Advancing Simulation Using Low-Cost, High-Impact HomeGrown Solutions

In this episode of Nursing EDge Unscripted, host Dr. Kellie Bryant explores the HomeGrown Solutions initiative with guests Dr. Rebekah Day and Dr. Robyn MacSorley. The conversation highlights how HomeGrown Solutions serves as a centralized platform for sharing innovative, low-cost simulation ideas developed by nurse educators and simulationists. Drs. Day and MacSorley discuss the importance of community-driven solutions, particularly for programs with limited resources or access to commercial simulation products. They also describe how the initiative promotes collaboration, creativity, and recognition of grassroots innovations that emerge from real-world educational challenges. Throughout the episode, listeners are encouraged to contribute their own ideas and engage with the simulation community to advance nursing education together.

Explore HomeGrown Solutions: https://www.nln.org/homegrown. 

Interested in submitting your own low-cost simulation innovation? HomeGrown Solutions applications are accepted three times per year, with deadlines on March 1, July 1, and November 1. Learn more and submit your solution here:
 https://www.nln.org/education/education/sirc/sirc/sirc-homegrown-solutions/how-to-submit-your-homegrown-solution.

Dedicated to excellence in nursing, the National League for Nursing is the leading organization for nurse faculty and leaders in nursing education. Find past episodes of the NLN Nursing EDge podcast online. Get instant updates by following the NLN on LinkedIn, Facebook, Instagram, Bluesky, and YouTube. For more information, visit NLN.org.

Transcript

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All right, welcome back everyone for another episode of the NLN podcast, Nursing EDge Unscripted. I am today's host for this episode, Dr. Kellie Bryant. I am the director of the Center for Innovation in Education Excellence at the National League for Nursing. We have a very interesting episode, something new that we haven't done before. We will be discussing HomeGrown Solutions. And for those of you that don't know, HomeGrown Solutions is an INACSL and an NLN initiative that collects and shares practical low-cost simulation innovations created by our simulation community. It serves as a hub where simulationists can share their do-it-yourself tools and adaptations with clear objectives and step-by-step guidance and even videos sometimes so that educators can replicate and implement these ideas in their own programs. So I am very happy to have our guest here with us today. We have Dr. Robyn MacSorley from University of Mississippi Medical Center where she is the associate professor and director of their clinical skills and simulation lab. And I want to mention that Robyn is also the chair of our HomeGrown Solution committee. And we also are joined by an INACSL HomeGrown Solution committee co-chair Rebekah Day who is an instructor and student competency educator at the University of Alabama at Birmingham. So, welcome Robyn and Rebekah and thank you for joining us today. How are you both doing? I'm doing great. Looking looking forward to this and sharing some information about HomeGrown because it is an amazing subcommittee of INACSL's education committee. So, this has been great. So, I'm gonna bump it over to you, Rebekah. Yeah, we're excited to share a lot of different ideas that have came about over the past few years and kind of get the word out to how people can apply for new ones and and spread the word to share to our community. Great. Great. So, one of my first questions is I just want to go back and talk about the history of HomeGrown because it's been around since about 2008. So, Robyn, can you tell us how did HomeGrown start? The concept of HomeGrown, tell us a little bit about the history. All right. Well, from my understanding, this sweet, sweet lady who did a presentation in INACSL around 2008, her name is Meg Meccariello, she just wanted to offer something to other people that gave them low-cost innovative, you know, because it wasn't out there at that time. She ended up putting a note on a door, inviting people and they all came together and discussed different types of innovations they had came up with at their facility and they were able to share it. And then a little bit later on, I think it was 2014, NLN and INACSL, they partnered up and they provided this opportunity to share across not only the United States but all over the world. That way people could go on to the website, find creative solutions, and just try it at their facility, share it with others, develop their own. It's just it's been amazing. And I think to date there are like over 109 solutions that have been submitted. Wow. Thank you. And her video, her video is also on the website, so you need to go to it and watch it. She tells her whole story. Great. Thank you for sharing that, Robyn. So, for those who are listening and you know, we we gave a little bit of background about what HomeGrown Solutions are. How would you define HomeGrown Solutions in your own terms for the simulation and education community? All right, Rebekah, do you want me to go or do you want to? I can go on that one. I think for me, I've I've not