dietetics simulation example

Simulation Lab goes Virtual for the Dietetic Internship Program

Last month, the director of Meredith’s Dietetic Internship program, Cathie Ostrowski, M.S., R.D., L.D.N., FAND, presented at the Nutrition Health and Human Performance virtual monthly meeting on the program’s addition of a virtual adaption of the simulation lab to its curriculum.

In this video, Ostrowski gives an overview of the lab’s use of video, Google Jamboards and other tools, and shares student feedback on the lab.


Cathie Ostrowski: So this was our presentation that we sent that we gave to an HP in beginning of October and we just talked about simulation in general in the lab. And so we started off with really low Fidelity. You can see on slide three like well, we just talked about it and then we did the timeline of like how the DI started with simulation and a kind of started in 2013 when we applied but didn’t receive a simulation grant was really big grant actually, but it kind of got our brains thinking that, oh OK, we should be moving this forward. So and then we started partnering with Wake Tech simulation. This is the nursing school.

Yes and then anyhow, so that’s there and then we talk about the benefit of simulation and so then we went to like a basic simulation of if you go to Slide 9 like that’s a basic simulation of like this is a patient like bedside table and like what’s wrong with this bedside table? So there’s tons of things that are wrong but these are things that we could do with students just simulating a lab. You know, this patient supposed to be on a pureed diet, but that’s not a pureed tray. The patient has their name tag, you know, not on their person. The patient has a wall of nutritional supplements. You know that’s not supposed to happen because they’re not going to drink them all in. It’s a waste, and anything that goes in the patient’s room has to be thrown away so you can’t use those supplements again, so that’s a waste. And then their dentures are on their tray, which means they could be lost, so there’s lots of like. Like safety issues there. So we started with that and then we went.

Another basic thing was a Jamboard like I one of the goals for the students a couple weeks ago was just too. I gave them 30 minutes of class time to do whatever they wanted and they knew about it ahead of time so it wasn’t a surprise but I gave him 30 minutes of class time to do whatever they wanted throughout the week and like then I had them do a Jamboard of what they actually did and so you could see there’s lots of ideas and they were small too. Really big ones. Like someone said, like I just realized, I can’t do this internship and actually work. So I quit my job. And like other students like Read a book, went bike riding one of the students went on a date, so it was just a way for us all to connect together.

And then we went into that case study. So that’s the case study if you click on it, it goes to that case study that you and I went through together where we added video and audio to the case study. It wouldn’t. Yeah, it wouldn’t show up in Google Docs, but it it showed up like in an actual PowerPoint presentation. So the goal with that case study was to let students do it on their own. So I have verbal prompts on the slides. So you help me with that and then we actually added a video to it. OK, Yep, and then I then I went to slide 13 which is our simulation lab where we set Avery. Is our mannequin an we set her up in all different scenarios across the room and we have all different we’ve tube feedings like this is a picture of somebody on oxygen, so we have just scenarios all over the place. There in the students walked through each station in person and could touch everything and see what like what a tube in the nose looks like. A tube in the stomach, the ulcers, the ostomies and so on. So this man again right here. The one of the face. Yeah, somebody was given away on Facebook because their their child went to cosmetology school and they were done with that face. In the head and I was like, oh, I want it. I said, oh, I want that because I’m going to use it for my simulation lab so OK and then this is so slide 14 is Amy’s work, so if you hit play it’ll actually play a 6 minute video on tube feedings for students.

We’re gonna talk about different types of feeding tubes and those feeding tubes are specifically used for enteral nutrition, so feeding the gut through enteral nutrition and there’s some different ways or so that there’s a different tubes that can help to get that enteral nutrition with that. So it’s just six minutes of going through her tube. This is Avery’s tubes, right? And then the next one. Oh, we did a training on we were interviewing. So this is Amy acting inappropriate at the site. She’s dancing. And then she interviews a collegiate student whose end with diabetic foot ulcer. She is a full story. Simulation there sure. We talked about the purpose of debriefing that debriefing is very important. It’s actually the most important part of it of the simulation lab, because the students can then go back and see what they understood and what they didn’t understand about what was going on.

