12 | Issue No. 5wpahospitalnews.comPenn State’s Nursing Simulation Lab Offers High-tech TrainingThe Penn State School of Nursing’s Nursing Simulation Lab features apediatric room for nurse training. Photo by Gene Maylock, Penn StateSchool of Nursing.By Deborah A. BenedettiWhen Florence Nightingale tirelessly nursed British soldiers during theCrimean War in the 1850s, she was beginning what would become the modernnursing profession. The legacies of Nightingale and all nurses are being honoredduring the 2010 International Year of the Nurse. It’s estimated that more than 15million nurses are working worldwide today, including 135,486 registered nursesin Pennsylvania. To prepare the next generation of nurses for the challenges of the21st century, Penn State’s School of Nursing has renovated its Nursing SimulationLab to create a state-of-the-art training center.“When our students enter the new facility, they feel like they are entering a professionalsetting,” said School of Nursing Dean Dr. Paula Milone-Nuzzo, RN,Ph.D., FAAN, of the $3.6 million lab. “It prepares students for the complex clinicalsituations they will face when they enter the real world. The lab also enablesRNs to get the quality hands-on education and training they need to maintain theirPennsylvania licensure.” Nurses are required by Act 58 to complete 30 continuingeducation hours every two years.The lab, located in the Health and Human Development East Building on theUniversity Park campus, takes up the entire ground floor. It is designed to mimica hospital setting and give students hands-on clinical experience.The lab features an intensive care unit, pediatric room, maternity room, main“fundamentals” lab and four-bed primary care unit, as well as high-tech humanpatient simulators — “Harvey,” “Sim Man,” pediatric and birthing mannequins —that can replicate symptoms, diseases and conditions nurses will encounter on thejob. Laptops at every bedside, equipped with the software hospitals use, give studentscritical documentation experience. Cameras and a control room enable activitieswithin the lab to be videotaped and data to be recorded for educational andtesting purposes.“Nursing is a very demanding profession,” Madeline F. Mattern, M.S., CRNP,School of Nursing Outreach Programs coordinator, pointed out. “There has beenan explosion in knowledge and technologies for patient care, and keeping up todate is a huge challenge for nurses.”Mary Anne Ventura, RN, M.Ed., M.S., instructorin nursing and Nursing Simulation Lab coordinator, said, “In the lab, we cansimulate situations nurses will see on the floor. They can practice using the lab’sequipment, so they become more comfortable with the health care procedures andtechnologies. They can make a mistake in a safe environment, and they will learnfrom their mistakes.”In addition to using the new lab to prepare students for the nursing profession,the School of Nursing is partnering with Penn State Outreach to offer continuingeducation programs for nurse professionals. The first seven one- and two-day programsare being offered starting June 18 and running through July 20. Topicsinclude diabetes, women’s health, advanced wound care, documentation andassessing/evaluating patients, among other health care issues. Programs are beingtaught by School of Nursing faculty and other clinical experts.Ventura, who has conducted refresher programs for nurses at hospitals, added,“It’s always helpful for nurses to periodically review their assessment skills and theSee SIMULATION On Page 13
Issue No. 5 | 13wpahospitalnews.comThe Doctor of Nursing Practice: What’s the fuss?By Judith Kaufmann and Peggy MigaudThe American Association of Colleges of Nursinghas designated 2015 as the year that the Doctorate ofNursing Practice will become the terminal degree inadvanced nursing practice and will be the degree mandatedfor entry-level nurse practitioner practice. Thecurriculum for the D.N.P. is built upon traditional master’sprograms for advanced practice nurses, providingeducation in evidence-based practice, quality improvement,systems leadership, and other key areas. Corecompetencies developed by the AACN were designedJudith Kaufmannto build upon competencies from the National Organizationof Nurse Practitioner Faculties that guide educational programs in preparingthe highly skilled nurse practitioners.Factors influencing this change in nursing education include: rapid expansionof knowledge in underlying practice, increased complexity of patient care, andnational concerns regarding the quality of patient care and patient safety, as wellas projected shortages of primary care providers. These factors provide the impetusfor a higher-level nursing education that parallels other health care professions.Surprisingly, the D.N.P. degree has met with opposition and has generatedunprecedented controversy among medical organizations, even within the nursingprofession. The basis of most of the criticism stems from lack of understanding ofthe “clinical doctorate.” The D.N.P. is not designed to replace the Ph.D., or to create“mini docs.” Doctorally prepared nurse practitioners will not try to pass themselvesoff as medical doctors. They will, in fact, proudly identify themselves asnurses practicing at the highest level of the profession.The