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25Episodes
Education

A podcast dedicated to the discussion of healthcare simulation. Debunking dogma, demystifying jargon and translating knowledge. Hosted by Dr Victoria Brazil and Jesse Spurr

Episodes

Simulcast is pleased to announce a collaboration with Advances in Simulation, an open access simulation journal based in Europe. In this interview with Editor in Chief Professor Debra Nestel (@DebraNestel), we profile the content, people and philosophy of the journal.  

Debra is already a friend of Simulcast, and wrote the expert commentary for our September 2016 Journal Club. 

Our plan is to produce a bi-monthly podcast featuring an article from Advances, with an interview with the author, and editor or another discussant. Our aim is to continue to connect the simulation community across geography, discipline and modality, and to help research to be translated to practice. This series will complement our ongoing Journal Club (which will still feature articles from across the relevant journals) and our usual podcasts. 

In this podcast, we take the opportunity to talk about diverse applications in simulation, peer review, open access journals, standards for simulated patients and the ethics of simulation.  

A wonderful chance to listen to a friend and mentor to many in the simulation community. 

Look out for our podcast with Ryan Bridges and his editorial From simulation research to education policy: how much evidence is enough?”. Advances in Simulation 20161:22  

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In our June journal club podcast Ben and Vic discuss the paper of the month. 

Cheng et al. “Coaching the Debriefer: Peer Coaching to Improve Debriefing Quality in Simulation Programs” Simulation in Healthcare : The Journal of the Society for Simulation in Healthcare. Publish Ahead of Print, POST AUTHOR CORRECTIONS, 20 May 2017 

Ben summarised the blog discussion and Walter Eppich’s expert opinion. 

 

We then reviewed some recent papers 

Roussin CJ1, Weinstock P.  SimZones: An Organizational Innovation for Simulation Programs and Centers. Acad Med. 2017 May 30. doi: 10.1097/ACM.0000000000001746. [Epub ahead of print] 

And 

Bong et al. The effects of active (hot-seat) versus observer roles during simulation-based training on stress levels and non-technical performance: a randomized trial. Advances in Simulation (2017) 2:7 

DOI 10.1186/s41077-017-0040-7  (Open Access) 

And Ben introduced next month’s paper on simulation faculty development. 

Looking forward to another great discussion  

Vic 

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Norma Robinson leads an interprofessional simulation program involving medical students from University of Queensland Rural Clinical School and nursing students from the University of Southern Queensland. 

The program is based in Toowoomba but has now been scaled up to include students from many part of rural southern and central Queensland

Interprofessional education and teamwork training at the student level has been a challenging area, although with some excellent programs, and I think simulation is at least part of the solution. 

Norma was kind enough to host me for a visit and I spoke to her afterwards about the program, the motivations for interprofessional education, and how to really build a healthcare workforce to serve a community. 

 

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Sara-Catrin Cook joined me for short chat about all things sim at smacc.  

Sara is part of a group who has put together a comprehensive simulation theme woven through the conference, including the SIMHaus – a showcase within the Tempdrom where attendees can meet and talk to other simulation enthusiasts ad experts. 

The SimHaus will be physically set up next to the main arena, and Sara tells us what to expect. Simulcast will be there covering the event for those who can’t make it.  

See you in Berlin

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In an effort to streamline blog posts, we are continuing a merged Journal Club Podcast and monthly wrap post.pdf

Please read our pdf summary of the May Journal Club article, the month’s discussion and our expert commentary here

 


JOURNAL CLUB

In our May journal club podcast Ben and Vic discuss the papers of the month – a duo on Rapid Cycle Deliberate Practice and the approach to debriefing in this format

Structuring feedback and debriefing to achieve mastery learning goals Eppich WJ1, Hunt EA, Duval-Arnould JM, Siddall VJ, Cheng A. Acad Med. 2015;90:00–00.  First published online doi: 10.1097/ACM.0000000000000934

Pediatric resident resuscitation skills improve after “Rapid Cycle Deliberate Practice” training Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, Bradshaw JH, Diener-West M, Perretta JS, Shilkofski NA. Resuscitation. 2014 Jul;85(7):945-51. doi: 10.1016/j.resuscitation.2014.02.025. Epub 2014 Mar 4.

