Maryland Clinical Simulation Resource Consortium

First Time Simulation Experience new window by Denise Lyons

Importance of Integrating EHRs in Simulation new window by Latasha Cousar

Johns Hopkins SON Online Use of Interprofessional Simulation for Nursing Student Instruction and Faculty Development new window

Interprofessional Education Integration of Advanced Practice Nursing Simulations new window by Jill Buterbaugh

Relationship-based Simulation: The key to academic-community partnership new window by Hannah Murphy Buc

Creating a Sim Team new window by Cathy Sikora

Integrating Simulation into a NICU Nurse Residency Fellowship Program new windowby Dawn Brittingham

DML in Multi-patient Simulations new window by Raquel Bertiz

Entrepreneur new window by Linda Goodman

Psychological Safety new window by Amy Daniels

Using Simulation to Decrease Incivility new window by Jasline Moreno

What's in the Prop Box? new window by Cassandra Hall

Implementing NCSBN Guidelines for Substitution new window by Denyce Watties-Daniels

The Multiple Patient Simulation Experience new window by Nancy Sullivan

Thoughts on Developing a Sim Center new window by Crystel Farina

Curriculum Integration new window by Tonya Schneidereith

Pediatric Simulation new window by Laura Nicholson & Ashleigh Harlow

Standard Patients new window by Myra Dennis

The Maryland Clinical Simulation Resource Consortium (MCSRC) is a new statewide funding initiative authorized under the auspices of the Nurse Support Program II (NSP II) and jointly approved by the Health Services Cost Review Commission (HSCRC) and Maryland Higher Education Commission (MHEC).

This program is designed to increase the quality and quantity of simulation used in nursing education. School of Nursing Deans and Directors and Hospital Chief Nursing Officers and Nurse Executives are encouraged to nominate nursing candidates, who are interested in serving as simulation leaders, for funding consideration. The program promotes the use of simulation in nursing education in Maryland, establishes simulation quality guidelines that promote patient safety, and provides resources to maintain simulation equipment for nursing programs.

There are currently twenty-five schools of Nursing in Maryland that graduate entry-level nursing students, ten universities and fifteen community colleges. Each of the schools utilizes simulation to a different degree. Although the Nurse Support II program, funded through HSCRC provided extensive support to the universities and colleges, there is a great deal of variety in the number of simulations being used in the programs. Continuing concerns are resources for faculty training and equipment. More hospitals are participating in simulations and developing resources. There is an emphasis on collaboration between education and practice to develop shared resources through funding by NSP I and NSP II.

MHEC administers NSP II. The Workgroup completed the recommendations for programs that are needed to meet the future nursing workforce. A centralized resource center for Maryland, to provide training and promote collaboration in the use of simulation statewide will be funded as a faculty focused State-wide Initiative. Two earlier NSP II funded programs have been foundational to the development of statewide resources. The Maryland Faculty Academy for Simulation Training (M-FAST) and the Maryland Community College Simulation User Network (MCCSUN) programs and resources are incorporated in the center collaborative. Another NSP II grant supported the development of some simulation scenarios at Montgomery College. The college committed to provide support through facilities, posting simulation scenarios through open access and designating a nationally recognized and credentialed faculty member as the Simulation Coordinator for the Collaborative.

The Health Services Cost Review Commission proactively created the NSP II to address the barriers to nursing education. At the May 4, 2005, public meeting, the HSCRC unanimously approved an increase of 0.1% of pooled regulated gross patient revenue for use in expanding the nursing workforce through increased nursing faculty and nursing program capacity in Maryland.

In 2014, at the conclusion of the original ten years of funding, the HSCRC and MHEC staff completed a comprehensive program evaluation with the assistance of an NSP II Advisory Board. This Health Sciences Cost Review Commission approved The Nurse Support Program II Outcomes Evaluation FY 2006 - FY 2015 and Recommendations for Future Funding report at the January 14, 2015 public meeting.

The overall number of nursing graduates in Maryland has increased by 43%, compared to a national increase of 21% between 2008 and 2013. While some undergraduate nursing degree increase is attributable to natural growth, data provided by NSP II competitive institutional grant project directors suggest that over 5,800 or 27% of all undergraduate nursing degrees produced between 2006-2013 are directly attributable to the NSP II competitive institutional grant program focused on student retention initiatives, redesigned curriculum options, and new programs. However, the State is projected to have a shortfall of 12,100 nurses by 2025 (HRSA, 2014). NSP II must find new avenues to meet these needs within the State’s educational capacity.

Simulation provides a safe environment for learning new skills and procedures, including prioritization and teamwork. As part of its patient safety program, the Agency for Healthcare Research and Quality (AHRQ) supports simulation research. The National Council of State Boards of Nursing, through a national simulation research study, determined that simulation can be included for up to 50% of the clinical experiences in a nursing program (Hayden, et., 2014) without impacting nurse graduate quality or performance. By providing a safe learning environment and decreasing the pressure on clinical agencies, clinical simulation can be used to promote safety and enable nursing programs to expand.

Providing high quality simulations requires not just the physical facilities and high level technology, but also requires faculty who have been educated in incorporating simulation into the curriculum. Faculty find implementation of simulation time consuming for preparation of the simulation, including developing the scenarios and setting up the laboratory space appropriately (Adamson, 2010) also identified that faculty felt a lack of support and utilizing the equipment were barriers to implementing simulation. Training and support is a theme that has arisen in the research in simulation (Adamson, 2010; Jansen, et. al., 2010; Pattillo, et. al. 2010; Seropian, 2010; Waxman, et.al., 2015).

The Oregon Simulation Alliance was formed to provide direction for implementation for simulation throughout the state (Seropian, et. al., 2006). This model makes training and equipment resources available and functions as a conduit for best practices. The process that Oregon used was “visits to communities, development of coalitions, simulation specialist education, faculty development, and a mechanism for allocation and distribution of funds” (Seropian, p. 58). Louisiana created a statewide simulation council to implement Interprofessional simulation. (Lemoine, et. al., 2015). The priority was faculty development. The simulation council created a 12-module curriculum that included three levels with four modules each. The Bay Area Simulation Collaborative (BASC) in California has a similar model with four levels of training: novice, advanced-beginner, competent and train the trainer or advanced (Waxman, et.al., 2011).

Maryland has two initiatives funded by the Nurse Support Program II through Competitive Institutional Grants. Each of these funded programs promoted an increased use and quality of simulations in nursing education. The Maryland Community College Simulation Users Network (MCCSUN) was developed by Hagerstown Community College and provided training and collaboration among Maryland’s community colleges. This network is continued through sponsorship of the Maryland Organization of Associate Degree Nursing programs (MD-OADN), Johns’ Hopkins University School of Nursing developed and implemented an intensive training program for Simulation Education Leaders. The Maryland Faculty Academy for Simulation Teaching in Nursing Education (M-FAST) provided week-long faculty training sessions for community college and university partners.