Girona university established a separate budget for simulation training already in the 1980s. The current amount in this budget averages € 40,000 and funding generated from research activity amounts to another € 30,000 per year. Hence, the simulation program administers an altogether € 70,000 for daily management and investments on a yearly basis. Investments such as advanced, costly equipment and expanded training facilities still require long term planning. Girona has an annual intake of 140 nursing students and the amount of time students are involved in facilitated simulation activities ranges from 10-40 hours per year.
The simulation program is headed by an emergency care nurse and administrative support is provided by office personnel from various departments at the university.
• 1 Emergency care nurse
• 6 Nurses facilitating the full range of simulations full time
• 6 Nurses facilitating emergency simulations part time
• 4 Physicians facilitating emergency simulations part time
Experience so far
Benefits: Simulation training requires the students to be far more active as compared with before, when lecturers would demonstrate new skill sets to them - and as the evaluation part has become both easier and more comprehensive, faculty have now better control. In the past, students 'learned by doing' with real patients in hospitals -now they simulate before entering clinical practice. Having the students build confidence and establish a greater understanding ahead results in enhanced patient care and increased patient safety. Although the students are a bit careful at start, they get very enthusiastic with simulation once they have gotten used to it, and they especially value the feedback provided during the facilitated debriefings that follow each scenario.
Dr. Dolors Juvinyà Canal points out that having a proper project plan in place has made it easier to obtain funding for the simulation program. She hopes however that future allocations will allow Girona to increase number of hours spent on simulation and to have medical students and nursing students train together in teams.
Challenges: Transforming from traditional teaching (demonstrating in the skills labs) to facilitating full fledged simulations is challenging for some faculty members, why there has been some reluctance to adopt the new teaching strategy. One hopes, however, to make it a requirement for new staff to get involved with the simulation program so that more faculty can share the work load, and students can have more hours of simulation training. It has also proved difficult to find the time for instructors to update their clinical experience on a regular basis.
''We learn protocols, skills and behavior and feel ready to start our careers as nurses, but more simulation training during school would have been beneficial. I feel safer now, but need additional clinical experience to be more confident.''
Albert Bartina I Planells, Graduate student at Girona University.
The 240 sq meter facilities comprise:
• 2 fullscale simulation theaters with adjacent control and debriefing rooms
• 7 skills labs equipped with hospital beds, carts, care accessories, a wide variety of manikins and skills trainers
• 1 separate room for BLS and ACLS training (with Resusci Anne Skills Station)
• 1 80 sq meter classroom (dividable into 4 smaller rooms) for lectures and CPR training
• 2 IT rooms with computers for self-directed learning