 

We then reviewed some recent papers

  1. Theilen, Ulf et al.Regular in-situ simulation training of paediatric Medical Emergency Team leads to sustained improvements in hospital response to deteriorating patients, improved outcomes in intensive care and financial savings. Resuscitation , Volume 115 , 61 - 67

A nice segue from Hunt et al – translating outcomes from individual performance improvement to patient and systems level outcomes

 

  1. Maicher, Kellen et al. Developing a Conversational Virtual Standardized Patient to Enable Students to Practice History-Taking Skills. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: April 2017 - Volume 12 - Issue 2 - p 124–131

One for the technology enthusiasts – using AI/ natural language processing to create patients we can have conversations with. Make sure you watch movies like Ex Machina and Passengers for your background reading 

 

And Ben introduced next month’s paper on peer coaching.

Cheng, Adam et al. “Coaching the Debriefer: Peer Coaching to Improve Debriefing Quality in Simulation Programs” Simulation in Healthcare : The Journal of the Society for Simulation in Healthcare. Publish Ahead of Print, POST AUTHOR CORRECTIONS, 20 May 2017

 

Looking forward to another great discussion

Vic

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This month we turned our focus to simulation delivery formats, and in particular a novel approach described recently. 

Sunga K, Sandefur B, Asirvatham U, et al. LIVE. DIE. REPEAT: a novel instructional method incorporating recursive objective-based gameplay in an emergency medicine simulation curriculum BMJ Simulation and Technology Enhanced Learning 2016;2:124-126. 

We were fortunate to be joined by 2 authors of the paper 

Kharmene Sunga (@Kharmene) is an emergency physician at Mayo Clinic in Rochester, Minnesota, where she is also lead for simulation in the ER residency. Daniel Cabrera (@CabreraERDR) is also an emergency physician at Mayo, a social media enthusiast and @smaccteam speaker. 

Their paper, and original blog post,  challenges our traditional approach to simulation delivery – often ether a scenario followed by long(ish) debrief, or  ‘pause and discuss’ where the scenario is paused at intervals for discussion and then continues on. 

Using gamification principles, and a fair bit of movie watching – Kharmene and Daniel have devised a sim format that involves ‘recursive objective based gameplay’ – where participants attempt to reach higher stages in the ‘game’ but have to repeat the level if they die. Seen from an educational theory perspective – this is deliberate practice in action. It’s a fast paced and engaging format, and provides a chance to practice again after a short and directive debrief. 

Inspired by the idea of forgoing some of the long debrief after a scenario in favour of a chance for participants to practice, I’ve adapted the principle to our final year student sims, which have been similarly well received.  

Comments and other ideas for adaption welcome. 

 vb 

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In our April journal club podcast Ben and Vic discuss the paper of the month – a classic debriefing article.  

Jenny W. Rudolph, PhD, Robert Simon, EdD, Ronald L. Dufresne, MS, and Daniel B. Raemer, PhD There’s No Such Thing as “Nonjudgmental” Debriefing: A Theory and Method for Debriefing with Good Judgment. Simulation in Healthcare • Volume 1, Number 1, Spring 2006 

 

We then reviewed some recent papers 

  1. The Simnovate series - all FREE for now

Rajesh Aggarwal. Simnovate: simulation, innovation and education for better healthcare. BMJ Simulation and Technology Enhanced Learning Mar 2017, 3 (Suppl 1) S1-S2; DOI: 10.1136/bmjstel-2016-000184 

Philip H Pucher, et al. Simulation research to enhance patient safety and outcomes: recommendations of the Simnovate Patient Safety Domain Group. BMJ Simulation and Technology Enhanced Learning Mar 2017, 3 (Suppl 1) S3-S7;  

Wayne Choi, et al. Engagement and learning in simulation: recommendations of the Simnovate Engaged Learning Domain Group. BMJ Simulation and Technology Enhanced Learning Mar 2017, 3 (Suppl 1) S23-S32; DOI: 10.1136/bmjstel-2016-000177 

  1. Simulation Fellowship Programs: An International Survey of Program Directors

Natal, Brenda MD, MPH; Szyld, Demian MD, EdM; et al. Academic Medicine April 4, 2017 

  1. An Innovative Approach: Using Simulation to Teach Primary Care Gynecologic Procedures.

Hellier, Susan D. et al. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare January 9, 2017 

 

And Ben introduced next month’s 2 papers – a complementary duo focused on Rapid Cycle Deliberate Practice. 

