Nurse Educator Nurse Educator Teaching Tools Teaching Tools Nurse Educator Vol. 33, No. 6, pp. 237-240 Copyright ! 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins 10-Minute Assessment for Patient Safety Lisa Wolf, MS, RN, CEN Elizabeth Fiscella, MS, RN, CNS Helene Cunningham, MS, RN O ne of the most difficult tasks that a novice student needs to master is the conceptual organization of the patient assessment; many of our clinical students spend a good amount of time standing outside a patient room trying to figure out what to do first. Our 10-minute assessment provides a script, a road map, and a method of student and self-evaluation, which increases student and faculty confidence and encourages patient safety. Why We Need a Script Nursing students anticipating their first clinical experiences are inherently stressed. Their exposure to anatomy, physiology, and pathophysiology has been purely academic; the prospect of translating this knowledge into patient care can be exciting, but it can also be intimidating. Students’ anxiety may be so acute that it impedes application of clinical skills newly acquired in the nursing laboratory. In our program, we bridge classroom learning and actual patient care with the use of human pa- tient simulators. Simulation is used to teach and reinforce basic assessment skills, giving students the opportunity to make diag- nostic and treatment errors in a safe and controlled setting. 1 Simulation is also used to evaluate students using a ‘‘standardized’’ patient, which is nearly impossible in a clinical setting. 2 Stu- dents report that simulations help cod- ify instructional knowledge and make it applicable to actual patient situa- tions. 1,2 Other studies report that simu- lation allows student-centered, active learning experiences. 3 Although prac- tice is a key component of skill ac- quisition, only a small percentage of students feel really comfortable in head-to-toe assessment even after simulated experiences. 4 Henneman and Cunningham 5 suggest that early expo- sure to simulation is important to in- crease student comfort. Because of these issues, we con- struct simulations, usable early in the program, that address both organiza- tional and critical thinking skills, espe- cially for these novice students. Unlike the actual clinical setting, the clinical simulation laboratory is a controlled environment using SimMan (Laerdal, Wappingers Falls, NY) manikins to pro- vide a predictable, constructive approach to help reduce student anxiety. This uninterrupted, supportive learning envi- ronment also promotes the practice of simple to complex problem solving and critical thinking through the use of simulation-mediated case studies. The students can practice their newly acquired skills without fear of making errors that might affect actual patients under their care. The laboratory allows for improvisation, spontaneity, and development of clinical rhythm and style, a beginning socialization into the nursing profession. In addition, this teaching- learning environment promotes one-on- one student-instructor interaction. Nurs- ing faculty can nurture the students’ development while facilitating the ini- tial task of just entering the patient room. The 10-Minute Assessment Our 10-minute assessment provides a simple framework for conceptualizing that first initial contact with a patient in an acute care setting. It is a step-by- step guide on how to approach the immediate patient care environment. Elements of the assessment are shown in Figure 1. In its initial form for our novice student, the 10-minute assess- ment requires the student to perform a concise, timely, and realistic head-to- toe assessment. The simulation begins with the student entering the room (sometimes the most difficult of all tasks for a novice); washing his/her hands; introducing himself/herself; and identifying the patient via name band, date of birth, and medical record num- ber. The student then observes the entire patient picture—the breathing pattern, level of consciousness, mental status, pain status, and equipment used and integrates these data with the pa- tient’s significant medical history and admitting diagnosis to identify and problem solve any immediate needs of the patient. In the initial simulation for our novice student, the assessment findings are normal as the student assesses the respiratory system, cardiac system, abdomen, extremities, skin, in- travenous catheter placement, and run- ning fluids. Novice students have to know what normal is before they can identify abnormal findings. All the students’ future clinical courses, including pediatrics, maternity, and advanced medical surgical, have a required 10-minute assessment simula- tion as a base for more complex simula- tions. In these more complex laboratory Nurse Educator Volume 33 & Number 6 & November/December 2008 237 Authors’ Affiliation: Clinical Assistant Pro- fessors, School of Nursing, University of Mas- sachusetts, Amherst. Corresponding Author: Ms Wolf, Arnold House, 715 North Pleasant St, Amherst, MA, 01003 (Noblewolf3@aol.com). Copyright @ 2008 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.