directors and educators worked diligently to find creative opportunities for continued learning during the period of lockdown.
Traditional brick and mortar or in-person programs could not rely on gathering in the classroom or simulation center to assist in the development of competence. As a program director, my pedagogy is based on Kolb’s theory of Experiential Learning, using simulation experiences to help students develop the knowledge, skills, and professional behaviors needed for practice in the clinical setting. Students could not spend valuable time with their experienced preceptors and thus were afraid that valuable progress would be lost during the time of isolation.
As an educator, I turn to simulation as a teaching strategy to solve educational problems in a safe setting. Since we could not gather, I focused on the INACSL Standards of Best Practice: Simulation©: Simulation Design.
How could simulation help us through this unprecedented educational experience in a pandemic?
The first step was to clarify the problem with a needs assessment to help determine a solution. Students needed clinical experiences. They could not examine people in person, but what could they do? The brainstorming began.
Classes moved to Zoom,
meetings moved to Zoom,
and HEALTHCARE MOVED TO ZOOM!
As our faculty midwifery practice prepared to implement telehealth, we realized that our students could use their vision, voices, and clinical intuition in a simulated telehealth visit. This would also prepare them to reenter the clinical setting if and when a telehealth option was offered. We decided to offer simulated telehealth on a weekly basis with varied patients so students could continue to gain experience with history taking, empathic communication, critical thinking, and clinical/shared decision-making. The midwifery management process could be applied to simulated telehealth visits with faculty supervision. Our educators created an eight-week simulated telehealth clinical experience. Students conducted visits on many topics, including prenatal care, options counseling, sexually transmitted infections, urinary problems, vaginal symptoms, perimenopausal changes, contraception counseling, COVID prevention, and genetic screening options.
Do you want to have a framework to use simulation to solve educational dilemmas?
At the upcoming ACNM 66th Annual Meeting, held virtually May 23 – 25, 2021, “Using Educational Resources Wisely During a Pandemic: Simulated Telehealth Visits to Develop Clinical Decision-Making Skills in Midwifery Students” will be presented. It will review the INACSL Standards of Best Practice: Simulation©: Simulation Design, and demonstrate how these practices can support the development of a simulated telehealth clinical experience during a global pandemic. There will be a focus on simulation development in conjunction with the importance of pre-briefing, debriefing, clinical documentation, efficient use of resources, and lessons learned during a global pandemic.
Dr. Erin McMahon has been a midwife for 21 years and is the Program Director for the Nurse-Midwifery Specialty at the Yale School of Nursing. She is an ACNM Fellow, a board member of the American Midwifery Certification Board (AMCB), and has served as a volunteer member to the Certificate Maintenance Committee. She is an active member of ACNM and International Nursing Association of Clinical Simulation and Learning (INACSL). Dr. McMahon has served on committees for the revision of the ACNM Core Competencies of Basic Midwifery Practice and the INACSL Standards of Best Practice.