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Diversity in Simulation-Exploring Patient Centered Care

Understand a broad concept of diversity for utilization in simulation. Identify a strategy for integration of diversity into the curriculum via simulation. 3. Recognize debriefing tecnhiques to uncover learners' biases and assumptions.

Jesika Gavilanes

on 25 October 2011

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Transcript of Diversity in Simulation-Exploring Patient Centered Care

Diversity in Simulation: Exploring Patient Centered Care Definition
A lifelong process of examining values and beliefs and developing an inclusive approach to practice with active intercultural engagement.

This definition reflects a broad description of culture that includes but is not limited to age, gender identity, race, ethnicity, religion, sexual orientation, socioeconomic status, and physical or mental abilities. There will be an integration of cultural competency into our simulation curriculum based on the American Association of Colleges of Nursing (AACN) published in September 2008 on Cultural Competency in Baccalaureate Nursing Education Toolkit Diversity in Simulation:
Exploring Patient-Centered Care Broad Definition of Diversity

Diversity includes but is not limited to age, gender identity, race, ethnicity, religion, sexual orientation, socioeconomic status, and physical or mental abilities. [Picture: Nurse and translator talking with patient Luis Gonzalez and his partner, Antonio]
Simulation Patient: Evelyn Downs Nurturing Cultural Competency in Nursing Nurturing Cultural Competency in Nursing http://www.ocnnursingdiversity.org/

Seven mini-grant 2009 Projects
Six mini-grant 2010 Projects Mary Cato MSN, RN
Jesika S. Gavilanes MA
Mary Anna Gordon DNP, RN Simulation Evaluations What are the top 3 things that you think of as being important in (intercultural) communication with your patients/clients, family, communities and other healthcare team members? Importance of (Intercultural) Communication

Knowing my own beliefs and cultural assumptions
Being open and respectful of the clients and their families What did you notice in terms of similarities? Cultural Similarities....
Being scared about the healthcare needs of my family members
Primary concern is patient comfort and well-being Cultural Differences...
Different ethnicities
Different languages
Different genders
Different beliefs
Clothing, requests, religion, food/diet, sexuality Patient Care Barriers

Education gaps
Goal differences
Lack of knowlege Lessons Learned

Diversity & culture goes beyond skin color and languages.
We all bring our unique cultures and life experiences to the table.
Students are great resources and content experts . Additional Simulation Cases
Valerie Jones, Jehovah Witness, 64 year old female.
Antwan Jones, Homeless, hospitalized with pneumonia.
Margarita Castillo, postpartum home visit, psychosocial issues.
Raven McDonald, Native American child, clinic visit with asthma. Jennifer/Geoffrey Vanderbilt, Gender Transition, 40-year-old transgendered male admitted today with pneumonia.

Learning Objectives: Demonstrate appropriate culturally competent care and communication related to gender transition
APA Transgender/Gender Identity website -http://www.apa.org/topics/transgender.html Jennifer/Geoffrey Vanderbilt
Debriefing Questions to uncover learners biases and assumptions:

What were some of the client's psychosocial issues?
What were some of the issues of the nurse that gave you report?
What's the best way to handle incidents like this in the workplace?
How can you best promote health for this patient?
What are the risk factors for this patient? New Learning Opportunities:

Student Leadership projects
Integration of standardize patients/family members
Community-based clinical placement
Somali Bantu community
Cultural implications for health care provider
Case creation, implementation, and debriefing by student authors Khadija Mohamed

Debriefing Questions to uncover learners biases and assumptions:

What are some of the strengths you noticed about Khadija? What are some of the challenges she faces?
Did you notice any internal beliefs/biases when client stated that she was pregnant?
In general, what are Islamic beliefs around birth control? How does this contrast with Western ideas about birth control? What kinds of discrimination might Somalis encounter around their beliefs? Khadija Mohamed

Debriefing Questions to uncover learners biases and assumptions:

When Khadija said she would stop feeding her baby sugar, do you believe that she will?
What barriers to access does she have?
What additional health issues could this client be experiencing? (eg, past sexual trauma, PTSD, depression, birth complications d/t FGC) Diversity in inter-professional training
Nursing culture and medical culture are different
Explicit integration of aspects of diversity into simulations
Explicit questions relating to diverse aspects of patients integrated into debriefing sessions
Continued integration of actors and standardized/simulated patients and family members Diversity in Simulation @ OHSU Gender Ethnicity Sexual Orientation Age Race Physical Abilities Economic status Marital status Blind spots Religious Background,
Beliefs Work style Values Trauma, Loss Personality type Coping style Resilience Birth order Conflict style Talents, interests Family background Work background Education Learning style Parenting status Leadership style Geography of Origin/Present Political Beliefs Cultural background Thank you! Planning Meetings Questions??? Next Steps: What did you notice in terms of differences? What were your barriers and how did you overcome them? Strategies to Barriers

Diabetes education
Nurse advocated for family
Translator/word choice/eye contact
Humility & patience
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