Virtual Simulated Care Coordination Rounds for Nursing Students.

In response to the Affordable Care Act, the Institute of Medicine (2010) called for the transformation of nursing education and a shift from task-based proficiencies to higher-level competencies. Given changes in the practice environment for nurses, the Institute of Medicine encouraged nursing education to provide entry-level nursing students with experiences in a variety of practice settings, with an emphasis on experiential learning activities in community and public health. Nurse educators can no longer focus learning experiences for students in acute care settings alone.Brennan and Sullivan-Marx (2012) present a case study of curriculum change at the University of Pennsylvania School of Nursing designed to provide the changing skills needed to practice nursing in the era of the Affordable Care Act. The focus of change includes health promotion with motivational interviewing skills and behavioral interventions, care coordination, and leadership skills in a variety of clinical settings, including settings based in the community. This article presents an innovative strategy for a nonclinical nursing course in an associate degree program: a virtual simulated experiential learning activity involving care coordination.SIMULATED CARE COORDINATION ROUNDSAccording to the Agency for Healthcare Research and Quality (2016), care coordination involves "deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient's care to achieve safer and more effective care. This means that the patient's needs and preferences are known ahead of time and communicated at the right time to the right people, and that this information is used to provide safe, appropriate, and effective care to the patient" (para. 1).Teamwork and care management are broad approaches to care coordination. Examples of care coordination activities include communicating and sharing knowledge, helping with transitions of care, creating a proactive care plan, linking to community resources, and working to align resources with patient and/or population needs.To address the call for providing experiential learning experiences in care coordination, a virtual simulated care coordination experience was designed for the online portion of the course. Simulation, the imitation of an action by another, can be met by a combination of roleplay and the use of low- and high-tech tools and can occur in a variety of settings (Society for Simulation in Healthcare, 2015). Our virtual simulated experience utilized National League for Nursing (NLN) Advancing Care Excellence (ACE) unfolding cases (NLN, n.d.). Designed to advance health care quality for vulnerable populations, NLN ACE cases make use of storytelling and can be manipulated to be congruent with the learning objectives of a variety of courses. Each case provides subjective data for a simulated patient and family member in audio format; a simulation toolkit and simulated chart documents are provided.The care coordination rounding assignment utilized a patient from ACE.S (for seniors) and a patient from ACE.V (for veterans), along with each patient's significant other. Audios for both the patient and spouse were uploaded to the learning management system. Students were provided with activities associated with care coordination as follows:* Teamwork: Care coordination teams of four to five students were tasked to coordinate care and manage appropriate transitions of care for their assigned patient.* Communicate and share knowledge: Subjective data were collected by students as they listened to the stories of the simulated patient and spouse. …