Interprofessional Student Teams Compete to Treat Simulated Patients

By Ben Boulden

UAMS College of Nursing student Ted Clowers, left, and UAMS College of Health Professions students Misty Lake and Brittany Reaves work to revive a manikin simulating a patient in cardiac arrest.

Mark Tanner, M.S.N., R.N., College of Nursing clinical instructor helps critique the performance of one of the teams participating in Sim Wars.

May 7, 2013 | Music from “Star Wars” filled a UAMS lecture hall May 2 as a Darth Vader-costumed emcee waved a light saber and opened the first Sim Wars competition to the cheers of about 200 students.

The UAMS Simulation Center, which organized the event, is used frequently by students for training in emergency and other medical procedures, but Sim Wars added a new, competitive element.

“That’s what Sim Wars is all about,” said Mary Cantrell, executive director of the Center for Clinical Skills and Simulation Education. “It’s pitting teams against each other and looking at how they deal with a crisis.”

By the end of the two-hour contest, the audience had voted, based on interprofessional skills, electronically to award the victory to “Team 4CE” — Ted Clowers and Michael Waldron, both UAMS College of Nursing students; Misty Lake and Brittany Reaves, College of Health Professions respiratory therapy students; and Heather Pinkard and Brian Sullivan, College of Medicine students. Sullivan led the team. In keeping with the Star Wars theme, teams named “A-Tachycardia of the Clones,” “The Bun Heads” and “Team Wookie” also took part.

Four teams of six students each competed in three rounds of simulations using a high-tech manikin as a patient. Volunteers trained to act as family members, nurses, a paramedic and an interpreter were part of the simulations. An interprofessional team of faculty and students developed the cases. The winners of the first two rounds competed in a final. Students were from the UAMS College of Health Professions, UAMS College of Medicine, UAMS College of Nursing and UAMS College of Pharmacy.

After a simulation, the faculty panel questioned each team, analyzed the decisions that the teams made, examined the medical techniques used and assessed how they performed overall. Panel members were Mark Tanner, M.S.N., R.N., College of Nursing clinical instructor; Toby Vancil, M.D., assistant professor in the College of Medicine Department of General Internal Medicine; and Kendra Jones, Pharm. D., assistant professor of Pharmacy Practice in the College of Pharmacy.

In the final round, the crisis involved a 75-year-old simulated patient who was experiencing tachycardia. A medication error by hospital staff was the cause of the tachycardia. Students administered a medication to slow the heart only to throw him into cardiac arrest. Soon, the patient’s wife appeared to inform the team that he was only in the hospital for a urinary tract infection. The wife, with power of attorney, insisted the team ignore the patient’s “do not resuscitate” request and “bring him back.” A hospital attorney then informed the team power of attorney takes precedence, and the patient was revived by both teams in each seven-minute simulation.

The overarching purpose of Sim Wars was to give the students an opportunity to participate on an interprofessional team. Sullivan, “Team 4CE” leader, and other team members said it was great to work with students representing other health professions.

“You can memorize the guidelines for Advanced Cardiovascular Life Support all you want, but until you know what everyone is doing and how you work as a team, it’s not going to flow,” Clowers said.

Another purpose was to give students experience selecting the appropriate medical guidelines for a patient’s condition. It gave the students an opportunity to use the guidelines for health care professionals who either direct or participate in the management of cardiopulmonary arrest and other cardiovascular procedures.

“If I were to show up next year (for my internship) and not have had an experience like this, then showed up for a real code, I wouldn’t have known any of the tools,” Sullivan said.

Sim Wars was produced with fun in mind. Richard Wheeler, M.D., executive associate dean for Academic Affairs in the College of Medicine, made an appearance as Darth Vader, and Cindy Stowe, M.D., associate dean in the College of Pharmacy, was his counterpart as Princess Leia.  The co-hosts, Jordan Brazeal, a College of Pharmacy resident, and Kyle Fulton, a College of Medicine student, wore Jedi warrior and Luke Skywalker costumes.

Michael Anders, Ph.D., R.R.T., director of simulation technology in the UAMS Simulation Center, said he was surprised how competitive the teams were.

“That’s a good reflection on them in terms of wanting to learn to do the protocols well and learn and win,” he said. “They really wanted to win, and I was impressed by that.”

Anders, Cantrell and other Simulation Center staff debriefed the teams after the competition to find out what worked best for them and what didn’t. They plan on doing it again in 2014.

Although each team, even the winning one, made its share of mistakes, all the students were positive about their experience overall and the value of the competition in learning.

“One of our central themes in the Simulation Center — for all learners, students, hospital staff — is that this is a safe environment in which to make mistakes,”
Anders said. “We learn from mistakes, and it’s OK to make them here.”