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The Importance of Data-Based Decisions for Curriculum Development ©Bauman 2012 All Rights Reserved


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The Importance of Data-Based Decisions for Curriculum Development: Why Research is Everyone’s Responsibility was presented on June 5, 2012 at the WAUKESHA COUNTY TECHNICAL COLLEGE -
Nursing Clinical Simulation as a Teaching Tool Confencence

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The Importance of Data-Based Decisions for Curriculum Development ©Bauman 2012 All Rights Reserved

  1. 1. WAUKESHA COUNTY TECHNICAL COLLEGENursing Clinical Simulation as a Teaching ToolThe  Importance  of  Data-­‐Based  Decisions   for  Curriculum  Development:    Why  Research  is  Everyone’s  Responsibility   Eric  B.  Bauman,  PhD   RN,  Paramedic   DeVry,  Inc  Healthcare  Group   Clinical  Playground  LLC   .  .  .  .  .  .  .  .  .  .  .               ©Bauman  2012  All  Rights  Reserved  
  2. 2. Professional  AffiliaIons     Disclosures/Conflict  of  Interest    DeVry  Inc.,  Healthcare  Group   •  Associate  Director  For  SimulaIon  –  Center  for  SimulaIon  Excellence    Managing  Member  –  Clinical  Playground,  LLC  Managing  Member  –  Forensic  AnalyIcs,  LLC  Games+Learning+Society   •  Affiliate  Society  for  SimulaIon  in  Healthcare  (SSH)   •  Chair  –  Website  CommiVee   •  Co-­‐Chair    –  Serious  Games  and  Virtual  Environments  Special  Interest  Group    Springer  –  contract  for  forthcoming  book  on  Game-­‐Based  learning  and  Clinical  EducaIon  Adjunct  Faculty  –  CAE  Healthcare  Relevant  Stock  –  CAE,  Zynga,  Pfizer,  GE   .  .  .  .  .  .  .  .  .  .  .               ©Bauman  2012  All  Rights  Reserved  
  3. 3. ObjecIves  •  ParIcipants  will  learn  the  importance  of  objecIve  driven   scenario  development    •  ParIcipants  will  explore  the  concept  of  fit  as  it  relates  to   simulaIon-­‐based  educaIonal  intervenIons    •  ParIcipants  will  be  able  to  idenIfy  how  educaIonal   research  influences  curriculum  decisions  •  ParIcipants  will  discuss  and  explore  how  they  can   contribute  to  research  in  their  educaIonal  se_ng  and   develop  lesson  objecIves  that  meet  curriculum  goals   .  .  .  .  .  .  .  .  .  .  .               ©Bauman  2012  All  Rights  Reserved  
  4. 4. ObjecIve  Driven  Scenario  Development     Why  is  ObjecIve  Driven  Scenario  Development  important?  •  Poorly  wriVen  or  executed  scenarios  are   confusing  and  frustraIng  at  best    •  Worse  -­‐  they  may  insIll  poor  pracIce   habits  and  allow  learners  to  misinterpret   important  cues  relevant  to  future  pracIce   .  .  .  .  .  .  .  .  .  .  .               ©Bauman  2012  All  Rights  Reserved  
  5. 5. ObjecIve  Driven  Scenario  Development     Why  is  ObjecIve  Driven  Scenario  Development  important?  We  need  to  be  able  figure  out  why  our  students  get  to  very   dangerous  places  for  very  good  reasons!   We  are  ocen  the  reason  why  our  students  get  to  these   dangerous  places!   .  .  .  .  .  .  .  .  .  .  .               ©Bauman  2012  All  Rights  Reserved  
  6. 6. ObjecIve  Driven  Scenario  Development     Picking  your  ObjecIve  •  What  is  it  you  want  your  students  to  learn   and  what  is  the  basis  for  this  objecIve?  •  Who  is  your  audience?  •  Can  or  should  a  scenario  have  different   objecIves  or  more  than  one  objecIve       ©Bauman  2012  All  Rights  Reserved  
  7. 7. ObjecIve  Driven  Scenario  Development     Tease  out  the  ObjecIve[s]  •  The  high-­‐fidelity  learning  environment  is   best  suited  facilitaIng  behavioral  change   –  Do  not  try  to  make  the  scenario  excessively   hard  or  tricky     –  Scenarios  must  be  realisIc   –  Scenarios  must  be  situated   –  Scenarios  should  be  engaging  -­‐  promoIng   interacIon   ©Bauman  2012  All  Rights  Reserved  
