Karyn Lee Boyar

Abstract

Title:    “I Don’t Know What to Say:” Novel simulations to develop student nurse practitioner communication competencies ID:   123028  Password:       826826 Submitted November 6th 2023 If necessary, you can make changes to your abstract submission To access your submission in the future, use the direct link to your abstract submission from one of the automatic confirmation emails that were sent to you during the submission. Or point your browser to /stti/reminder.cgi to have that URL mailed to you again. Your username/password are 123028/826826. Background At a large, urban College of Nursing, our educational model is designed to help family nurse practitioner students attain competencies prescribed by the standards of our profession. Students are trained to meet or exceed these competencies which include assessment, diagnosis, treatment and the plan of care of their patients. However, what happens if the student nurse practitioner assessment uncovers a terminal diagnosis, an incurable sexually transmitted disease or a diagnosis that results in a strong emotional response? To prepare our graduate nurse practitioner students with the competency to manage difficult conversations we created a series of novel simulations. Simulation enhances the skills of the graduate nursing students by providing a safe environment to practice difficult conversations. Patients who discuss their prognosis, medical, treatment and personal goals with their clinicians are more likely to experience better quality of life and receive goal concordant care. Teaching these critical communication skills requires strong, creative pedagogy and is accomplished successfully through simulation exercises. Methods Faculty created five unique scenarios in which students interact with Standardized Patients (SPs) in 30 minute intervals practicing skills to conduct challenging conversations with patients and families. Students are given a synopsis of each simulation prior to the experience, however simulations are randomized on the day of the simulation. Scenarios are tiered (simple, moderate, difficult and referral). Students also receive  a 1.5 hour interactive presentation on how to manage difficult communication. Specific tools include use of the SPIKES framework to help guide the encounter and the use of empathic statements (NURSE Statements). Student/peer collaboration is encouraged; students are assigned into groups where one student conducts the interview, while others observe. Students rotate through five unique scenarios, changing rooms and roles. Faculty are each assigned a simulation and provide evaluations and comments using faculty developed evaluation forms..  SPs and peer observers provide feedback at the end of each simulation before students move to the next.. Simulations are filmed to further provide substantive feedback. Presentation will feature excerpts from the simulation. Outcomes  Students are expected to demonstrate understanding, application and evaluation of how to conduct sensitive, thoughtful conversations with patients which may be challenging in nature. AACN and NONPF competencies for patient/provider  communication interactions are supported  throughout the content. Evaluation Evaluations are completed by student’s subjective responses and faculty evaluations of concrete skills. Students’ complete self-evaluation reflection by using a unique SELF-SOAP note model Students are asked to complete an anonymous survey at the end of the simulation experience.  Faculty offer verbal and written student evaluations. The course coordinator works with the faculty to use all evaluations to revise, edit, and improve future experiences. References Bowen, R., Lally, K. M., Pingitore, F. R., Tucker, R., McGowan, E. C., & Lechner, B. E. (2020).       A simulation based difficult conversations intervention for neonatal intensive care unit nurse       practitioners: A  randomized controlled trial. PLoS ONE, 15(3), 1–12.       https://doi-org.proxy.library.nyu.edu/10.1371/journal.pone.0229895 Gorski, S., Prokop-Dorner, A., Pers, M., Stalmach-Przygoda, A., Malecki, Ł., Cebula, G., & Bombeke,  K.  (2022). The Use of Simulated Patients Is more Effective than Student Role Playing in Fostering Patient-Centred Attitudes during Communication Skills Training: AMixed Method Study. BioMed  Research International, 1–10. https://doi-org.proxy.library.nyu.edu/10.1155/2022/1498692 Kaplan M. (2010). SPIKES: a framework for breaking bad news to patients with cancer. Clinical  Journal of Oncology Nursing, 14(4), 514–516. https://doi.org/10.1188/10.CJON.514-516 Lippe, M., Davis, A., Stock, N., Mazanec, P., & Ferrell, B. (2022). Updated palliative care  competencies for  entry-to-practice and advanced-level nursing students: new resources for nursing faculty. Journal of Professional Nursing, 42, 250–261. https://doi.org/10.1016/j.profnurs.2022.07.012 Perez, A., Gaehle, K., Sobczak, B., & Stein, K. (2022). Virtual Simulation as a Learning Tool for Teaching Graduate Nursing Students to Manage Difficult Conversations.Clinical Simulation in Nursing, 62, 66-72–72. https://doi-org.proxy.library.nyu.edu/10.1016/j.ecns.2021.10.003     Reidy, J.A., Clark, M.A., Berman, H.A. et al. (2022) Paving the way for Universal Medical  Student Training in Serious Illness Communication: the Massachusetts Medical Schools’  Collaborative. BMC Med Educ 22, 654. https://doi.org/10.1186/s12909-022-03702-2  Zehm, A., Scott, E., Schaefer, K. G., Jacobsen, J., & Nguyen, P. L. (2022). Improving Serious Illness Communication: Testing the Serious Illness Care Program with Trainees. Journal of Pain and Symptom Management, 63(2), e252-e259–e259.  https://doi-org.proxy.library.nyu.edu/10.1016/j.jpainsymman.2021.10.013