Why every simulationist needs a basic clinical expertise, and how I got mine (almost) for free


by SimGHOSTS Board Member, Billie Paschal



Why every simulationist needs a basic clinical expertise, and how I got mine (almost) for free

I started my career in healthcare simulation without a clinical background. My journey began over seven years ago when I returned to the workforce after being a stay at home mom for sixteen years. Initially I was hired because of my "mom" skills: stay on budget; spend money wisely; create a schedule for a one-woman lab; keep things showcase ready at all times; and, by the way, could you also put that "person" together in the large box in the closet? 

They had me at "put that person together" but it also made me realize that to do the job I needed to know exactly how a person goes together. It was quickly apparent that my lack of clinical background put me at a disadvantage and I needed a plan in place if I was going to pursue a career in simulation. Trust me, grasping the how, why and what that happens when someone is suffering from hyperkalemia comes in handy when being "Maria Gonzales" from behind the glass. I’m going to share with you what I have done and resources I have found that helped me to develop some clinical expertise.  

      Being employed by a community college made the first steps very easy as I had subsidised access to their courses. When I first started reading simulation scenarios I thought they were written in a foreign language. That gave me my starting point - some clinical fundamentals: medical terminology, as well as taking the same courses required for those in the medical billing field.  Having this foundation was very beneficial. It gave me the ability to break down the words in scenario content such as endoscopy,  duodenal ulcer and  craniosynostosis. Next up were Anatomy and Physiology I and II, the same courses required for all health science students at our college.  The medical terminology class was helpful in learning A&P as well. These classes equipped me with the knowledge to understand the scenario, moulage the patient, and think about what equipment would be needed to provide care for the patient.  If you don’t have access to courses in your workplace there are plenty of low cost (<$100) options like SimGHOSTS Clinical Concepts online course or courses offered through platforms such as EDX and Coursera.

These courses gave me the knowledge, but not much in the way of experience. I reached out to clinical staff to teach me how to take blood pressure. Learning this skill was crucial as it gave me the ability to calibrate the BP function in manikins. I was always on the lookout for lectures in our simulation classroom that I could join.  If I was not available to sit in on the entire lesson, I reached out to the professor for guidance and almost always received a copy of the PowerPoint presentation. I also started to think about the resources that the clinicians use in their day to day work. When it came to medications I found the Epocrates app was brilliant and I was able to get what I needed even on just the free version. Epocrates gives the brand and generic information, an image of the medication, offers adult and pediatric dosage, as well as black box warnings.  The information is updated regularly and could help prevent a “simulated” medication error that someone could have unintentionally written into the simulation. 

One of the greatest untapped resources is the student resource center (or equivalent department that provides student learning support) and library.  Find out who works with the students that come to your simulation center, and tell them your situation.  Librarians are the keepers of knowledge and are proud to share what they have. 
Networking on campus can be extremely beneficial for you and your program - get to know people and find out what they do, most are happy to help. 

By simply asking the campus student resources staff member I instantly had a set of the previous editions of all books on our students’ reading list. Since I am a visual learner, Mosby’s Nursing Video Skills: Basic, Intermediate and Advanced Skills were invaluable for learning what would be expected for supplies and set up. I  was able to view these videos because I had access to the reference material in the school library.  I used it so much that when the new edition arrived, they gave me one of the older versions that they would no longer be needing. 

     I recently attended a session with a librarian from my hospital.  Two resources she talked about made me think of moulage right away: Visual DX.com and Skinsight.com. Visual DX is a resource available for skin issues, wounds, and in general how a patient would present.  This website is a free service for some institutions, but if not possible it does cost $39 per month with a student option of $19 a month. Not only is Skinsight.com free there are great pictures available as well. It allows a search by condition or by patient age, gender, and body location. 

     My mission to learn more about life as a clinician has helped me in ways I never anticipated.  What I have learned in the simulated world has made me a better patient and a better advocate for my family when I take them to the doctor. It has also helped me advocate for the student when faculty didn’t realize the level of knowledge gap the student had. Growing is a good thing, and letting the administration know that you are gaining knowledge and showing passion helps them to identify opportunities to assist you. If you want to grow and succeed in your simulation technology or operations career, I hope these tips put you on the right course.