Simulation Training in Haiti

By: J. Cedar Wang, MSN, APN, GNP-BC, CHSE

Traveling to a remote tropical island sounds all too wonderful, until you are struck with appendicitis or another life-threatening injury. Have you ever witnessed medical care in the third world? All of sudden, your paradise quickly turns to imminent peril, unless, of course, you find yourself in Milot, Haiti.

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Nestled in the lush, green mountains of Northern Haiti is arguably one of the most advanced health care training environments in the Caribbean, Hôpital Sacré Coeur. It’s a full-service, tertiary care medical center and official Haitian referral center attracting patients from the surrounding region. Physicians, nurses, and community health workers travel from all over Northern Haiti to attend simulation-based training with Dr. Jamice Julmice and his colleagues through the Jhpiego grant-funded Maternal and Child Survival Program.

Northern Haiti is not the place you would anticipate finding health care workers engaged in simulation-based training, but the practical, hands-on nature of this style of learning quickly overcomes language and educational barriers. The result is the development of evidence-based practical skills being used in direct patient care.

Nowhere is the need for rapid health care improvement greater than in this type of environment. If simulation training can be accomplished in Haiti, why not also in other third-world locations? Why is it not being utilized at many more modern institutions?

Hôpital Sacre Coeur is the destination of many US-based medical mission teams coordinated through the Crudem Foundation and Holy Name Medical Center in Teaneck, NJ. Over the last 20 years, these organizations have supported the Haitian staff and administration to promote excellent and compassionate care. As the level of medical care has rapidly improved through their efforts, nurse professionals have elevated their competence and commitment to reach the highest standards of care.

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Photos from Hopital Sacre Coer, the CRUDEM foundation, and Holy Name Medical Center’s involvement in Milot, Haiti. 10/23/13 Photos by Jeff Rhode / Holy Name Medical Center

This nursing professional development initiative has required an innovative training approach. Under the direction of Dean Judith Kutzleb, DNP, RN, CCRN, CCA, APN-C, a nurse practitioner at Holy Name Medical Center and frequent traveler to Milot, the Hôpital Sacré Coeur Nurse Training Program is graduating its first cohort of 15 nurses this year to meet the demands of the Haitian community and to serve as an international example of innovative learning.

The Hôpital Sacré Coeur Nurse Training Program uses a novel approach to foster learning among current staff. Under the direction of chief nursing officer Nathalie Dorcin, and with the support of Dr. Kutzleb and her US-based team, the program is equipped with translated curricula and uses adult learning theory. Participants are given a computer-based assessment at the beginning of the program and then take a series of 7-week courses including Health Assessment, Pharmacology, Pathophysiology, Fundamentals of Nursing Practice, and two levels of Medical-Surgical Nursing. Working through basic simulated scenarios and proctored clinical practicums allows the nurses to develop crucial skills and receive faculty feedback.

The nurses use simulation to demonstrate various skills in video-recorded simulation sessions. Three different bedside hand-off scenarios, complete with moulage, standardized patients, and defined learning objectives, were created by the Haitian faculty. (See this video used to train current and future staff.) This innovative approach to nursing advancement serves as an example of nursing excellence amidst the challenges of health care in Haiti.

If it can be done in Haiti, it can be done almost anywhere. Give it a try!

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