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Teaching Innovations at Vanderbilt: Mary Lauren Pfieffer, Anna Richmond, and Pediatric Simulations

Posted by on Monday, May 13, 2019 in Commentary, News.

By Faith Rovenolt, CFT undergraduate intern

Teaching Advanced Practice Nursing in Primary Care of the Child is a challenge: students need to understand a range of concepts for caring for children and adolescents across a large developmental spectrum, building knowledge that has cognitive, psychosocial, and motor components. Mary Lauren Pfieffer, Instructor in Nursing, and Anna Richmond, Assistant Professor in Nursing, tackle this challenge in a high-enrollment hybrid course, where students do most of their learning at a distance but come together on campus for 12 days during the course.

Pfieffer and Richmond knew that their students could benefit from more opportunities to apply their knowledge and see what things look like in the clinic. They therefore developed what they are calling “Pediatric Simulation Day.”

During Pediatric Simulation Day, the class of 100 students is divided in half, with one half doing the simulation activities and the other listening to a guest lecturer. The groups then switch, so all students get the opportunity to engage with all the activities in relatively small groups. There are three simulation rooms that focus on different skills:

  1. Simulated child respiratory cases where students must communicate with caregivers to generate a diagnosis, plan a course of action, and educate the patient’s caregiver on plan of care.
  2. Computer models of four different ear cases, where students determine a diagnosis and treatment plan. Students practice using otoscopes and other care with models. Pfieffer and Richmond use a workbook to guide students through the experience.
  3. A dual well-child case and five example cardiac murmurs on simulated patients.

Students receive a pre-brief to the simulated event, spend 40 minutes in each room, and then work through a debrief with a faculty member to discuss their diagnoses and plans.  They work on an assignment through the experience where they record diagnoses, treatment and plan of care for the patients. This is submitted individually but can be worked on as a group, which will occur often when students are in clinical practice and collaborating with other healthcare providers.

Pfieffer and Richmond began developing Pediatric Simulation Day four years ago in response to students’ comments that they wanted more hands-on experiences with pediatric patients. Feedback since its implementation has been very positive. Currently, they are planning to schedule the simulation day towards the beginning of the semester rather than the end, to help prepare students for clinical interactions with pediatric patients.

Other healthcare classes, and possibly some STEM lab courses, could also do similar things. Pfieffer recommends:

  • Taking pictures of the entire setup, keeping clear lists of supplies, and producing diagrams of the layout to make it reproducible;
  • Taking advantage of resources, such as experienced lab faculty;
  • Using spaces that may not be traditionally used, such as computer labs;
  • Making the activity graded to raise the stakes and encourage student involvement;
  • Never feeling afraid to ask for help from other faculty members.

Pfieffer and Richmond are continually looking at other ways to give students more opportunity to synthesize and apply their knowledge, such as having student groups evaluate each other as they do a well-child assessment with a family member or friend.  To learn more about their philosophies, read the profiles Pfieffer and Richmond wrote during their time in the Junior Faculty Teaching Fellows program.


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