Making Off-Unit Clinical Simulation EPIC!
Written by Sandra Cohen, MSN, CRNP, RN
Instructor at St. Luke’s School of Nursing
Published August 2022
As the nation’s oldest continuously running nursing school still in operation, St. Luke’s School of Nursing is no stranger to change and adaptation. St. Luke’s takes pride in its evolution and ability to provide students exceptional learning with the support of the St. Luke’s University Health Network. Traditionally, nursing students complete 900 hours of diverse clinical experiences throughout various network campuses, offices, and community health partners. However when the COVID-19 pandemic emerged, the traditional in-person clinical learning experience quickly turned to distance education and simulated environments. It was then that St. Luke’s School of Nursing faculty like Sandra Cohen, MSN, CRNP, RN, knew that to continue to graduate highly competent clinically prepared nurses, new and creative ways of clinical immersion had to be developed.
Cohen is a current St. Luke’s nursing instructor and an alumnus; she has always found creativity utilizing technology in innovative ways to enhance student learning. During her time in graduate school, she was also part of an online community of learners that stressed the importance of connectedness and quality (despite distance). This foundation placed her in a unique position to bring enrichment to the simulation learning environment.
When CARES Act money became available, the nursing program was able to purchase new technology, including Microsoft Teams hubs, upgraded faculty laptops, iPads, and a computer workstation on wheels. Although most of these items were initially purchased with didactic distance learning in mind, Cohen had a vision to utilize these for simulation enhancement as well.
In her own course, Cohen began experimenting with the network’s electronic medical record (EMR) training environment, the EPIC Playground. Using the connectivity from the network laptop, she was able to modify patient data in the EPIC Playground to resemble her simulation patients. Then she created scannable patient bracelets using EPIC orientation worksheets. Finally, in collaboration with the St. Luke’s pharmacy, she collected scannable barcodes for the medications that students utilize in simulation scenarios. Students became able to utilize the five rights of medication administration with the full realism of the EMR, including patient and medication scanning during their simulation. Though the process started on a small scale in just Cohen’s course, the enhanced technology and creative use of the EPIC Playground is now giving all faculty and students the ability to find realism in the off-unit environment. Student learning in the classroom, whether in-person or virtual, is enhanced by viewing and interacting within the EPIC Playground patient charts.
Additionally, Cohen alongside some colleagues is now leading the way to expand realism in simulation by integrating this technology into an open skills lab for nursing students of all levels at St. Luke’s. In the skills lab, students find EMR orders from the EPIC Playground related to the skill station they are working at. They then practice interpreting the order, completing the skill, and any follow-through activities such as EMR charting. The scenarios challenge students to move beyond the completion of a simple task and instead critically think through the entire process with realism from beginning to end. Even clinical math problems can now be creatively delivered by providing screenshots of EPIC orders with rates or doses removed, requiring the student to figure out the amount to deliver in the scenario.
St. Luke’s holds within its core values: accountability, flexibility, and teamwork. Cohen’s flexibility in a changing educational environment, her teamwork with colleagues and other departments, and her demonstration of accountability for the success of the next generations of registered nurses have launched multiple exciting innovations that bring clinical realism to the classroom and simulation.
Sandra Cohen, MSN, CRNP, RN
St. Luke’s School of Nursing
Sandra Cohen can be reached via email at [email protected]