1 July 2020
About 30 – 40 % of the COVID-19 patients in the ICU experience delirium which is also referred to as an acute confusional state. This was reported in an article from the New York Times. This is a large number, with serious consequences; the occurrence of delirium is a particularly frightening experience which can delay recovery and is an important risk factor for the occurrence of permanent cognitive and psychological problems associated with Post Intensive Care Syndrome.
In order to help delirious patients in the best possible way, it is important that professionals are well-trained in recognising and acting upon delirium. In addition to these skills, it is also important that professionals are able to develop a better understanding of the patient’s experience. In June, Kiki Buijs-Spanjers obtained her PhD for research conducted among doctors and nursing students. She showed that a serious game, The Delirium Experience, can contribute to improving education about delirium. The success is mainly due to two factors, which can make a very useful contribution to medical education.
A safe, interactive environment
It is important to offer education about a delirium in an interactive way, so that students can experiment with different options in a safe environment. By including different forms of feedback in the serious game, this experimentation can also motivate students to actively look for answers.
Realistic patient perspective
In order to improve students’ understanding of what a delirious patient is going through, it is important to include a realistic representation from the patient’s perspective in education. In the Delirium Experience, both students and trained care providers learn from two perspectives how to recognise and treat a delirious patient. Through the eyes of a delirious patient, you can see how frightening delirium can be and what impact the choices of the care provider can have on the course of the delirium. From the perspective of the healthcare professional, you can then discover what the best interventions are. The game not only provides feedback on choices, the sequence of the actions is also important.
The Delirium Experience is not about learning a fixed protocol but about learning to recognise and apply interventions that bring a patient back to the here and now. The patient’s experience is central in this. Students and caregivers learn to improvise in a fun way, after all, every situation is different.
“We use the delirium game in teaching residents prior to their geriatrics residency. The students have indicated that they find the game a fun way to learn, and that it is instructive from the doctor’s perspective, as well as the perspective of the patient and nurse. In the classroom, I have also noticed a difference in level between the students who have played the game and those who haven’t”.
– AKO Geriatrie, UMC Utrecht
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