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28Episodes
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

Michelle Kelly (@KellyKelmich) was our guest on Simulcast for the inaugural Book Review, discussing Healthcare Simulation Education: Evidence Theory and Practice – a recently published textbook for the simulation practitioner.  

Editors Debral Nestel, Michelle Kelly, Brian Jolly and Marcus Watson have drawn together a diverse range of authors to produce a comprehensive, but disciplined, review of current theory and practice in healthcare simulation.  

Michelle is a simulation academic and practitioner from Curtin University in Perth and past chair of the Australian Society for Simulation in Healthcare (ASSH). Her academic publications and extensive sim experience have made her well placed to edit the book, and to discuss some ‘big picture’ issues in healthcare sim. 

In the podcast we discuss highlights from the book, the writing process, simulation terminology, and predictions for the future.  

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

Peterson, Dawn Taylor PhD; Watts, Penni I. PhD, RN, CHSE-A; Epps, Chad A. MD; White, Marjorie Lee MD, MPPM, MA, CHSE (2017)   “Simulation Faculty Development : A Tiered Approach” Simulation in Healthcare : The Journal of the Society for Simulation in Healthcare. Publish Ahead of Print, POST AUTHOR CORRECTIONS, 18 March 2017. 

 

We then covered some interesting stuff on simulators dying 

Weiss et al. Does the unexpected death of the manikin in a simulation maintain the participants’ perceived self-efficacy? An observational prospective study with medical students.   

BMC Medical Education (2017) 17:109 DOI 10.1186/s12909-017-0944-x 

 

And a deep dive into team science 

Rosenman et al.  Changing Systems Through Effective Teams: A Role for Simulation. Acad Emerg Med. 2017 Jul 20. doi: 10.1111/acem.13260. [Epub ahead of print] 

 

Looking forward to another great discussion  

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The dasSMACC (social medial and critical care) conference was recently held in Berlin. Simulation was a theme woven throughout the conference, and we thought a simulcast episode recapping on some of the messages and themes was timely.

Smacc has arguably redefined the way we think about medical conferences – great speakers, great messages, hard core critical care in an engaging format.

This year, simulation activities were embedded in main stage talks, workshops, panel discussions and the ‘Sim Haus’ we previewed in a recent Simulcast episode.

A series of linked main stage talks from Clare Richmond, Chris Hicks and Jon Gatward gave us a framework for thinking about simulation modalities and matching method to objective. Following the journey of a head injured patient, we saw performances by actor Renee Lim, the incredibly realistic manikin made by Lifecast, and how end of life discussions, organ donation, cognitive biases can be addressed using simulation just as well as the action sequences involving airway management of a head injury.

Also on the main stage - Brian Burns opening talk wasn’t about simulation, but rather was a futuristic trauma simulation in which he demonstrated the ways technology might improve our pre-hospital trauma care in the not too distant future, including drone delivered blood products.

Jenny Rudolph gave us a practical insight and skills for dealing with ‘WTF’ moments, by seeking out the underlying frames for behaviour we find annoying or disappointing. She led a whole of audience exercise in resetting our response from unhelpful emotion to curiosity, bringing to life her longstanding work in double loop learning and debriefing using advocacy inquiry.    

The interprofessional panel discussion (aka ‘the tribalism panel’) sparked conversations about how simulation can be an agent of culture change, but also how deliberate our strategies need to be in making our educational outcomes truly interprofessional.

Both Jesse and I were involved in the education panel on Day 3 where simulation was again a core theme, especially as it pertains to preparing learners for the future, connecting with quality improvement in hospitals, and integrating into everyday work. Walter Eppich’s work on how to take our debriefing skills into the clinical area through coaching conversations received a lot of attention. As the Twitter moderator, Jesse wonderfully captured some audience questions and responses in this storify.

Pre-conference workshops on Debriefing, Leave the Sim Lab behind and Stress Inoculation were a chance for attendees to deep dive with internationally respected faculty. Jan Schmutz presented his recent work on team reflexivity in the debriefing workshop (an enlightening read, but you will need to concentrate).

The last of those workshops connected with a presmacc meeting in London – the Performance Psychology in Medicine Seminar. This fantastic program connected the worlds of high performance in pre-hospital care, other healthcare, elite sport and on stage. The event highlighted work like Mike Lauria’s Psychological skills to improve emergency care providers performance under stress, and others like Vicki Leblanc.

 

The Sim Haus was a dedicated physical space within the conference venue, which housed industry displays and ‘meet the experts’ session. There was some fascinating new technology and an atmosphere of sharing sim ideas and challenges.

 

Where to for more?

Feel free to go back to #dasSMACC and also #simHaus, and of course wait for the talks and podcasts to be released on the smacc website and podcasts over the year.

Next smacc conference is in Sydney February 2019

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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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