been around as long as Robyn has on the committee. This will be my second year, but my first year at INACSL which was about 3 years ago, I was saw on the agenda and I was saw this HomeGrown Solutions and it was a hands-on workshop and I was new to simulation. So I was like, "Yeah, let's go see what it is." And I had no idea. And I walk into this room and there's all these different things in there and I was kind of thinking, "What have I gotten myself into here?" But then as you started going around to the different tables and seeing these different solutions that people had submitted and they had tried at their institution and it really worked for the learners and it was a cost-effective or easier ways to do it. It just really kind of hooked me in. But also the community that I met. I met Robyn there that year and then she kind of got me onto the committee and I've just met so many other people. So to me, I think a HomeGrown Solution is anything that somebody comes up with that is cost effective, a simpler way to do things so that we can get more of those kind of produced and out there for our students to get their hands on instead of kind of being stuck with just one task trainer, one item for a whole cohort of students. Yeah. Because, you know, people assume when we're in a simulation world that, you know, we have all these resources that the we have all these beautiful state-of-the-art simulation centers and not everybody comes from that kind of environment. So, for an educator listening who feels overwhelmed and and maybe not have access to all the resources, where would you suggest that they start with creating or adapting their own HomeGrown Solutions? Well, the first thing I would tell them is definitely go to our website. And the nice thing about it is even when you look through all the different types of solutions available, you can even adapt what they have to make it your own with what you have because you might not have all of those different little items, but you might have them in your pantry. you might have you know some broken parts pieces that you can you know use to make it work for what you need to do. And you know, just to say, you know, kind of throw this in there. I was an old emergency room nurse. And if you know, ERs are very expensive. You utilize a lot of resources. It cost a lot of money. You don't recoup it. That's to me similar to simulation. You utilize a lot of expensive resources, you know, and you really don't get your money back. Well, except in education. But it's the same way with with this. You find pieces and parts and broken things and you adapt it to make it what you want. And you know, even people out there, they have ideas that they can share. And it's just amazing to have a community of resources and a community of people that can share ideas with others. Great. Now, Rebekah, do you have anything to add? Any advice you would give someone who's just starting out, maybe doesn't again have all the bells and whistles or the money to buy because these disposables and equipment is expensive as we know those of us in the simulation field. What advice would you have for somebody just starting out? Just be willing to share your ideas with people. Don't think that it's just, you know, simple or it's too elaborate or anything like that because I mean I'm fortunate enough that our institution, we do have a hospital that we are able to get like expired items and things like that, but we still use a lot of these cost-effective solutions because like I was saying earlier, even though you you may have an institution that can afford certain cash trainers, sometimes it's rare that you can afford enough for a large cohort of students. So being able to use these at any facility whether you are have needs or not, you're able to use all of these. So just don't be afraid to submit your solutions. Get out there and communicate with a other institution so that we can share these ideas and and get them across to all of our students. So talking about submitting solutions, let's say someone is very creative and they have a great idea they want to share. Can you tell us the steps to submitting a solution to an INACSL? Okay. So, when you go to SIRC HomeGrown Solutions, you can click on submit a solution and there's different categories that you can choose from. The ones that we have had in the past is enhancing mannequin functionality, equipment, medical supplies, moulage ideas, also everyday solutions. And we have just recently, as of November, added two new ones. and they are called AI simulation solutions and also 3D printing because these are some areas that a lot of people are getting more and more involved in and we would like to see some of these solutions submitted. So when you submit a solution, you have different categories such as identification of the problem. If it's a unique idea, objectives, and that's one of the areas that we have found that people that submit struggle with, they need to be smart, specific, yeah, all of those. Yeah. All of that good stuff. And go to you also utilize blooms when you start filling out your smart objectives. Supplies and ingredients and then steps to creating the solution. And with that, please include pictures and videos are