  8. 8. ObjecIve  Driven  Scenario  Development     Novice  Learners  •  Consider  scenarios  that  focus  on  just  ONE   objecIve   –  Calling  for  Help   –  Administering  a  medicaIon   –  Maintaining  the  airway   –  Assessing  the  paIent     ©Bauman  2012  All  Rights  Reserved  
  9. 9. ObjecIve  Driven  Scenario  Development     Intermediate  and  Advanced  Learners  •  Consider  the  introducIon  of  events  that   focus  on  serial  objecAves  rather  than   mulIple  “All-­‐At-­‐Once”  events   –  Overly  complicated  scenarios  are  difficult  to   evaluate     •  Unpredictable   •  Ocen  lack  fidelity   •  Can  be  very  confusing  for  learners  -­‐  and  are  ocen   not  believable   ©Bauman  2012  All  Rights  Reserved  
  10. 10. ObjecIve  Driven  Scenario  Development     Research  and  Data  Driven  ObjecIves   How  do  I  know  what  is  and  is  not…    Research  and  Data  Driven?  SimulaIon  scenarios  and  their  objecIves  should  support  your  curriculum   Your  curriculum  should  reflect  accreditaIon  guidelines   …and  best  pracIces!     ©Bauman  2012  All  Rights  Reserved  
  11. 11. ObjecIve  Driven  Scenario  Development     Research  and  Data  Driven  ObjecIves   SimulaIon  scenarios  and  their  objecIves  should  support  your  curriculum   Commission  on  Collegiate  Nursing  EducaIon  (CCNE)    NaIonal  League  for  Nursing  AccrediIng  Commission  (NLNAC)   School  Curriculum  CommiVee     ©Bauman  2012  All  Rights  Reserved  
  12. 12. ObjecIve  Driven  Scenario  Development     Research  and  Data  Driven  ObjecIves   ©Bauman  2012  All  Rights  Reserved   EvaluaIng  the  Source  Best  PracIces  are  defined  by  research  and  are  peer  reviewed:     •    Peer  Reviewed  Journals                 •    Other  Peer  Reviewed  PublicaIons   •   Books   •   White  Papers   •    Government  PublicaIons/Websites   •    VeVed  Conference  PresentaIons  
  13. 13. ObjecIve  Driven  Scenario  Development     Research  and  Data  Driven  ObjecIves   ©Bauman  2012  All  Rights  Reserved   In  General  Research  ReporIng  Should  Include  •  Problem  statement    •   Purpose  and  research  quesIons  •  Hypothesis    •  Literature  review    •   Framework  or  theory  •     Methods  secIon  •  Results  secIon  based  on  analysis  of  a  dataset    •   Findings  •  Discussion  secIon      
  14. 14. ObjecIve  Driven  Scenario  Development     Research  and  Data  Driven  ObjecIves   ©Bauman  2012  All  Rights  Reserved   Types  of  Research   QualitaAve   QuanAtaAve   Quality  of  Design   Experimental  Design   TheoreIcal  Basis   Quasi  Experimental  Design   Quality  of  Analysis   ObservaIonal  Study   (QualitaIve  facets  are  NOT  linear  -­‐  they  are   (Types  of  design  are  hierarchical)   cumulaIve)      QualitaIve  Research  can  and  does  stand  on  it’s  own  but  is  also  ocen  used  to  inform  quanItaIve  research  
  15. 15. ObjecIve  Driven  Scenario  Development     Resources   ©Bauman  2012  All  Rights  Reserved  SimulaIon  in  Healthcare:  The  Journal  of  the  Society  for  SimulaIon  in  Healthcare  (SSH)  hVp://  hVp://  Clinical  SimulaIon  in  Nursing:  The  Journal  for  the  InternaIonal  Nursing  AssociaIon  for  Clinical  SimulaIon  and  Learning  (INACSL)  hVp://  hVp://  Games  and  SimulaIon  for  Healthcare  online  library  and  portal  hVp://  
  16. 16. ObjecIve  Driven  Scenario  Development     Research  and  Data  Driven  ObjecIves   ©Bauman  2012  All  Rights  Reserved   Challenges  related  to  best  pracIces!     American  Heart  AssociaIon  ResuscitaIon  Guidelines   Established  and  Published  Guidelines  by  AHA   Best  PracIces  based  on  Peer  Reviewed  ScienIfic  Literature  Ewy,  G.  (2007).  Cardiac  arrest—guideline  changes  urgently  needed.  Lancet,  369(1),  882-­‐884.  Kellum,  M.,  Kennedy,  K.W.,  Ewy,  G.  (2006).  Cardiocerebral  ResuscitaIon  Improves  Survival  ofPaIents  with  Out-­‐of-­‐Hospital  Cardiac  Arrest.  The  American  Journal  of  Medicine.  119(4),  335-­‐349.  Kanto-­‐SOS  Study  Group  (2007).  Cardiopulmonary  resuscitaIon  by  bystanders  with  chest  compression  only  (SOS-­‐KANTO):  an  observaIonal  study.  Lancet,  369(1),  920-­‐926.  
