THE CHALLENGE
Due to the pandemic, nursing programs worldwide are experiencing issues with standardized patients and clinical hours. Briar Cliff University is no exception. This private, Catholic Franciscan liberal arts university is located in Sioux City, Iowa. They have a good student-to-faculty ratio of 14-to-1 and they support a range of advanced nursing degree programs.
The Nurse Practitioner program is conducted online with the exception of two on-site summer sessions. It is during those required campus days that there was a need to realistically experience and learn how to conduct a pelvic exam in their health assessment classes.
“The one skill that is hard to teach in the health assessment setting is the pelvic exam,” said Assistant Professor, Heather Stehr, DNP, ARNP, FNP-BC. ”It can be one of the most nerve wracking experiences in a clinical setting – especially when the students are not prepared for it.”
Originally, hard plastic mannequins conveyed the location of the cervix but not other important anatomy or pelvic exam technique.
An outside company was hired to bring in live pelvic standardized patients. These exams were rushed and some students only had 1 or 2, and sometimes 3, pelvic assessments on live patients by the end of their schooling which wasn’t enough. Timid learners had very little experience so an alternate solution was deemed necessary.
Additionally, COVID-19 presented challenges with clinical sites, live labs and on-campus activities. All had to be re-vamped. Some students fell short of the 600 mandatory clinical hours with a preceptor. A new solution had to be found.
THE SOLUTION
The PELVIC Mentor was selected as an additional assessment and simulation tool for students.
“The PELVIC Mentor is not something to only be considered by institutions that have a lot of resources. We definitely don’t have an abundance of funds, but we did invest in the PELVIC Mentor simulator,” said Dr. Gretchen Wheelock, Associate Professor of Nursing; Graduate Nursing Program Director; Advanced Registered Nurse Practitioner. “It has been a valuable educational tool for our students, especially our graduate education learners.”
The money came from a private donor who funded the equipment.
The lab budget will pay for the speculum and pap test module to be purchased next year. The PELVIC Mentor is used during their on-site annual visits. Learners who live locally, can make an appointment and come to campus to use the simulator as needed.
“Not only is the simulator life-like, but it helps learners master the anatomy as the PELVIC Mentor provides feedback as to what anatomical structures they are identifying or the student’s technique itself,” said Dr. Stehr. “At Briar Cliff we do group and individual instruction of skills and the pelvic exam procedure so students can gain confidence on the simulator before hands-on patient interaction. They can also experience various pathologies which is not an option with
standardized patients.”
THE ADVANTAGE
Nurse educators guide students on pelvic exams in a realistic environment, resulting in clinical equivalency prior to – or in lieu of – standardized patients.
This educational tool helps the trainee gain confidence, improve hand-eye coordination and the accuracy of the protocol, before performing the examination on a real patient. It provides learners with a simulation substitute for pelvic exams that includes group and individual instruction with performance monitoring.
When COVID-19 posed an issue with students who were having trouble obtaining the mandatory number of clinical hours, the time on the PELVIC Mentor in the health assessment classes was used to fill the gap and help learners reach their threshold so that they could meet the requirements of the program.
Since COVID-19 did not allow the on-site learning in 2020, the PELVIC Mentor will have twice as much use and support two cohorts worth of students in health assessment labs in 2021.
