Simulcast

Simulcast Journal Club Podcast 4

 

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 

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

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

3. 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 

Ep. 7 - Moulage and Making Stuff

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

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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).

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:  

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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.

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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)

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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.

 

Simulcast Journal Club Podcast 3

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 Judgment. Simulation in Healthcare • Volume 1, Number 1, Spring 2006 

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

Vic 

Pause & Discuss - Translational Sim (VB as Guest)

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.

Pause & Discuss - Are you Experienced? Recruiting for ISS Debriefing Study.

There is increasing use of ‘in situ’ simulation (ISS) – conducted in the actual care environment – as a healthcare simulation modality. This method supports teamwork training, process improvement and the identification of safety threats related to the environment or care systems within that real clinical environment.1,2  

The shared reflective experience during simulation promotes transfer of lessons back to the workplace. Debriefing achieves improved operational performance across a range of fields, including outside healthcare.3 Most guidance on debriefing strategies4-6 comes from theoretical frameworks developed within and outside healthcare, and from educationally focused simulation. An exploration of self reported expert debriefing practice revealed that factors such as values and artistry may be as important as specific techniques.7  

Optimal debriefing strategies for ISS remain unclear, and current practice has not been reviewed systematically. Most published reports of ISS programs lack detail as to how debriefing is conducted. How expert and experienced in situ debriefers adapt their practice for this context has not been previously reported, nor have measures of effectiveness been developed or tested. This exploratory study will use survey and interview methods to identify the characteristics of debriefing currently conducted within in situ simulation programs in healthcare.  

Specifically: -  

What are the features of currently practiced debriefing approaches following in situ simulation (ISS) in healthcare? 

• Characteristics of the ISS 
• Characteristics of the debriefer and participants 
• Characteristics of the debriefing process 
• Characteristics of any evaluation of the debriefing 

Our aim is that identification of effective debriefing strategies will have implications for design of in situ simulation programs, faculty development for simulation educators and could inform further research questions related to measures of debriefing effectiveness. 

If you are someone with experience of in situ simulation debriefing (ie in the real clinical environment, rather than skills lab), we’d like to invite you to participate in a survey based study, with an option to also participate in a subsequent interview. 

If you are interested, please click here to provide your details for study recruitment or write an email to ISSdebreifing@gmail.com 

Victoria Brazil, Walter Eppich, and Margaret Bearman 

 

References 

1. Guise JM, Mladenovic J. In situ simulation: identification of systems issues. Seminars in perinatology. 2013;37(3):161­5.

1. Rosen MA, Hunt EA, Pronovost PJ, Federowicz MA, Weaver SJ. In situ simulation in continuing education for the health care professions: a systematic review. The Journal of continuing education in the health professions. 2012;32(4):243­54. 

1. Tannenbaum SI, Cerasoli CP. Do team and individual debriefs enhance performance? A meta­analysis. Human factors. 2013;55(1):231­45. 

1. Cheng A, Eppich W, Grant V, Sherbino J, Zendejas B, Cook DA. Debriefing for technology­enhanced simulation: a systematic review and meta­ analysis. Medical Education. 2014;48(7):657­66. 

1. Eppich W, Cheng A. Promoting Excellence and Reflective Learning in Simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing. Simul Healthc. 2015;10(2):106­15. 

1. Sawyer T, Eppich W, Brett­Fleegler M, Grant V, Cheng A. More Than One Way to Debrief: A Critical Review of Healthcare Simulation Debriefing Methods. Simulation in Healthcare. 2016;11(3):209­17. 

1. Krogh K, