Practice development
Figure 2 (left). Simulation of a fungating wound after debridement Figure 3 (right). Necrotic pressure ulcer on the heel of the foot.
References
18. Wolfgram LJB, O’Leary-Quinn A (2011) Integrating simulation innovatively: evidence in
teaching nursing education. Clin Sim Nurs Available at: http://
www.sciencedirect.com/science/ article/pii/S1876139910001660 (accessed 26, July 2011)
19. Nehring WM, Ellis WE, Lashley FR. Human patient simulators in nursing education: An overview. Simulation and Gaming. 2001; 32(2): 194–204
20. Kneebone R, Kidd J, Nestel D, Asvall S, Paraskeva P, Darzi, A. An innovative model for teaching and learning clinical procedures. 2002; Medical Educ 36: 628–34
21. Lapkin S, Levett-Jones T, Bellchambers H, Fernandez R. Effectiveness of patient
simulation manikins in teaching clinical reasoning skills to
undergraduate nursing students: a systematic review. 2010; Clin Sim Nurs 6: 207-222
22. Kreger NE. Five fast fixes. 2009; Clin Sim Nurs 5: e85
23. Moule P, Wilford A, Sales R, Haycock L, Lockyer, L. Can the use of Simulation Support Pre-
registration Nursing Students in Familiarising Themselves with
Clinical Skills before Consolidating them in Practice? Faculty of Health and Social Care. 2006; University of the West of England (UWE), Bristol
development, wound assessment and removal of necrotic tissue. The simulated necrosis was designed to be separate from the ulcerated heel [Fig 3]. Jones added layers of simulated sloughy tissue to the wound bed and then placed the necrotic tissue on top.
Simulation of a dehisced abdomen with a stoma site A dehisced abdomen with a stoma site was based upon a patient who had infected diverticulitis and had undergone an urgent hemicolectomy and stoma formation. The wound had dehisced post-surgery and was healing by secondary intention. The rationale for including this wound was
for students to explore the management of a heavily exuding wound that was further compounded by a stoma site. It also provided the opportunity to consider the patient’s goal of going home without experiencing wound leakage [Fig 4].
Simulation of a leg ulcer A simulated leg ulcer was designed [Fig 5] so that it could be stuck to the leg of an actor. The aim was to assist students in developing knowledge and assessment skills around venous leg ulcer management. The ulcer and surrounding skin needed to display signs of venous hypertension as well as an ulcerated wound bed with moderate exudate.
Outcomes At the end of the 16-week programme, the students’ responses were collated using a Likert scale. They were asked:
38 Wounds International Vol 3 | Issue 3 | ©Wounds International 2012
n Whether using the simulated wounds aided learning?
n What was the usefulness of the simulated wounds to their practice?
n For any other comments students wanted to make about the wounds.
From the 16 students who provided feedback, it was found that: n All strongly agreed that the wounds helped their learning
n All strongly agreed that they found the wounds useful to their practice.
General comments included: n ‘I found the practical session most useful’
n ‘The wounds related so well to our place of work’
n ‘Practical demonstrations using the wound care model were really beneficial’
n ‘The opportunity to discuss the problems associated with the wounds, whilst they were in front of you, and then to develop familiarity with wound assessment and management, aided my learning’.
The lecturer found that the simulated
wounds enabled greater discussion of tissue viability practice and that students could better relate to the wounds seen in practice. It also helped them to deal better with the complexities of assessment, management and treatment.
DISCUSSION The NMC[3]
strongly supports the use of
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