D.N.P. represents education of direct care nurses at the highest level. Theclinical doctorate places the nurse practitioners, nurse anesthetists, clinical specialistsand certified nurse midwives on the same professional level as the otherprofessions, including pharmacy, dentistry, chiropractics, speech therapy, physicaland occupational therapy. Like these other disciplines, it does not change the scopeof practice that is clearly legislated by each state board of professional licensure.According to the AACN, there are 92 D.N.P. programs nationwide, and another102 nursing schools considering starting D.N.P. Programs. There is broad latitudefor final doctoral projects, which include quality improvement initiatives, translationof current evidence-based research into clinical practice, and expanded directcare practicum hours. D.N.P.-prepared nurse practitioners will complete more than1,000 hours in precepted direct patient care prior to sitting for national certificationexams. In contrast, master’s-prepared NPs complete between 500 and 600hours during their programs. This increase in mandated internships is consistentwith the need for highly trained healthcare professionals.Patients will benefit from the additional academic preparation of the D.N.P., andphysicians working with N.P.s can be confident in their skills and advanced clinicalreasoning. In this complicated health care environment, multidiscipline teamscan maximize patient outcomes, and advanced practice nurses will clearly play arole in the provision of holistic patient care.One area of concern from within nursing is the variation among programs. Forexample, Colombia University School of Nursing’s program is based on a modelthat requires an intensive, year-long clinical residency that somewhat parallelsmedical education. Students pursue an area of concentration, and participate ingrand rounds and seminars. Students integrate didactic instruction, seminars andclinical experience to develop case studies that demonstrate increasingly complexand proficient practice, as well as complete a scholarly project. The curriculum isbased on competencies outlined by the Council of Achievement of ComprehensiveCare. Graduates from clinical practice doctoral programs are eligible to take theComprehensive Care exam, although the scope of practice for nurse practitionerswill not change. Those who pass the exam will be designated as Diplomate inClinical Doctoral Nursing.The Drexel Dr.N.P. is another alternative to the AACN model for D.N.P. education.It is best described as a “hybrid degree,” combining the professional practicedoctorate with the academic research doctorate to help advance the evidence baseof nursing. This is a practice-focused academic doctorate requiring a clinical dissertationthat will generate evidence-based nursing science.A number of other programs throughout the country integrate medicine andnursing competencies into the content of physical assessment and diagnosis,advanced pharmacology and pathophysiology. They maintain the “heart and soul”of nursing, which is ultimately in healthcare promotion and patient communicationand advocacy. As such, the D.N.P. curriculum incorporates current theoreticaldevelopments and evidence-based research in health behavior change, behavioralsciences, exercise physiology, nutrition, epidemiology and genetics.The AANC has painted a broad brush across the D.N.P. landscape with theexpectation that the D.N.P. will be the terminal practice degree by 2015. They havegiven broad latitude for the development of educational programs as well as finalclinical projects. Many stakeholders have placed their claim on part of the D.N.P.education arena, and they are varied in both their clinical and philosophicalapproaches. The variety and type of D.N.P. programs may have contributed tosome of the confusion among nurse practitioners, and certainly among physiciangroups. But as the role evolves, it is clear that the degree is an important step inthe advancement of nursing as a profession and in the direct care of patients.Judith Kaufmann, Dr.P.H., F.N.P., is an associate professor nursing at Robert MorrisUniversity and the director of the school’s D.N.P. program. Contact her at 412-397-5482 or kaufmann@rmu.edu.Peggy Migaud, R.N., M.S.N., is studying for herD.N.P. at RMU.SIMULATION From Page 12procedures and policies unique to their hospital. These are the kinds of programswe are offering at the simulation lab. New nurse graduates and RNs who needmore expertise in a particular area can use our summer programs to become betterprepared.”Mattern said, “Our programs will increase nurses’ knowledge, competenceand comfort level with new technologies. The programs also will promotecritical thinking and clinical judgment that can be transferred to the work setting.”For information about the School of Nursing’s Nursing Simulation Lab, visitwww.hhdev.psu.edu/nurs/simlab/, and for information about summer continuingeducation programs for nurses, visit http://outreach.psu.edu/cape/simlab/index.htmonline.Penn State nursing instructors can observe and videotape activities inthe intensive care unit unit of the lab for playback and evaluation.Photo by Gene Maylock, Penn State School of Nursing.
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