CALM and confident: six virtual patients help boost critical-thinking skills
An NUH employee has devised a virtual patient bay for healthcare workers to sharpen their critical decision-making skills.
Louise Kirk recognised the importance of confidence in learning to prioritise, when caring for multiple patients. She created the e-learning programme as part of her BSc in Leading and Innovation, funded by Nottingham Hospitals Charity.
Louise, a clinical educator nurse at Nottingham University Hospitals NHS Trust, created a Virtual Patient Bay (VPB) to guide nurses through the complexities of prioritising care across a number of patients, using a systematic CALM approach:
- Can’t wait, must be done now
- Action, as soon as possible
- Look to do sooner rather than later
- Make time later or hand over
There are six scenarios, with a friendly virtual assistant to help guide decision making, and links to further training resources, and aims to build learners’ confidence in five key areas:
- delegation
- prioritisation
- escalation
- critical thinking
- competency
The VPB came about after a paper handbook Louise created attracted excellent feedback – and requests to create an online version to make it more widely available.
Louise adopted a multi-disciplinary approach and worked with the Institute of Nursing and Midwifery and Daniel Jones in DREEAM to create the digital version. DREEAM is NUH’s academic department, which aims to integrate research and education seamlessly with clinical practice, to deliver excellent patient care.
The self-paced course is free for all NUH staff and is available nationally for £40 per person for six months’ access – via a phone, iPad, or PC. “The virtual assistant helps you along the way and there is no getting it wrong, because that can cause anxiety, you’re just told to try again,” said Louise. “It’s about building confidence.”
It takes around an hour to complete the six scenarios – longer if the learner digs deep into the additional learning content provided with each scenario.
“The VPB allows people to develop and refine their prioritisation skills in a controlled, risk-free environment,” said Louise. “That includes newly qualified nurses, nurse associates, international nurses, third-year students, or those returning after a break.”
At the moment, OSCEs – Observed Structured Clinical Examination – are used to assess a healthcare student’s clinical competence in a non-clinical environment, and involve a simulated patient and a scenario.
“OSCEs is a way of assessing new nurses, but there is only one patient,” said Louise, “and there are other training simulations, but they all involve just one patient. The reality is that nurses have to look after a group of patients at the same time – the VPB creates a safe environment for them to do that and build their confidence.”
Louise is already planning the next six scenarios to be added to the VPB, and is exploring the possibility of incorporating it into the third-year of a nursing degree.
Chricy Kainga, Assistant Divisional Nurse, and Lead for People, Workforce and Education praised Louise for her commitment to supporting newly-qualified nursing staff and added: “The Virtual Patient Bay is evidence of how motivated Louise is in supporting new learners in response to their feedback.”
Professor Frank Coffey is Director of DREEAM and Honorary Professor at Nottingham Trent University. He said the project was “brilliant”, adding: “Collaboration at its best – well done to all involved!”