And then this last video here was a debrief on like Amy’s performance, so it’s me telling me what she did right and what she could do better. And then this last video here is our simulation lab. So this one marketing did. OK, did this video until it talks about in IPE interprofessional education. That’s other professional video. So and then we just went through and talked about the data and outcomes student feedback and then we gave different tools. See, we give you a shout out alright? We started off with like tools available to everybody like campus and then we went to others like you have good lighting, you have to have a selfie light. You know video should be in landscape. All the things that you know you could have had mentioned and then a couple of websites and then just a few more tools like these states. He gave us these tools, avatar tools like free papers. I get all my pictures from Pixabay and then there was like 2 videos on a two books on simulation ’cause we were doing this to exercise and nutrition. And then we had them. We had them complete a Jamboard on all we’re going to do in the future. You know, with the faculty, and so we just said, hey, listen, we just used an iPhone and a selfie light and a selfie stick. And that’s all we did to make our video. So they’re not perfect, but they’re OK, sure. Yep, So what in there would be useful.

Paul Keys: Oh, so I guess just tell me a little bit more about these are. So there ’cause your students are online but they are able to come fit like like like you had that room set up where they would. You said they would go through the room was that they physically come to campus and go through that room.

Cathie Ostrowski: Yes yes. So that was like a brainchild that I had where a lot of students have never stepped foot in a hospital before even though we recommend it, they may never have walked into a patients room. And some of them are so like debilitatingly nervous about walking in a patients room that we had them practice walking into a patients room. We had them go in there and, you know, say you know this is an Ng tube. It goes through the nose and then it goes all the way down to their stuff. Make this is what it looks like on the inside. This is what it looks like on the outside. You know, touch it, feel it, open the port, pretend to put two feeding in, pretend to flush, pretend to pull out residuals just so that they could feel it and touch it. And know what it look like. So I spent about two years purchasing all these supplies and so that way they could see what everything looks like because my whole goal in the internship is that they walk into a room and there or they meet their their preceptor, their teacher for the first time in the hospital and I want them to elevate their practice like I want them to know a little more than their supposed to so that they have a level of confidence. Obviously they don’t know a lot. But I just want them to feel comfortable with what they see when they walk in a room. One of our goals, yeah? So yes, they come in normally and walk through this, but since we couldn’t this year, Amy and I we went through every single one of these stations. With it with the video camera from Rick McBain in the Library for Media Services, like a high definition camera on a tripod, and we went through each one and described it all for them.

Paul Keys: Right. And how about any student feedback yet?

Cathie Ostrowski: Yes, so some of this feedback here. So right starting right here on this slide, I really enjoyed the NFPE, so that’s nutrition focused physical exam. And so we did that via zoom. So this was one of the feedbacks here, gave me a good idea of what to expect in the room. But then the other comments are from like actually being in the room, right? The other ones there. But students felt that their competence was elevated when they knew what to expect when walking into a room, and they knew the difference between the tube feedings and they knew the difference between like on this picture. Right here is TPN so that yellow is protein and carbohydrates. And the clear is actually just Ivy fluids, but just so that they understood like that’s what I’m looking at, so they could feel competent when talking with their preceptors. OK, yeah, we actually found a company called Vitality, Vitality, medicine like Vitality, Medical, this company right here is a medical company and normally you have to have a prescription to order everything. But we just we signed like a little email. That said, we will never use any of these products on actual people. Rather, they actually let us buy whatever we want to buy. OK, I can buy tubes, I can. The only thing I don’t have is like a tube feeding pump but they let us buy bandages and Ann. TPN, actually the TP and we got off the sample TP and we got off Amazon. We got the wheelchair off Amazon. We got the Ivy pull off Amazon in the sample Ivy fluids we got off Amazon. OK yeah and then everything else we bought from Vitality Medical. We just had a promise we wouldn’t use them on actual patients and of course we’re sure.

Paul Keys: And I think you did it during the cohort at one point. But can you define what the Preceptor is again?

Cathie Ostrowski: Oh sure, so a preceptor is a cross between a teacher in a mentor. So a preceptor takes a student and their knowledge in their information and helps them apply that information with real patients. So they, the student already has the knowledge, is taking that knowledge and applying it to real patients so that they can do full assessments. Of patients and educations of patients so there right across between teaching and being a mentor. There kind of like guiding them. Usually in a one on one type of situation, either knowledge or their didactic information. So that they can do the work of a registered dietitian with having somebody at their side right?

Paul Keys: And present what is the NHP?

Cathie Ostrowski: Nutrition, Health and Human performance.

Paul Keys: OK and so did like a virtual presentation?

Cathie Ostrowski: Yes, because they they just want to see what we were doing with simulation amid covid. Normally it’s in for our orientation is in person and so we had to adapt it and they just wanted us to show them.

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