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Simulation center part of Pastoral Care learning experience

Wednesday, October 23, 2013

Actors offer a realistic portrayal of some of the dynamics encountered

Pastoral Care leaders and residents watch and evaluate a simulated encounter
Pastoral Care leaders and residents watch and evaluate a simulated encounter that another resident has with a family in conflict over the patient’s desire to have a Do Not Resuscitate (DRN) order. WellSpan Pastoral Care is on the cutting edge of using a simulation center as part of its learing experience.

Pastoral Care resident Leslie Benfield entered the patient room with a notebook in her hand.

The patient’s husband and sister were at her bedside. The family was embroiled in conflict over the patient’s desire to have a "Do Not Resuscitate (DNR)" order.

The husband wanted the best for his wife, but he had some questions and misconceptions about the DNR.

The sister strongly disagreed with the DNR and wanted the patient to try everything medically possible to extend her life. She declared it was “God’s will.”

For the next 25 minutes, Benfield patiently listened, asked questions, occasionally interjected points of clarification and eventually brought the family together in prayer.

The session was intense as the family members’ emotions mirrored a roller coaster ride. Voices were raised, tears were shed and concerns were expressed.

Instead of taking place in a patient room, however, this scenario occurred in the simulation center at WellSpan York Hospital.

The patient and her family members were played by actors, and the scenario was observed live by Pastoral Care residents and leaders via a monitor in another room.

The group took notes as the scenario unfolded, completed a questionnaire and provided feedback to Benfield afterwards.

“It was tougher than reality,” offered Benfield. “It definitely felt like the real thing. I completely forgot I was on camera and being observed.”

Ken Hayden and Peter Kuhn, managers of pastoral care, praised Benfield’s efforts. They cited her calmness, clear explanations and attempt to get the individual family members to hear each other.

They also offered different strategies that might have been helpful. The Pastoral Care  residents, as well as the actors, provided valuable feedback.

“It was a good learning exercise,” said Kuhn. “It was intense, real and challenging.”

Ted Trout-Landen, director of pastoral care, said, “This simulation experience offers a fairly realistic portrayal of some of the dynamics we encounter. Patients in the hospital are automatically in crisis. There is so much going on with patients and their family members.”

This is the first year the Pastoral Care program has used the simulation center. Trout-Landen isn’t aware of any other pastoral care programs using simulation centers as part of their learning experience.

“We’re definitely on the cutting edge,” he said. “We feel it’s important and extremely beneficial to offer pastoral care residents a learning experience in a safe environment.”

Duane Patterson, director of the medical simulation center, said, “Issues of the heart are often more difficult to navigate. Learning in a safe environment where everyone is focused on helping you makes people more comfortable when they encounter similar situations in real life.”

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