Nursing News

Preparing Student Nurses for Workplace Technologies

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By Megan M. Krischke, contributor

April 9, 2010 - As medical technologies quickly progress, nursing schools are working to keep pace. The challenge is to graduate nurses who are up to date on the latest advances and are knowledgeable about commonly used software and patient care devices.

George Demiris, Ph.D.
"What students need to understand is how technology can be used to improve quality of care and patient safety," said UW's George Demiris, Ph.D.

“Nurses will definitely be expected to use electronic medical record systems and also general information technology for decision support, billing and documenting and archiving information,” stated George Demiris, Ph.D., associate professor and director of clinical informatics and patient centered technologies at the University of Washington (UW) School of Nursing.

“Additionally there are many new technologies for processing data from remote patient-monitoring devices with which new nurses should be familiar. These technologies are moving beyond novelty and becoming part of standard care,” he added.

Angela Lorianni-Cimbak, MSN, RN, director of the Brunner Lab and Nursing Simulation Center at the University of Pennsylvania School of Nursing, says instructors should teach new technologies like they might teach someone to drive a car: “If you learn to drive in a Ford, you should also be able to drive a Mitsubishi. Nurses move from one institution to another, so you need to teach a nurse how to use the concept of a program and to apply it to another system.” 

Demiris agrees. “It isn’t so much that students need to know a specific product. The specifics they can learn on the job. We want students to understand that technology is an integral part of quality improvement and to know how IT tools can be used to improve and redesign health care services.”

“In the 28 years I have worked as a nurse, technology has become increasingly prominent among the tools nurses use to provide care,” remarked Debbie Sutter, RN, BSN, clinical simulation facilitator for the Goldfarb School of Nursing at Barnes Jewish College in St. Louis. “We want to expose nurses to technologies they can use to provide improved patient care, but not communicate to them that technology can replace the personal component of patient care.”

One significant change in nursing curricula in recent years is the use of high-fidelity simulators.

“When I was a student everything in the skills lab was static,” Sutter reflected. “We had a mannequin to use for skills practice, but it didn’t do anything. In our labs today, we have mannequins that are high fidelity, meaning they have vital signs, they can breath, they have blood pressures and heart and lung sounds.”

A great advantage of simulators is that they allow students to learn and practice skills in a no-risk environment. Students can take as long as they need to master a skill or to understand how a device works. They can create scenarios they may never see during their clinical rotations and take the time to debrief the experience.

“With simulators, students can practice and perfect their skills and learn from their mistakes,” said Sutter. “While the mannequin or other simulations don’t replace the clinical experience, they can be a bridge between the lecture and the hospital.”

“When we talk about technologies, we talk about a system of tools, skills and knowledge,” stated Lorianni-Cimbak. “Students have to understand not only how to operate the technology, but also the interaction between the patient and the technology.  If something isn’t working correctly, they have to be able to think through what could be wrong and make decisions quickly. Simulators help students learn about prioritizing care and bedside decision making”

Lorianni-Cimbak believes nursing schools need to consider whether they want to teach technology competencies as a separate course, or integrated into clinical courses.

Demiris sees incorporating technology into existing courses as the way to go. “I think it is strategic that UW hasn’t treated informatics as a completely separate area. By integrating it into standard courses, students begin to see informatics as a tool anyone can use. Students grasp how technology can impact patient safety, improve organizational effectiveness and be integrated into a number of focal areas.”

Keeping abreast of emerging technologies is an ongoing battle. UW strives to ensure that their standard nursing courses address the competencies recommended by the American Association of Colleges of Nursing, the American Medical Informatics Association and the American Nursing Informatics Association. In addition to being integrated into several required courses, there are elective informatics courses for students desiring more training.

“Attending conferences and reading the latest research helps us keep up with trends,” stated Demiris. “We are constantly updating the curriculum so that our students are exposed to the most recent information.”

Lorianni-Cimbak also recommends schools maintain tight affiliations with clinical settings.

In addition to their own facilities, Lorianni-Cimbak and Demiris recognize University of Maryland-Baltimore, Columbia University, University of Utah, Barnes Jewish College, University of Pittsburgh and Georgetown University as leaders in preparing student nurses for the technologies they will be using in the workplace.

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