  17. 17. ObjecIve  Driven  Scenario  Development     Research  and  Data  Driven  ObjecIves   ©Bauman  2012  All  Rights  Reserved   Challenges  related  to  best  pracIces!     SimulaIon-­‐based  Experience  counIng  for  Clinical  hours  Gore,  T.,  Van  Gele,  P.,  Ravert,  P.,  &  Mabire,  C.  (2012).  A  Survey  of  INACSL  membership  about  simulaIon  use.  Clinical  Simula:on  in  Nursing,  8(4),  e125-­‐e133.  Faragher,  J.F.,  Boese,  T.,  &  Decker,  S.,  Sando,  C.  (2011).  Standards  of  best  pracIce:  SimulaIon.  Simula:on  in  Nursing,  7(4),  S1-­‐S20.  Nursing  Midwifery  Council  (2007).  Nursing  and  Midwifery  Council  Circular,  36(2007),  United  Kingdom.  Utah  AdministraIve  Code,  Nurse  PracIce  Act,  Rule  R156-­‐31b,  SecIon  E,  Sub  ii.  Accessed  electronically  01/15/2012  Wisconsin  Department  of  Health  Services,  WMS  SecIon  (2011).  Wisconsin  Standardized  Paramedic  Curriculum.  
  18. 18. ObjecIve  Driven  Scenario  Development     Research  and  Data  Driven  ObjecIves   ©Bauman  2012  All  Rights  Reserved   Challenges  related  to  best  pracIces!    Can  be  difficult  to  adequately  evaluate  sources  The  research  associated  with  best  pracIces  and  simulaIon  and  game-­‐based  learning  in  the  health  sciences  is  sIll  immature    Best  pracIce  must  relate  not  only  to  paIent  outcome  but  also  clinical  educaIon   BeVer  PreparaIon  =    BeVer  PracIce  =  BeVer  PaIent  Outcome  
  19. 19. TranslaIonal  Effect   ©Bauman  2012  Rights  Reserved  BeVer  PreparaIon  =    PracIce  PracIce  =  BeVer  PaIent  Outcome  
  20. 20. Good  Fit  and  SimulaIon   ©Bauman  2012  Rights  Reserved  •  Are  you  using  simulaIon  to  meet  your  needs  or  your  students  needs  •  Using  technology  for  the  sake  of  technology  ocen  leaves  students  confused   and  faculty  frustrated    •  Understand  that  all  forms  of  technology  have  their  limitaIons  •  Play  down  the  “coolness”  and  “be-­‐all…  end  all”  factor  with  students.    R.  Kyle  
  21. 21. Good  Fit  and  SimulaIon  •  Mannikin-­‐based  simulaIon  taking  place  in   created  spaces    or  simulaIon  occurring  in  digital   environments  are  best  leveraged  for  lessons  that   encompass  designed  experiences  that  focus  on   behavioral  or  decision  aspects  of  pracIce  and   some  forms  of  targeted  psychomotor  training…   –  AcculturaIon   –  Decision  Making   –  Team  Training     –  Workload/Time  Management   –  Procedural  DemonstraIon   .  .  .  .  .  .  .  .  .  .  .               ©Bauman  2012  Rights  Reserved  
  22. 22. Good  Fit  and  SimulaIon   RelaIonship  between  objecIves  and  Fit   Remember  ObjecAves  First   …  Everything  else  follows,  including:   Technology  In  other  words  how  can  technology  help  you  meet   your  curriculum  objecAves!!!!!!!   .  .  .  .  .  .  .  .  .  .  .               ©Bauman  2012  Rights  Reserved  
  23. 23. Research  and  Curriculum    New  Curricula  and  the  Technology  supporIng  it  should  be  evaluated   for  its  potenIal  fit  within  an  exisIng  curriculum    IntegraIng  technology  and  teaching  techniques  that  include  SimulaIon   &  Game-­‐Based  Learning  into  your  curriculum  represents  a  change  in   your  curriculum  and  must  be  evaluated   ©Bauman  2012  Rights  Reserved  
  24. 24. Research  and  Curriculum   ©Bauman  2012  Rights  Reserved   Research:  Best  PracIces  &  ContribuIon…  •  The  concept  of  Best  PracIce  applies  to  educaIonal  processes  as   well  as  paIent  intervenIons  and  outcomes!  •  InvesIgaIon  defines  Best  PracIce?  •  Defining  Best  PracIce  is  fluid?   –  Best  PracIce  is  defined  by  current  knowledge.  The  knowledge  base  of   any  discipline,  parIcularly  in  the  health  and  biological  sciences  is  rapidly   evolving  and  changing.  