extremely helpful. That is one thing that when you go to the website, look at it, see what other people have submitted and just really hone in on the solution and make sure that it makes sense because these have got to be replicable. And you know it's also open access. Anybody can go in and access them to be able to review them which is just wonderful. We also have a HomeGrown Solution rubric. It's just been updated and it's very easy to use. It gives detailed information of what we want you to add and also you can reach out to us. Once we reach out to you after we've reviewed it, we'll send you some questions for clarification and we want you to be successful. And you can also a lot of colleges you can use this towards your promotion and to you know go up for promotion and all of that because it is peer reviewed. So, we really want you to submit your ideas so everybody can have access to them. Great. Thank you for that. And I'm really excited particularly about the new AI one. I'm a little biased because that that's the hot topic now. So, I cannot wait to see the solutions that people submit underneath that category. So, I want to dive a little bit deeper. You you did a wonderful job explaining how to submit, but what does the selection process look like? Because obviously this is done by your committee. Can you tell us a little bit about the review process and what the next steps are after you submit your your idea? I can start on that one. So, since Robyn is the chair of the committee, she does get a form the application that does have the patient that does have the submission title names and things like that. So then she sends out a copy of that to two reviewers on the committee so that it doesn't have anyone's names, university, anything like that. So it's just an unbiased and we review those and we each two of us will go through using the rubric and we'll follow looking at the objectives, the reason that we want to have this solution and how they kind of came up with their idea and what they do for that. So we'll watch the videos, we'll look at the pictures and review that. Then we submit that back into Robyn. once we're finished with the rubric, it kind of gives that a score. So, we're able to say if it's, you know, if we accept it or if we are declining that one, but a lot of times there's just little things that need to be fixed. So, it may just be accepted with some revisions and things like that. So, sometimes we just need to change a few of the objectives or maybe we do need that video if it wasn't submitted so that we can just get a better idea for what what it looks like. But the two reviewers will go over that separately and then we send those back into Robyn for the final decision based on most. And how many times a year are you accepting? Our next one actually comes up in March. So if anybody has anything they want to send in to us, please, please, please do so. And then after the March cycle will be July, November, it's three times a year, but we had some reviews sent to us with the last cycle and we received 12 of them. And as of those 12, four have already been accepted with revisions and they are now on the website. I looked this morning and they have been posted to the website. Great. We are still reviewing more and cannot wait to see how those reviews turn out and then send it to them. Okay. And so I have a personal question. Yeah. Any of you ever submitted a HomeGrown Solution? Oh yes. And it took me years to submit it too because I really didn't think that it was good enough to submit. I had some pediatric faculty reach out to me and they wanted to do a they had a simulation that they built out and it was a pediatric child that was postart cath and they wanted a complication to occur such as an arterial bleed at the insertion site. So, I kind of was trying to figure out, you know, manikins, how do you get them to bleed from the femoral area? I mean, really, how do you get them to bleed from there? So, I got to thinking about it and I remembered that there was a bulb on the end of a tube that came out of one of our task trainers that we never used. You could pump it and it would give them pulses. We never used that. And the IV rubber tubing. I got to thinking, you know, I could put that there and let's get some 4x4s and let's fill it up with simulated blood, you know, in that bulb syringe and then we can have a family member in the room that could push the bulb from a certain area that's around the mannequin. And lo and behold, the child starts getting nauseated, starts getting sick. The vital signs are stable. There's no bleeding at the insertion site. But then as soon as the child starts throwing up, you know, the child's vital signs start tanking, the students reassess the insertion site and lo and behold, it's bleeding. So, something that simple and it can make it realistic. So when you have a chance, it was accepted. I submitted it really nervous about it. And another thing that I did that I thought was really helpful when submitting, I looked at all the different types of questions and I went ahead and I had all my information typed up first. Then that way when I went on to the website, all I had to do was copy and paste what I had typed up in each of those sections