The U.S. Air Force pilot simulated medical unit: a teaching strategy with multiple applications

Historically, Air Force military hospitals have provided excellent training platforms for students and nurses to remain proficient and ready to deliver competent care in a war-time environment. Because of a decrease in the number of admissions, the opportunity to maintain competence is diminishing. The concept of a Simulated Medical Unit (SMU) is being developed at Sheppard Air Force Base, Wichita Falls, Texas to assist in the training and evaluation of such skills. The SMU is a simulation of an actual enactment of an inpatient unit that begins with shift report to the oncoming nursing team. The instructor can then guide the student and team through a series of complex situations using specialized mannequins and live actors as "patients." The student is expected to carry out physicians' orders, perform nursing assessments, document nursing care, as well as administer medications and IV fluids. Scenarios can be made to be as simple or as complex as the situation demands and can be adapted to any specialty. The student can practice technical know-how, sharpen critical thinking abilities, and exercise delegation skills. Should an error occur, the instructor can freeze the moment and assist the student in developing more appropriate choices in their delivery of care. The use of algorithms, performance checklists, and videotaping can be used to evaluate the student's performance. Other adaptations for the SMU can include orientation, cross training into different specialties, competency assessment, and upgrade training.