  25. 25. Your  ContribuIon  to  Research  and  Curriculum   ©Bauman  2012  Rights  Reserved   Why  should  I  contribute?  •  Curriculum  Change  is  expensive  and  risky  given  the  tradiIonal  high  pass  rates   associated  with  the  NCLEX   –  It  is  your  job  to  validate  both  curriculum  and  pedagogy  used  to  implement  your  curriculum   –  Graduate  marketability  and  success  are  a  direct  reflecIon  of  your  program:  On-­‐boarding  and   new  hire  orientaIon  is  expensive.  Are  you  grads  standouts  for  the  right  reasons?  •  SimulaIon  is  here  to  stay  many  schools  have  already  invested  in  the  hardware   –  AdministraIve  Code  and  AccreditaIon  Agencies  are  going  to  require  simulaIon:  Are  you   going  to  meet  minimum  standards  or  define  best  pracIce?   –  What  is  your  responsibility  to  the  profession  and  your  graduates:  Are  you  leveraging   innovaIon  to  define  educaIonal  pracIce?  
  26. 26. Your  ContribuIon  to  Research  and  Curriculum   ©Bauman  2012  Rights  Reserved   How  do  I  contribute?  •  All  of  your  all  new  and  exisIng  curriculum  should  be  evaluated  •  Start  Small:  “All”  contribuIons  are  important  to  the  field   –  Look  for  projects  that  represent  program  CQI  or  Internal  Curriculum  validaIons   –  Avoid  student  percepIon-­‐based  research  •  Partner  with  more  experienced  invesIgators  and  intuiIons  •  Use  consultants  to  increase  the  breadth  of  your  experience  •  Set  up  research  guidelines  and  expectaIons  at  your  insItuIon  
  27. 27. Your  ContribuIon  to  Research  and  Curriculum   ©Bauman  2012  Rights  Reserved   An  evaluaIon  of  bag-­‐valve-­‐mask  venIlaIon  using  an  ergonomically   designed  face-­‐mask  among  novice  users:  a  simulaIon-­‐based  pilot  study   Evaluated  and  compared    the  use  of  a  standard  facemask  for   posiIve  pressure  venIlaIon  and  an  ergonomically  designed   facemask  among  novice  users      Bauman,  E.B.,  Joffe,  A.M.,  Lenz,  L.,  Hetzel,  S.J.,  DeVries,  S.A.,  Seider,  S.P.  (2010).  An  evaluaIon  of  bag-­‐valve-­‐mask  venIlaIon  using  an  ergonomically  designed  face-­‐mask  among  novice  users:  a  simulaIon-­‐based  pilot  study.  Resuscita:on  81(2010),  1161-­‐1165,  doi:  10.1016/j.resuscitaIon.2010.05.005.    
  28. 28. Bag-­‐valve-­‐mask  study  data   ©Bauman  2012  Rights  Reserved   Partnership  between  Western  Technical  College  &  UW-­‐Madison  The  effect  of  each  mask  during  venIlaIon  over  Ime  was  assessed  using  repeated-­‐measures  ANOVA.  Assessment  of  mask   technique  among  parIcipants  and  associaIon  between  mask  type  and  hand  reposiIoning  were  analyzed  using  the   Wilcoxon-­‐Rank  Sum  Test  and  McNemar’s  paired  proporIons  test,  respecIvely.    
