Clinical Simulation in Nursing (2015) 11, 433
www.elsevier.com/locate/ecsn
Letter to the Editor
Enhancing Participants
Engagement During Teamwork
Training Using Hybrid Simulators
Asun Benito, RN
Operating Room Nurse, Hospital virtual Valdecilla, Avda.
de Valdecilla s/n, 39008 Santander, Spain
Alejandro Martnez, RN
Simulation Instructor, Hospital virtual Valdecilla, Avda. de
Valdecilla s/n, 39008 Santander, Spain
Jose M. Maestre, MD, PhD
Education Director, Hospital virtual Valdecilla, Avda. de
Valdecilla s/n, 39008 Santander, Spain
Corresponding author: jmmaestre@hvvaldecilla.es
To the Editor,
We found of interest the Tracheostomy Overlay System for
use with standardized patients (Cowperthwait et al., 2015).
The coupling of different types of simulators to match and
support trainees learning needs (hybrid simulation) might
have the potential to enhance learning (Hamstra, Brydges,
Hatala, Zendejas, & Cook, 2014). This device was designed
to improve students tracheostomy care and suctioning.
Other part task trainers are used for integrated communica-
tion and technical skills teaching (Kneebone et al., 2002).
Virtual reality is utilized in combination with manikins to
engage all members of a multidisciplinary team to practice
Figure Hybrid simulator coupling ex vivo animal models with a patient simulator.
1876-1399/$ - see front matter 2015 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1016/j.ecns.2015.05.008
behavioral skills in the operating room (Kjellin, Hedman,
Escher, & Fellander-Tsai, 2014). When virtual simulators
are not available or part task trainers do not have sufficient
fidelity, ex vivo animal models can be used. We placed skin
over a bag of simulated blood to evoke a neck hematoma
after a thyroidectomy. And, a polyester mold adapted
over the manikin belly to contain abdominal viscera (stom-
ach, intestine, liver, biliary system, pancreas and spleen) to
simulate a patient stabbed in the abdomen. A small cut was
made to the portal vein, and vessels were attached to an
aquarium fish tank water pump to allow the simulated
blood to circulate (Figure). In a postsimulation survey,
participants indicated the cases were very realistic and
engaging.
References
Cowperthwait, A. L., Campagnola, N., Doll, E. J., Downs, R. G., Hott, N. E.,
Kelly, S. C., . Buckley, J. M. (2015). Tracheostomy overlay system: An
effective learning device using standardized patients. Clinical Simulation
in Nursing, 11(5), 253-258. http://dx.doi.org/10.1016/j.ecns.2015.03.001.
Hamstra, S. J., Brydges, R., Hatala, R., Zendejas, B., & Cook, D. A. (2014).
Reconsidering fidelity in simulation-based training. Academic Medicine,
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