Structuring feedback and debriefing to achieve mastery learning goals Eppich WJ1, Hunt EA, Duval-Arnould JM, Siddall VJ, Cheng A. Acad Med. 2015;90:00–00.  First published online doi: 10.1097/ACM.0000000000000934 

Pediatric resident resuscitation skills improve after “Rapid Cycle Deliberate Practice” training Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, Bradshaw JH, Diener-West M, Perretta JS, Shilkofski NA. Resuscitation. 2014 Jul;85(7):945-51. doi: 10.1016/j.resuscitation.2014.02.025. Epub 2014 Mar 4. 

 

Looking forward to another great discussion  

Vic 

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This episode was a ‘mix tape’ of moulage and other techniques to achieve physical realism in simulations – including procedural and anatomy teaching


Clare Scott offered her considerable expertise in moulage and making bespoke manikins for trauma simulations. She emphasized keeping in simple, keeping it real and doing your research – online and through networks of interested sim moulage folks (like Behind the sim curtain).

IMG_4998

Clare offered some practical examples for making ‘Schkin’ for moulding wounds and other skin defects, bile from coke green food colouring, and more. She has a fabulous handout here:  pdf


Keri Shafer shared her plans for using 3 D printing hearts to learn about congenital heart disease. Keri (@kerizozo) is a cardiologist from Boston whose clinical and educational work is focused on those tricky plumbing issues. Using a process designed to help surgeons operate better, she went to the 3D printing group within the Boston Childrens Hospital Simulation program and developed models of various forms of congenital heart disease. Fabulous collaboration between clinician educators and engineers. We wait with interest to hear the outcomes of her research in evaluating this educational technique.


We asked Andy Buck, of ETM course fame, about his favourite home made part task trainer, and how he makes it. Andy cited better functional task alignment and lower cost as key reasons to ‘make your own’. We chatted about whether 3D printing is ready for prime time for the average simulation educators? For those superkeen Andy is happen to be contacted on Twitter via DM (@edexam)


Finally, we spoke to Jessica Stokes-Parish in her minimal spare time between work and convening this year’s Australasian Simulation Congress. She’s just published an article that asks us to reflect of how much ‘bang for buck’ we get from the moulage efforts we make as sim educators.

Does Appearance Matter? Current Issues and Formulation of a Research Agenda for Moulage in Simulation. Stokes-Parish, Jessica B. M. Nurs (Adv Prac); Duvivier, Robbert MD, PhD; Jolly, Brian PhD. Simulation in Healthcare February 2017 - Volume 12 - Issue 1 - p 47–50

I enjoyed this article so much I wrote a blog post about it for the International Clinical Educators Network blog.

 

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Simulcast Journal Club podcast March episode 

 

In our March journal club podcast Ben and Vic discuss the paper of the month Marshall, S. D. (2017) “Helping experts and expert teams perform under duress: an agenda for cognitive aid research.” Anaesthesia, 72: 289–295. doi:10.1111/anae.13707. We shared some highlights from the online discussion, and Ben’s pdf summary is also included here. There’s more to a good checklist thean we realise. 

We then reviewed 3 recent papers (links below)   

Greig PR, Darbyshire JL, Richards E ‘The most useful exercise of medical school’: simulated death can be successfully incorporated into undergraduate simulation. BMJ Simulation and Technology Enhanced Learning Published Online First: 07 March 2017.  

Kessler DO, Chang TP, Auerbach M, et al Screening residents for infant lumbar puncture readiness with just-in-time simulation-based assessments BMJ Simulation and Technology Enhanced Learning 2017;3:17-22.  

Cheng et al.  Conducting multicenter research in healthcare simulation: Lessons learned from the INSPIRE network. Advances in Simulation (2017) 2:6 

 

And Ben introduced next month’s paper – a classic 

Jenny W. Rudolph, PhD, Robert Simon, EdD, Ronald L. Dufresne, MS, and Daniel B. Raemer, PhD There’s No Such Thing as “Nonjudgmental” Debriefing: A Theory and Method for Debriefing with Good JudgmentSimulation in Healthcare • Volume 1, Number 1, Spring 2006 

Looking forward to comments from across the range of simulation debriefing experience 

Vic 

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I shifted to the other side of the mic a couple of weeks ago - as interviewee. I had spoken at a breakfast meeting of the Australasian College of Health Service Management, and was then interviewed by Anthony Frangi of @popupradioAU about Translational Simulation – my take on how we might think about using sim for quality improvement.

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