and it just made it flow so much smoother as far as the submission process that I wasn't having to, you know, think about it and type it in with each one as I was up, you know, it just made it so much easier to have it ready. Great. So, thank you for sharing that, Robyn. You're welcome. So, here's a general one. you know, our simulation world, we're very, very creative. So, I'd like for you to share whether it's something that you've seen that was most creative or maybe your favorite HomeGrown Solution. Tell us about it. And I'll start with you, Rebekah. What's one of your favorites or I don't want to get anybody in trouble that you're picking on because there's a lot of great ones out there, but maybe one that you find very creative that you'd like to share. I think there are a lot of great solutions out there. Robyn and I both have one that we both use a lot, but I'm going to let her elaborate on that a little bit more. One that I recently found looking for a solution at my own institution was a artificial rectum for suppository insertion. And I just thought it was really neat because a lot of students don't get that opportunity. It's something that they're very nervous about doing. And someone had submitted this. They actually took a specimen cup with some Jell-O and some different items in there and they were able to make enough of them for every student to be able to get that simulation of being able to insert a suppository and see how that really should be for them. So, something I know it seems simple, but like Robyn was saying is a great idea and you're able to make a lot of those at a low cost. So, every student's going to get that opportunity. So it takes a little bit of that nervousness out before they go to clinicals. Excellent example of you, like you said, creating a low-cost solution for deliberate practice of a skill that students may not get in a clinical setting that they're nervous about. It's a great example. And Robyn, what about yours? What's one of your favorites? Okay, so I was tasked with bringing IV arms to an interprofessional education activity here at the medical center. And I'm thinking, I do not want to lug those big old arms around. So, guess what? I went to HomeGrown Solutions and I'm like, somebody just came out with one and this is like perfect. So, it's called Caboodle Noodle 2.0. Okay, so what I got, and I will show you the supplies, and then I'll show you my final product. The person that developed it, her name is Stephanie McKee, and she has actually done several. I would love her creative ability, but this is one of the ones that she did. So, this is a cut piece, but it's a pool noodle. One of the smaller pool noodles. It's got a hole in it. I got this from a place for like the whole one for a dollar, which I think they're $2 now. We know. Yes. Then I ordered some skin, tattoo skin off of Amazon. You can get like a pack of 20 for $9 or you can spend up to $25 depending. And I got 20 of those. Then I ended up, you've got this IV tubing that you put in IV arms. So we had, it's the IV tubing that you use when you have IV arms and you have to change them out from being stuck too much, you purchase it, but it comes in a lot like a big old roll of this. So, I just cut off a piece of it. Then I also have, it's just some type of a BD syringe tip cap. And these are just supplies that I had based off of her thing. And it's just like a little blue cap. And I stuck it in the end of my IV tubing like that. And then you have press and seal because it's kind of got that sticky. So then and then of course I had like a little saline lock and we have like little small bags. And the neat thing about it, one of the people that just submitted a solution orders little bags like these and it's like vampire blood fake in a little IV bag and you can even put 500 milliliters of solution in it. So you can do simulated blood in it and the the learners can learn how to start an IV and you can have the blood in the bag and they can practice starting IVs or they can push medicines in it. And look how small this is. This is only like 6 inches and you can make a lot of them. so inexpensive com and you can it's easy to transport instead of having to take all these IV arms you know to and from one building to another. So, I made nine of these. Great activity. And just to go back because you showed us the supplies, but how do you actually assemble it? The you take this a pool noodle and you take your IV tubing. Okay. Like this. And then you take your press and seal. Okay. And you wrap it around this. You connect your IV bag to this. Mhm. And you take your skin, if I can get it open. And so when you have your thing there, you just wrap it around it. Oh, and I forgot to tell you. And you staple this with a stapler. You just open up the stapler and staple it. Good. You are expensive. You have all of this stuff underneath that and it's like you can't beat it. Yeah, that is a favorite one I have to say. Oh, I love it. Thank you. We got a live demonstration the first time on a podcast. I appreciate that. Robyn, today I wanted to share one of my favorites. I think it's a recent one. When I was a a dean of a simulation center, we had a lot of NP programs and one of the things we had our our