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Students studying to become licensed practical nurses (LPN) through Bitterroot College experienced hands-on medical simulation training last week to help them experience stress and learn the training lessons.

The Simulation in Motion – Montana (SIM-MT) vehicle was parked on Main Street next to the college. Inside, one end was set up as an Emergency Room in a rural hospital with a “patient” on a gurney and the basic tools medical responders need for diagnosis and treatment.

Lee Roberts, program manager for SIM-MT, described the scenario and what the nursing students could expect.

“We try to create as realistic of a scenario as we can for you,” Roberts said. “We try to make it somewhat challenging to your scope, level, skills, knowledge and attitudes, everything that you bring with you as a caregiver.”

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The challenge was for the LPN students to work together as a team to treat the mannequin patient as a real human being and provide the best medical treatment they could.

“This is a safe space,” Roberts said. “We trust each other, respect each other’s histories, knowledge, skills and behaviors because we all approach our patients a bit differently. Our basic assumption is that you are all capable, intelligent, care about doing your best and that you want to improve.”

Roberts and Levi Meyer, Billings team leader for SIM-MT, worked in the control area in the middle of the vehicle to activate the technology.

The $10,000 mannequin “John Smith,” made with cell phone parts and mechanical drives, has an anatomically correct airway. His chest rises and falls to show breathing, he has lung sounds, pupillary responses, a heartbeat with the pulse felt in the neck, wrists and feet. His oxygen levels, heart rate and blood pressure readings show on the monitors of the automated vital check systems, which were controlled by Roberts and Meyer.

“What we’d like you to do is take the blood pressure cuff, put it on John and click the button up there to actually get the data, so it immerses you in the scenario,” Meyer said.

Smith responded (voice provided by Meyer) to questions about his medical status how he felt and what prescriptions he was taking. A little sarcasm was thrown in for real-life simulation as he was an adult male, age 68, who lived in a nursing home, and he had blue lips, shortness of breath and wanted a cigarette.

“Today is mostly about assessments and samples,” Roberts said. “If you need to call in a report or request resources, just pick up the phone and somebody will answer, it will sound a lot like me.”

Meyer said the simulation is data-driven.

“You’re going to take vital signs, ask him lots and lots of questions and get a real good patient history,” he said. “I recommend you assign roles.”

The students gloved up, talked to John, asked him questions, patted his hand, raised his head, made him comfortable and assured him that he was getting the best of care.

The Bitterroot College LPN students are registered as students of Helena College, do hands-on skills labs and clinical work in Hamilton and will earn their license without leaving the Bitterroot Valley.

Bitterroot College Academic and Student Services Director Lea Guthrie said it is a great partnership, funded by a COVID grant, allowing students to earn their LPN locally. The medical tools purchased with the funding also benefit other Bitterroot College students.

“We couldn’t do it without Helena College, we can only offer an AA degree,” Guthrie said. “This is a way for us to meet needs. There is a cohort in Helena and our students are here. Our students can do their education here, take their test and get their LPN license.”

The LPN instructors come from Helena College to teach at Bitterroot College through the University of Montana. During the SIM-MT simulation, the instructors served as guides, prompters and scribes.

After the simulation, there was a guided debrief to discuss what went right or could have been handled differently. Roberts said the process improves patient outcomes and builds confidence and team collaboration. A few of the students said they felt great about the experience, one said it made her nervous and that she was not as helpful as she felt she could be.

Instructor Susan Robinson, RN, said the simulation experience helps to dispel anxiety.

“This was a great experience for them,” Robinson said. “They knew what to do and had the skills but occasionally were hesitant.”

Roberts said stepping back and observing before acting can also be good.

“There’s a role for everybody,” he said. “It’s based on who you are, what you know, how you were raised, and that unique perspective can help the patient as long as you embrace it and move strongly ahead.”

He emphasized working as a team, supporting each other, talking to each other, and promoting awareness and ideas.

Simulation in Motion is a nonprofit that brings high-quality simulation training to emergency medical service agencies and critical care hospitals in rural areas. It has three mobile unit training vehicles, each set up to resemble a rural emergency room with the tools medical responders need and provide simulation training which “reduces medical errors, improves patient outcomes, increases team performance, identifies latent patient care threats and more,” the program’s website says.

Bitterroot College Director Victoria Clark said the Simulation in Motion training was positively received.

“We’ve had multiple requests from students to have Simulation in Motion return and to sponsor additional similar activates in the future,” Clark said. “There is just no substitute for hands-on learning.”

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