  29. 29. Wrap-­‐up  &  Review   ©Bauman  2012    Rights  Reserved  •  We  Reviewed  and  Emphasized  the  importance  of  objecIve   driven  scenario  development    •  We  explored  and  emphasized  the  concept  of  fit  as  it  relates   to  simulaIon-­‐based  educaIonal  intervenIons    •  We  idenIfied  and  discussed  how  educaIonal  research   influences  curriculum  decisions  •  We  discussed  and  explored  how  parIcipants  can  contribute   to  research  in  their  educaIonal  se_ng  and  develop  lesson   objecIves  that  meet  curriculum  goals   .  .  .  .  .  .  .  .  .  .  .              R.  Kyle  
  30. 30. QuesIons?   ©Bauman  2012    Rights  Reserved  R.  Kyle  
  31. 31. Selected  References  &  Recommended  Readings  Bauman,  E.  (2007).  High  fidelity  simulaIon  in  healthcare.  Ph.D.  dissertaIon,  The  University  of  Wisconsin-­‐Madison,  United  States.  DissertaIons  &  Thesis  @  CIC  InsItuIons  database.  (PublicaIon  no.  AAT  3294196)    Bauman,  E.  B.  (2012).  Game-­‐based  Teaching  and  Simula:on  in  Nursing  &  Healthcare.  New  York,  NY:  Springer  Publishing  Company.    Bauman,  E.  (2010).  Virtual  reality  and  game-­‐based  clinical  educaIon.  In  Gaberson,  K.B.,  &  Oermann,  M.H.  (Eds)  Clinical  teaching  strategies  in  nursing  educa:on  (3rd  ed).New  York,  Springer  Publishing  Company.  Bauman,  E.B.  and  Games,  I.A.  (2011).  Contemporary  theory  for  immersive  worlds:  Addressing  engagement,  culture,  and  diversity.  In  Cheney,  A.  and  Sanders,  R.  (Eds)  Teaching  and  Learning  in  3D  Immersive  Worlds:  Pedagogical  models  and  construc:vist  approaches.  IGI  Global.    Bauman,  E.B.,  Joffe,  A.M.,  Lenz,  L.,  Hetzel,  S.J.,  DeVries,  S.A.,  Seider,  S.P.  (2010).  An  evaluaIon  of  bag-­‐valve-­‐mask  venIlaIon  using  an  ergonomically  designed  face-­‐mask  among  novice  users:  a  simulaIon-­‐based  pilot  study.  Resuscita:on  81(2010),  1161-­‐1165,  doi:  10.1016/j.resuscitaIon.2010.05.005.    Benner,  P.  (1984).  From  novice  to  expert:  Excellence  and  power  in  clinical  nursing  prac:ce.  Menlo  Park,  CA:  Addison-­‐Wesley.  Benner,  P.,  Tanner,  C.,  &  Chesla,  C.  (2009).  Exper:se  in  nursing:  Caring,  clinical  judgment,  and  ethics.  New  York:  Springer  Publishing  Company    Culhane-­‐Pera,  K.A.,  Reif,  C.,  Egli,  E.,  Baker,  N.J.,  and  Kassekert  (1997).  A  curriculum  for  mulIcultural  educaIon  in  family  medicine.  Family  Medicine,  29(10),  719-­‐723.  Ewy,  G.  (2007).  Cardiac  arrest—guideline  changes  urgently  needed.  Lancet,  369(1),  882-­‐884.  Faragher,  J.F.,  Boese,  T.,  &  Decker,  S.,  Sando,  C.  (2011).  Standards  of  best  pracIce:  SimulaIon.  Simula:on  in  Nursing,  7(4),  S1-­‐S20.  Fitz-­‐Walter,  Z.  (2012).  hVp://  Games,  I.  and  Bauman,  E.  (2011)  Virtual  worlds:  An  environment  for  cultural  sensiIvity  educaIon  in  the  health  sciences.    Interna:onal  Journal  of  Web  Based  Communi:es  7(2).    Gee,  J.P.  (2003)  What  Videogames  Have  to  Teach  Us  About  Learning  and  Literacy.  New  York,  NY:  Palgrave-­‐McMillan.  Gore,  T.,  Van  Gele,  P.,  Ravert,  P.,  &  Mabire,  C.  (2012).  A  Survey  of  INACSL  membership  about  simulaIon  use.  Clinical  Simula:on  in  Nursing,  8(4),  e125-­‐e133.  Jenson,  M.  (2012).  Engaging  the  learner:  GamificaIon  strives  to  keep  the  user’s  interest.  T  &D,    January,  2012,  41-­‐44.  Kanto-­‐SOS  Study  Group  (2007).  Cardiopulmonary  resuscitaIon  by  bystanders  with  chest  compression  only  (SOS-­‐KANTO):  an  observaIonal  study.  Lancet,  369(1),  920-­‐926.  Kellum,  M.,  Kennedy,  K.W.,  Ewy,  G.  (2006).  Cardiocerebral  ResuscitaIon  Improves  Survival  ofPaIents  with  Out-­‐of-­‐Hospital  Cardiac  Arrest.  The  American  Journal  of  Medicine.  119(4),  335-­‐349.  Kolb,  D.  (1984).  ExperienIal  learning:  Experience  as  the  source  of  learning  and  development.    Upper  Saddle  River,  NJ:  PrenIce  Hall.  Larew,  C.,  Lessans,  S.,  Spunt,  D.,  Foster,  D.,  &  Covington,  B.  (2006).  InnovaIons  in  clinical  simulaIon:  ApplicaIon  of  Benners  theory  in  an  interacIve  paIents  care  simulaIon.  Nursing  Educa:on  Perspec:ves,  27(1),  16-­‐21.    Nursing  Midwifery  Council  (2007).  Nursing  and  Midwifery  Council  Circular,  36(2007),  United  Kingdom.  Prensky,  M.  (2001).  Digital  naIves,  digital  immegrants,  part  1.  On  the  Horizon  9(5).  Popkewitz,  T.  (2007).  CosmopoliIanism  and  the  age  of  school  reform:  science,  educaIon  and  making  a  society  by  making  the  child.  Routledge.  Taekman  J.M.,  Segall  N.,  Hobbs  G.,  and  Wright,  M.C.  (2007).  3DiTeams:  Healthcare  team  training  in  a  virtual  environment.  Anesthesiology.  2007:  107:  A2145.  Schön,  D.  A.  (1983).  The  reflec:ve  prac::oner:  How  professionals  think  in  ac:on.  New  York:    Basic  Books.  Skiba,  D.  J.  (2009).  Nursing  educaIon  2.0:  A  second  look  at  Second  Life.  Nursing  Educa:on  Perspec:ves,  30,  129-­‐131.  Squire,  K.  (2006).    From  content  to  context:  Videogames  as  designed  experience.    EducaIonal  Researcher.    35(8),  19-­‐29.    Squire,  K.,  GiovaneVo,  L.,  DeVane,  B,.  &  Durga,  S.  (2005).  From  users  to  designers:  Building  a  self-­‐organizing  game-­‐based  learning  environment.  Technology  Trends,  49(5),  34-­‐42.  Taekman  J.M.,  Segall  N.,  Hobbs  G.,  and  Wright,  M.C.  (2007).  3DiTeams:  Healthcare  team  training  in  a  virtual  environment.  Anesthesiology.  2007:  107:  A2145.  Tervalon,  M.  and  Murray-­‐Garcia,  J.  (1998).  Cultural  humility  versus  cultural  competence:  A  criIcal  disIncIon  in  defining  physician  training  outcomes  in  mulIcultural  educaIon.  Journal  of  Health  Care  for  the  Poor  and  Underserved,  9(2),  117-­‐125.    Turkle,  S.  (1995)  Life  on  the  screen.  Iden:ty  in  the  age  of  the  Internet.  New  York:  Touchstone.  Utah  AdministraIve  Code,  Nurse  PracIce  Act,  Rule  R156-­‐31b,  SecIon  E,  Sub  ii.  Accessed  electronically  01/15/2012  Wisconsin  Department  of  Health  Services,  WMS  SecIon  (2011).  Wisconsin  Standardized  Paramedic  Curriculum.   ©Bauman  2012  Rights  Reserved  
  32. 32. Contact  InformaIon   Eric  B.  Bauman,  PhD   hVp://   hVp://  Clinical  Playground  LLC   @bauman1967