The dean of the Texas A&M College of Nursing testified before a U.S. House committee last month and discussed technological and other innovations in academic nursing.
Nancy Fahrenwald, who began her work as the nursing college’s dean in June 2018, told the U.S. House Committee on Small Business on Nov. 13 that pairing cutting-edge technology with foundational nursing principles is vital for “upscaling” the future of health care.
“As we continue in this era where there are rapid changes in technology, health profession schools like Texas A&M are including clinical simulation, virtual reality, telehealth and other technology-based education platforms within the curriculum to prepare tomorrow’s practitioners,” Fahrenwald told the
committee in Washington, D.C. “These types of high-tech innovations, once dreamed up in science novels, are now cutting-edge tools that provide students an immersive learning experience without the fear of harming a live patient.”
For the committee, Fahrenwald shared about some of the technology being used for the academic formation of nursing students at A&M and elsewhere. She mentioned that in Bryan, students learn at the 24,000-square-foot Clinical Learning Resource Center (CLRC), the site of the simulation lab that gives nursing students myriad opportunities for hands-on learning, from high fidelity manikins to human actors simulating medical situations.
“Our center has high fidelity, full-bodied, computer-programmed mannequins that can simulate a range of responses — they can bleed, have dynamic heart rates and even birth babies,” she said to the committee.
In a recent interview with The Eagle, Fahrenwald expanded on the College of Nursing’s mission and aims. Citing news reports of nursing shortages in Texas and nationwide, Fahrenwald said that one factor of the shortage is a lack of nurse educators in some areas, something she said the college is aiming to address.
Fahrenwald was joined in the interview by Angela Mulcahy, a clinical assistant professor at the college whom Fahrenwald described as “the champion” of the school’s simulation work.
Mulcahy came to A&M in the fall of 2012, and said she saw a need to propose alterations to the way the college did simulations.
“I remember taking students to the hospital one of my first years here, and they were just so nervous to do basic things like walk in the room and touch the patient to get blood pressure and use the stethoscope — all of that was so nerve-wracking,” Mulcahy recalled. She said that experience taught her and others to work on “basic” simulations involving personal proximity with live persons posing as patients.
Mulcahy praised the standardized patient actors who work to give the students authentic practice experience. She said that simulations with human actors allow students more leeway to make mistakes and work through them, since an actual patient is not in danger.
“I always tell students, ‘Remember your A’s,’ ” Mulcahy said. “Don’t assume; assess your patient; and go from there.”
A number of colleges within the Texas A&M Health Science Center are focused on addressing the health care needs of Texans in rural and other underserved areas. Fahrenwald and Mulcahy said that through simulations and other tech and clinical training, nursing students are learning techniques that will help provide better care to rural Texans.
Mulcahy said nursing students at A&M practice administering telehealth care, in which they are conversing with patients electronically or via video.
On Friday, two about-to-graduate nursing students, Annie Jones and Megan Necessary, said that the college’s simulation lab and clinical experience have given them the skills and situational practice they need to feel confident as they start their careers.
“You get to know the professors really well, and it’s more one-on-one, very hands-on. I wanted to have that personal aspect so I could learn to be the best nurse — I want to have that same approach with patients in my practice,” Necessary said. She said that after she graduates this week, she will start work at Houston Methodist Hospital.
Jones, who will soon be working as a pediatric ICU nurse at Texas Children’s Hospital in Houston, said that work in the simulation lab, which she called “sims,” has helped prepare her by providing her and other students with a wide variety of situations to work through.
“With sims, you have a standardized patient, and you have a 30-minute encounter with the patient, and our professors are in the other room, watching through a video camera and taking notes,” Jones said. “As soon as our time is up, we get instant feedback — what to work on and what we did really well.”
Necessary agreed. “Especially the first couple of times, having that simulation before having an actual patient experience — it’s really nice to have some sort of flow down before going into an actual hospital room.”
“It’s much more high-stress in here, having professors watch you constantly,” Necessary added with a laugh. “You learn how to stay calm under stress.”
In 2008, 44 students were part of the college’s inaugural class; today, Fahrenwald said, more than 400 undergraduate and graduate students are in the college in Bryan and in Round Rock. The college has graduated nearly 1,000 nurses; it has partnerships with more than 350 clinical learning sites.
Fahrenwald said the college also has a Second Degree BSN program, a 15-month program for students who already have a bachelor’s degree in another field of study.
In August, the A&M System’s Board of Regents gave formal approval for the Center of Excellence in Forensic Nursing. Directed by Stacey Mitchell, Fahrenwald said the new center is working to devise strategies that address various forms of interpersonal violence. Forensic nurses focus work at the intersections of health care, criminal justice and legal systems, according to the school’s website.
The college was selected by the Texas Office of the Attorney General to establish the state’s first telehealth video conferencing program, another effort to support rural and other underserved areas. The legislature approved approximately $1 million for the initiative.
Mulcahy and Fahrenwald said that the college plans to continue weaving innovative uses of tech with a “patient-centered care” ethos in its curricula.
“Part of the reality of technology in education and care delivery is knowing that it’s still really about the patient — and the personal relationship and personal connection that builds trust. That’s so important,” Fahrenwald said.