Simulations, Evidence and the NPL –What to do when you don’t have the right case.Lucy Bellwood RVN

Veterinary Nursing Centre Co-ordinator, Myerscough College

Lucy Bellwood RVN A1 V1

VN Centre Co-ordinator at Myerscough College

Internal verifier for 7 years

Manage and co-ordinate team of 4 other IVs

Plan and run monthly standardisation events

Previously A1 Assessor for 6 years

Soft spot for slightly damaged staffies

Those Sticky Skills…..

Placement and management of nasogastric feeding tubes

Nursing Care Plans

Placement and management of indwelling urinary catheters Placement – we expect male dogs only

Radiography Positioning

Exotics – comparative anatomy and nursing

Equipment – endoscopes, ultrasonic instrument cleaners

NB. Always check with your own Centre / Internal Verifier if in any doubt

Option No. 1 - Simulations

“…an event or situation that is made to resemble clinical practice as closely as possible. It has a detailed scenario, patient and/or client information and requires careful planning” (RCVS, 2011)

Option No. 1 - Simulations

“…an event or situation that is made to resemble clinical practice as closely as possible. It has a detailed scenario, patient and/or client information and requires careful planning” (RCVS, 2011)

Option No. 1 - Simulations

“…an event or situation that is made to resemble clinical practice as closely as possible. It has a detailed scenario, patient and/or client information and requires careful planning” (RCVS, 2011)

Option No. 1 - Simulations

“…an event or situation that is made to resemble clinical practice as closely as possible. It has a detailed scenario, patient and/or client information and requires careful planning” (RCVS, 2011)

Option No. 1 - Simulations

Use for addressing first aid and emergency elements in SAVN18 and EQVN24

Clearly highlighted within Guidance Notes on individual skills Use for opening up and signing off skills if necessary

BE PREPARED! Ensure relevant equipment is freely available Rope other people in – managers, receptionists, clients?? Set up a mock emergency – be dramatic! No laughing

Option No. 2 – Set Tasks

“A set task is an opportunity for students to demonstrate clinical skills in areas that do not require a patient, for example preparing necessary equipment and materials for administration of intravenous fluids, applying bandages” (RCVS, 2011)

Option No. 2 – Set Tasks

“A set task is an opportunity for students to demonstrate clinical skills in areas that do not require a patient, for example preparing necessary equipment and materials for administration of intravenous fluids, applying bandages” (RCVS, 2011)

Option No. 2 – Set Tasks

“A set task is an opportunity for students to demonstrate clinical skills in areas that do not require a patient, for example preparing necessary equipment and materials for administration of intravenous fluids, applying bandages” (RCVS, 2011)

Option No. 2 – Set Tasks

“A set task is an opportunity for students to demonstrate clinical skills in areas that do not require a patient, for example preparing necessary equipment and materials for administration of intravenous fluids, applying bandages” (RCVS, 2011)

Option No. 2 – Set Tasks

“A set task is an opportunity for students to demonstrate clinical skills in areas that do not require a patient, for example preparing necessary equipment and materials for administration of intravenous fluids, applying bandages” (RCVS, 2011)

Option No. 2 – Set Tasks

Utilise dummies – halti head, soft toys, mannequinsCadaversRadiography patients – PATIENT WELFARE MUST BE

PARAMOUNTLeft over lab samplesLive patients / staff petsCreate a ‘mock box’ for easy access on quiet days -

include the above plus a range of consumables, and a file with NPL skills list and up to date OSCE methodologies

Support with professional discussion

Set Task – VN17, skill 7

• Place, or assist with placement of, naso-gastric or oesophageal tubes

• Manage naso-gastric or oesophageal tubes

Set Task – VN17, skill 7

Set Task – VN17, skill 8

Manage indwelling urinary catheter

Set Task – VN17, skill 8

Set Task – VN17, skill 8

Set Tasks – Unit 10 - ‘Would you like a blood smear with that?!’

Set Tasks & Practical Exams

Utilise to practice OSCE tasks – use methodologies and cross reference to NPLAdministering bolus medicationNasogastric tube managementUrinary catheter managementPreparing anaesthetic / diagnostic equipment –

secondary practices? Preparing IVFT equipmentFine – tuning laboratory skills

Option No. 3 – Professional Discussions

Use to support set tasks and simulationsMust ensure demonstrates sufficient depth- plan Link to specific set task eg. Place NG tube in cadaver,

now explain maintenance for that patientGive mock scenario – ask student to explain and justify

care Not the easy way out!

Professional Discussions

Plan your subject, theme and prepare a templateOpen discussion regarding evidence, eg, nursing care

planMock scenarioQuestion and answer

Provide open and relevant questions Be prepared to revisit if necessary Document and store evidence

Option No. 4 – Use of Assignments /GLH

Students must learn to triangulate evidence and knowledge

Know the NPL inside out!Coaches – are you familiar and confident with

nursing models and care planning? Take care with currency and validity

Use of Assignments /GLH

Encourage note book / jotter system when writing and planning assignments to pick up specific skills

NPL skills list usefulCan help prevent students focussing too much on

one area of studyStore care plans in evidence file

Option No. 5 - Secondment

Equine / SA crossover Diagnostics Exotic or orthopaedic work

Secondment

Foster relations!Must be an RCVS approved TP or aTP Always check with your IV / Centre – written agreements

will be necessary Not just for auxiliary Training Practices

Insufficient caseload presents unexpectedly Student requires more support or experience that can be

provided with current caseload / circumstances.

Use of Cadavers

Used extensively in human and veterinary medicine for centuries

Human – choice made by ‘donor’

Use of Cadavers

For Routinely used in VN education

within colleges - dissections

Biologically accurate

Easily accessible

Efficient – multi-use

Some assessments on live animals may have welfare considerations

Against Ethical concerns

Don’t react as live patients do

Yuk! factor

In Summary -Different skills suit different methods…. Feeding tube / urinary catheter

placement

Feeding tube / urinary catheter management

Radiography skills

Emergency first aid

Species specific nursing

Nursing care plans

Bandaging

Set task (cadaver/dummy)

Professional discussion

Set task (dummy / patient)

Simulation

Secondment / set task

Assignment content

Simulation / set task

Thank you very much for attending!

Remember, anything worth doing is worth doing well!