Duke University

A Twitter soap opera teaches nurses about patient care, privacy, quality, and safety from the eyes of a medical simulation mannequin

• By Meg Lloyd, David Raths
• 08/02/10

Not many mannequins have their own Twitter accounts. But for a week in February 2010, more than 90 nurse educators followed Stanley Sim, a mannequin in the Duke University (NC)School of Nursing’s simulation lab, as he tweeted about love, Duke basketball, pulled pork sandwiches, and the cardiac care he was receiving for chest pains.

SimSoap, a Twitter soap opera tied to a cardiac care simulation, is a project of Innovative Nursing Education Technologies (iNET), a federally funded collaborative effort among the nursing programs at Duke, Western Carolina University, and the University of North Carolina at Charlotte to integrate technology into nursing education. The goal of SimSoap is to create teaching materials that are fun and immersive for nursing students. “Our hope is to model the use of Twitter and spark the curiosity of nurse educators,” says Mary Barzee, iNET’s program coordinator.

Although social media have been used on other campuses to promote student interaction, the development of a Twitter-based drama that encourages improvisation and collaboration as part of a learning module sets SimSoap apart.4

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Several factors came together to put Stanley on Twitter. First, iNET educational technologist Newman Lanier, enthusiastic about the technology, was looking for a way to introduce Twitter into nursing education. Then, Barzee saw an article in The New York Times about how the Broadway show “Next to Normal” had gained followers by publishing an adapted version of the show over Twitter, one line from a character at a time. “I started thinking about that as I took a tour of our simulation lab here at Duke,” she recalls. “I got the idea of creating a soap opera told from the perspective of the simulation mannequin as he went through all these procedures.” Twitter provided a free way to disseminate the “serialized” narrative to many people at once.

As they sketched out a scenario, Barzee and Lanier enlisted the help of Midge Bowers, a nurse practitioner specializing in cardiology, and Margie Molloy, a nurse who runs the simulation lab, to infuse the drama with pedagogical content. The project targets the learning competencies of patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics.

“We wanted a way to model Twitter’s use, but we had to make sure it had educational value,” Barzee says.

The scenario, revealed through tweets by Stanley and an iNET nurse narrator, was a compelling story of a patient looking for a long-lost love. But it also included some provocative scenarios related to patient privacy, safety, and quality. For instance, one nurse didn’t wash her hands between patient encounters and another violated federal law by revealing Stanley’s protected health information in a Craigslist ad. (The project even received a response to the Craigslist post from a reader who was concerned about the patient’s privacy.) SimSoap followers asked questions and made comments via Twitter.

The iNET team members used TweetDeck to help them organize their Twitter feeds and update multiple Twitter accounts at one time. They used their Apple iPhones to take some of the photographs incorporated into the project, and a Flip Cam to record video elements. Open source software from Jing allowed the team to embed screen captures in Twitter messages.

A transcript of the first chapter of SimSoap is available on iNET’s website (inet-nurse.org). The site also offers instructor guides, discussion prompts, and links to key health and patient safety initiatives.

The iNET team is already working on the next SimSoap episode, which has to do with cultural competencies. “We are thinking about how to better integrate it into classroom work,” Barzee explains. “We want to partner with a faculty member to make it part of a course assignment, with students required to respond at least once.”

There is potential in future episodes for more improvisation based on student responses, she adds. “We hope nurse educators will harness the interactive, participatory nature of Twitter in support of simulation exercises.”