Carol Okupniak, Director of The Center for Interdisciplinary
Clinical Simulation and Practice (CICSP) at Drexel University
College of Nursing and Health Professions, says, “I love what
I do. My career started in the infancy of technology, and I’ve seen
a gradual transformation in healthcare. It seems only right that I
find myself in the middle of transforming nursing education with
the use of simulation.”

Okupniak conducted a beta test of the PROMPT birthing simulator in the CICSP’s new Human Patient Simulation Center with pre-licensure nursing students. Each quarter, students rotate into the simulation lab for two of their eight clinical days in maternity and, says Okupniak, “the response from the PROMPT
trial was overwhelmingly positive. Both the faculty and the
students preferred it over the birthing simulator we had used
previously. The faculty would very much like to have this as a
part of our simulation offerings in many of our undergraduate
and graduate programs.”

Hybrid simulation offers greater realism

The use of the PROMPT Birthing Simulator with professional
actors as standardized patients (a birthing mother and her same
sex partner) was incorporated into existing curricular simulations
such as normal births, breastfeeding and newborn care.
Prior to the mid-term, the students used a full-body simulator for a
normal birth. After the mid-term, the students used the PROMPT
Birthing Simulator for a complicated delivery: complications
included shoulder dystocia requiring two maneuvers before the
baby’s release, and a post-partum hemorrhage. “You never know
what’s going to happen with labor and delivery, and students
were able to experience that,” says Okupniak.
Students compared previous use of full-body simulators versus
hybrid simulation (using the PROMPT Birthing Simulator and
standardized patients), and cited many advantages of the latter:
- “Real reactions by the patient give a better idea
of interpersonal experiences.”
- “Actors made the simulation more realistic and required
you to think critically.”

- “The delivery progressed more naturally and hands-on
experience is always better than lecture.”
Their evaluations also highlighted educational values of the
PROMPT hybrid simulation experience:
- “It allows for extra hands-on experience within minutes
as opposed to the unreliability of timing with live birth.”
- “It gets you thinking more about real-life experiences
and not plastic dolls.”
- “It puts you closer to a real-life situation – need more of it!”

Plans and recommendations for future training

Okupniak recommends using a fetal monitor in conjunction with
the PROMPT Birthing Simulator so students experience changes
in vital signs. And, she stresses that training of the standardized
patients must be very precise.

“We practiced, taught them with role play, and ran through
the scenario with faculty. Once the actors watched the video
following the scenario, they understood they shouldn’t speak or
giggle during contractions, and we adjusted feet and leg positions
for more accuracy,” explains Okupniak. “With more time, there’s
more consistency; using the same standardized patients is good
because as they repeat the scenario, they get better. That’s what
simulation is all about; it’s constantly evolving.”

Plans are developing to use the PROMPT in transdisciplinary education programs for residents interested in force monitoring, and faculty has requested an increased number of undergraduateobstetrics clinical days featuring hybrid simulation.