Simulation case: Young couple

Simulation case: Young couple

Objective

The objective is to practise authentic guidance situations, learn to provide information about the dangers of smoking and describe its impact on fertility/pregnancy/unborn children.

Target group and the group size

Students should have prior knowledge of

  • Dangers of smoking and its effects on fertility, pregnancy and the unborn child
  • Electronic cigarettes
  • Motivational interviewing

Two students act as customers and one student acts as the nurse. Other students watch the simulation in the classroom and assess it afterwards. Alternatively, the case simulation can be recorded and played back.

The simulation can be supervised by one or two people to monitor the time, present the cases, debrief and provide feedback. The supervisor can be a lecturer or an advanced student.

Time use

  • Description of the simulation process: approx. 15 min. If there are several simulations in one day, the presentation should be given only once, before the first simulation.
  • Role assignment and briefing of the role players: 5 min.
  • A brief description of the case customers to the observing students: 2 min.
  • The customer case simulation: approx. 20 min. (Timed by the lecturer or the camera operator if the simulation is recorded on video)
  • Debriefing and assessment: approx. 20 min.

Preparation, supplies, facilities and equipment

A simulation classroom or video equipment for making a recording for later viewing.

The simulation requires an environment (a simulation space or a classroom set up for video recording) set up as a nurse's office. The Fagerström questionnaire form (Appendix 1) and other guidance materials are placed on a table.

Choose the participants for the simulation: one or two students to act as nurses and one student to act as the customer.

Assignment and work instruction

It is recommended to havetwosupervisorsguiding the simulation case. One canbrief the studentacting as a nurse and the othercanbrief the studentwhotakes the customerrole. Alternatively, the case assignmentcanbe a paperhandout.

Case: The nurse is seeing a couple (in their early 30s) who both smoke. The couple are thinking of starting a family and they would like to quit smoking. The woman is especially ready to quit and sees smoking as a bad habit and addiction. The man still needs motivation and discussion. He is thinking of not quitting until the baby is born and doesn't feel the matter is urgent. However, his wife thinks that it would be easier to quit together and support each other. They have already attempted to quit smoking without success. The woman is also interested in the impact of smoking on conception.

The couple are interested in using electronic cigarettes as replacement therapy.

Ask students observing/assessing the scenario (Appendix 2) to pay particular attention to what went well, what could have been done differently, and what they learned from the scenario. They should also assess interaction and the use of different methods.

Notes

Give a round of applause to the role players after the simulation.

  • Ask the customer/nurse what the scenario was like as an experience.
  • The nurse should self-assess his/her guidance skills, and the customers should assess the way they were treated, heard and helped. What went well, what could have been done better, what did they learn?
  • The observing students should assess the participants' performance in a constructive way. Students can be divided into 2-4 groups, with a specific assessment topic given to each group. Assessment topics can include (Appendix 2. Simulation assessment form):
  • Interaction/non-verbal communication
  • Methods used
  • The nurse's knowledge/guidance skills

The supervisor(s) should assess the topics with the students (Appendix 3. Assessment and discussion tips for the supervisor/debriefer)

Appendix 1

Fagerström's questionnaire on dependence

Question / Quantity / Points
How soon (in minutes) after waking up do you have your first cigarette?
less than 6 / 3
6-30 / 2
31-60 / 1
over 60 / 0
How many cigarettes do you smoke per day?
less than 10 / 0
11–20 / 1
21–30 / 2
over 30 / 3

Scoring:
Total points 0–1 = low nicotine dependence, 2 = moderate dependence,
3 = high dependence, 4–6 = very high dependence

Appendix 2

Simulation assessment
Interaction observations/non-verbal communication / Content of advice (information/instructions)
Choice and use of methods

Appendix 3.

Tips for the supervisor/debriefer:

  • Giveconstructive feedback! Provideconcreteexamples of how to dealwith the situation.
  • Whatdid the studentlearnfrom the situation? Whatwentwell in his/herview? Whichareasneededmoreattention?
  • Did the nurseask the customershow long theyhadbeen smoking, howmuchtheysmoke per day, in whatsituations, anypreviousattempts to quit (whatquitting aids didtheyuse and whydidn'tthesework in theiropinion)
  • The nurseshouldaskopen-endedquestions to allow the customers to respond in theirownwords (e.g. whatdoes smoking mean to them, howdidtheystart smoking)
  • Is the nurseable to get the customers to reflect on the benefits and risks of smoking?
  • Does the nursegiveinformationabout the healthbenefits of quitting?
  • Is the nurseinterested in the customer'sanswers, doeshe/shelisten?
  • Does the nurseaskaboutsupportnetworks (family, friends)
  • The nurseshouldnotrecommendelectroniccigarettes as a replacementdue to insufficientresearch data; other smoking cessationmethodsshouldbesuggestedinstead.

Sources:

Fagerströmin riippuvuustesti. Terveysportti /Käypä hoito. Accessed 1 December 2006.

Simulation case – Young couple, an exercise authored by HAMK nursing students. Supervised and edited by Sari Mäki,licensedunder a CreativeCommonsAttribution-ShareAlike 4.0 International licence.

Enhancedteaching and learning of smoking cessationmethods in uppersecondary and highereducation 2014 - 2016