Nursing educators at U of T have decided to get creative about how they offer clinical instruction to nursing students and other health care providers.
Co-creators Katherine Trip and Jean Wilson, assistant professors at the Lawrence Bloomberg Faculty of Nursing, are developing a simulation tool for gynecological examinations. This innovative digital tool will provide key knowledge and clinical skills that support education and health promotion when it comes to pelvic examinations and cancer screening, such as Papanicolaou or pap testing, as well as testing for sexually transmitted infections.
“This tool has a huge potential for impact,” says Trip, who is also the coordinator of the Master of Nursing, Nurse Practitioner (NP) program. “It offers a unique learning opportunity for students who, through simulation, get to review and practice prior to contact with a real patient. This open access tool will also allow students who have graduated, as well as health care providers in the community, an opportunity to refresh and enhance their skills.”
Trip and Wilson acknowledge that a key impetus behind the creation of this simulation tool was the pandemic, and the decreased opportunity for students to participate in the Simulation Lab on campus as well as limited in person clinical practicum time. While some students might have an opportunity to learn and practice gynecological assessments while in practicum, Wilson and Trip felt there was a significant gap in the hands-on opportunities available to develop this scholarship, education and expertise around gynecological health, women’s health, cancer prevention, and sexual well-being.
“Registered Nurses and Nurse Practitioners are very capable of doing pap testing and screening. That kind of prevention and health promotion are in our wheelhouse,” says Wilson, “Adding this expertise into a nurse’s scope of practice can have a direct impact on improving health for marginalized populations where nurses are often the only primary health care contact.”
The Simulation of Gynecological Examinations tool is one of several projects receiving funding from the Virtual Learning Strategy program with eCampusOntario. This investment by the Ontario Ministry of Colleges and Universities is intended to drive growth and advancement in virtual learning. The open access nature of the simulation tool will also provide life-long learning opportunities for nursing students and nursing professionals working in remote communities or serving marginalized populations.
Using the eCampus platform, students will be presented with clinical cases that contain multiple branching scenarios. Depending on which branch the student takes from a clinical perspective, they will need to make care decisions along the way. At the end of their simulated assessment, they will receive feedback about their choices.
The tool will be accompanied by four learning modules with integrated video and medical illustrations. Some of these will focus on well-women check-ups, pre/post menopause considerations, pre/peri/ and postpartum check-ups, and follow-up assessments for individuals with gynecological concerns.
Trip and Wilson are especially focused on making the tool inclusive of certain populations including the LGBTQ2S community and those who are differently abled. Due to a lack of appropriately tailored care, many of these individuals face barriers to access and are under-screened for a variety of gynecological health issues, including cancer or sexually transmitted infections.
Content and language supported by RN and NP expert care providers for these relevant populations, will be included in the simulation tool with an aim of supporting learners in providing sensitive and accessible care.
“We are very excited that these essential educational components will be included in our simulation modules,” says Wilson. “It is a huge step forward in ensuring equitable access to care.”
The Simulation for Gynecological Examinations tool is also being developed in collaboration with Nurse Practitioner experts Heather Thomson, assistant professor, and Neal McInnes Communication Technology Supervisor at the Lawrence Bloomberg Faculty of Nursing and some of its partners including Margaret Verkuyl NP and Professor at Centennial College and Sue Hranilovic NP-PHC at Unity Health Toronto (St. Michael’s Hospital Academic Family Health Team). The tool will also undergo rounds of usability testing, which Trip and Wilson are hopeful will include students in the Nurse Practitioner program at the Faculty of Nursing.
“Simulation is increasingly utilized to teach clinical skills, and it seems to be a good adjunct to learning for students in addition to their placements and courses,” says Trip. “It certainly won’t replace hands-on learning, but it will give our students and other health care providers a head start in becoming experts in gynecological health.”