Addressing health inequities through simulation training and education in rural and tribal communities.

Background: The nursing shortage is serious and getting worse in medically underserved areas. Nursing education needs to include faculty education in simulation-based education that focuses on public health and cultural education. New nurse graduates are inadequately prepared and need additional training to provide culturally appropriate care to varied and rural populations. Method: This project used simulation-based education and rural clinical placements to enhance the training and education needs of faculty, students and community partners to better address the health care needs of people living in rural and medically underserved areas of the Navajo Nation and northern Arizona. Results: The project increased knowledge and interest among faculty and community partners on simulation-based education as well as positive student learning experiences. Conclusion: Public health and culture can be integrated into simulation-based education. Partnerships with tribal communities can play a valuable role in nursing education.

High-Fidelity Simulation Improves Long-Term Knowledge of Clinical Swallow Evaluation.

Purpose Clinical swallow evaluation (CSE) is a critical skill that speech-language pathologists who manage swallowing impairment must learn. The objective of this mixed-methods study was to determine if using a human patient simulator (HPS) to train speech-language pathology graduate students in CSE improved knowledge, preparedness, and anxiety as compared to traditional instruction alone. Method This was a controlled trial with repeated measures. Participants included graduate students from two cohorts who were enrolled in a swallowing disorders course in consecutive academic years (n = 50). Students in the experimental group participated in a simulation experience in which they performed a CSE on an HPS, generated a treatment plan, and communicated in real time with the HPS, the patient's wife, and a nurse. Quantitative results included quizzes that measured short- and long-term CSE knowledge, and qualitative findings included written feedback from instructors and students. Results Students who participated in simulation training had significantly higher long-term quiz accuracy than the control group, but their short-term quiz scores did not differ. Student ratings of preparedness and anxiety did not differ between the two groups. Many students reported that they appreciated practicing the use of patient-friendly language and preferred clinical simulation over traditional teaching methods. Facilitators reported that simulation increased student engagement and critical thinking skills more than traditional teaching methods. Conclusions CSE simulation provided objective and subjective advantages over traditional teaching methods. Recommendations from students and instructors for improving the CSE simulation training are reported.