students do is incision and drainage, you know, of abscess. And I was surprised at how expensive those, you know, task trainers were. And a lot of times once you cut into it, it was done. So, we were always trying to find solutions and and I wish I would have known this solution when I was back dean of the simulation center, but it was taking a glove, filling it with cat litter and then putting the little pods like the dishwashing pods, putting that in the glove in various positions, and that is the abscess. And then you go in and I was like, how creative is that? That would have saved me a whole lot of money back in the day. So, again, another great solution. Probably one of my favorites. So there's a lot of talk about competency based education and we have a lot of nurse educators that are looking for ways to implement CBE whether and a lot of times they look to the simulation center. So do you have any solutions that support competency based education or clinical judgment development? I don't really have just one solution. I think all a lot of them in general have really been key in our competency based education switch over the last year. I know since we've just finished rolling out our new curriculum, it's been a really big factor to use a lot of these solutions in our classroom settings now. So, in our lab settings and things, not just in the actual immersive simulation, but in our classroom settings that we're using a lot of these solutions, like I mentioned earlier, so that every student is getting a hands-on opportunity. You're not waiting to pass that task trainer around. I think when we have that and we're able to let our students apply these solutions with the clinical judgment model, it kind of puts the two together. So, while you're learning about this one thing, you're also getting that hands-on aspect that maybe you wouldn't get for several months until you're in a clinical setting. And I think these solutions are allowing us to apply that competency based education on the daily in our classrooms. Now, great Robyn. I totally agree with Rebekah. you know, I think a lot of them could fit to help with the competency-based education. You know, because we're trying to build the the knowledge, the skills and all of that. And, you know, the realistic the realism that a lot of them offer. I just, you know, I think that they're accessible. You know, you can develop a lot of them. It just really helps hone in on, you know, the the critical thinking. you know, even with this IV one, you know, that's a skill that you've got to make sure that you don't, you know, break sterility with different things. There are a few that are based on urinary task trainers type things and so so a lot of them can be used for that. Okay. So, we are I could go on and on and on for hours talking about different solutions, but we are running out of time. So I do want to end with one final question because again you are very involved with the HomeGrown Solution committee which again is part of the INACSL education committee. Where do you see your work with within HomeGrown changing evolving over the next 3 to 5 years? Oh, well, like I said, with the new solutions that have come out, AI, I mean, that is really, who knows where that's going to be. And, you know, you're a guru of it. So, we might even have a chatbot or something where they can, you know, you have an idea and it'll tell you a HomeGrown Solution and spit it out for you to use. Who knows? That might be the future. Rebekah, where do you see the future of HomeGrown and how it may evolve over the next three to five years? I know we've already grown so much in the year and a half that I've been on this committee and I think just getting the word out. A lot of people still have not even heard about HomeGrown Solutions. So, I think just getting the word out, I think it's going to continue to grow and I think it's really just going to evolve our whole simulation network of institutions, friends, because we all can learn so much from each other. So, I just really see this this committee evolving into so much more and and getting so much more recognition to help schools out there. Great. And and it starts with this podcast. We're hoping that people will listen to this podcast. You're going to get a ton of submissions and we need this because we, you know, a lot of us, like I said, we have a lot of students and and running a simulation center costs a lot of money. So, any idea solutions that can save money, that's creative, I think we should be promoting it. and this is a great example of promoting that. So, I want to thank you both Rebekah and Robyn for joining us today and giving us this great insight on HomeGrown Solutions. I would encourage people to go on the website. Again, this is a wonderful joint collaboration between NLN and INACSL and look at some of the HomeGrown Solutions. It's categorized for by category and then I would encourage you if you have an idea, submit, submit, submit because we need to share ideas within our simulation community. So again, thank you for joining us today for another episode of Nursing EDge Unscripted, brought to you by the National League for Nursing, and we look forward to seeing you on our next episode. Thank you. Thanks.