It is now approaching a week that we have resided in Lesotho. We have been so absorbed preparing simulation materials to discuss with faculty and our presentations to the nursing students that there has been scarce time to write and update our blog. The days have already started to get shorter, and the weather colder, especially in the mornings and evenings, but we are warm and well cared for. Frequently we are asked if we have everything we need and if we are warm enough by staff members as they greet us. An extra space heater was delivered upon the mere mention of the changing weather during a short visit by one of the faculty. And each day, the presentation and composition of our meals seems to get a little fancier and more elaborate consisting of several dishes prepared specially for us, including deserts like pound cake with peaches custard and most recently carrot cake with ice cream. We wonder if this is because the college is pleased with the all the work we have done or if the kitchen ladies just like us a lot. We hope both are true. The conversations we have had over the past week have been fascinating, and I wish I could summarize all of them here. Just this evening, as I struggled against the faulty internet connection to check my email (AKA Facebook) in the little lounge adjacent to the cafeteria, I spoke with a third year nursing student from Zambia on a wide range of topics such as dating and relationships, God and religion, witchcraft and transmogrification, cultural and juvenescent violence, alcohol abuse, and personal growth. Needless to say, we are not bored. And while we came here with some uncertainty as to what to expect, and what would be expected of us, it is evident much has been learned by all.
Our work to help improve the quality of the nursing education in Lesotho through its simulations curriculum has raised several themes we could not have anticipated. For one thing, the inadequate communication between doctors and nurses in the hospitals. In the US, a team based collaborative approach is upheld as a pillar in practice for safely providing patient care; that is not the case here given the scarcity of physicians. In the simulations materials we presented and discussed with faculty, we included an introduction to standardized communication. The example we used was the SBAR model. To implement such a model however would need support across disciplines.
Another theme that arose from our discussions on simulations and simulation implementation in the skills lab was the lack of resources the faculty here have to work with, and classroom/scheduling organization. We discussed ways to manage students, such as breaking them into groups of five or six, and utilizing senior students as TA’s to help facilitate groups. The group brainstormed how to schedule time so that not all 50 students would be at the skills lab at once; possibly into two groups of 25 and setting up five work stations for students to circulate through since there are multiple rooms dedicated for simulations and a computer lab with 30 computers that they could employ. This way students could get more personalized support from faculty and would be more actively engaged while learning through several modalities: including using online tutorials, videos, and discussions. We found and compiled several free online resources the faculty could use to do this easily, and if planned in advance could be downloaded in such a way so that students did not have to all be on the network at the same time.
We were also able to tour the hospital this week in preparation for how to make our simulations scenarios as realistic as possible, and to get an idea of where we would like to spend our clinical time in the hospital next week. We will have more to blog on that subject after our time observing with hospital staff and patients.
With the current school year ending this week, and students having taken their final exams and migrating home today and tomorrow, the energy and hum of the campus has lessoned in its intensity of preparing for exams and there is an anomalous sense of juxtaposed excitement and calm to the dorms. The usual passing chatter of students has been replaced by only a few voices who are still waiting to make leave and can be heard singing hymns and pop songs that echo within the corridors. I will miss the singing voices of Lesotho.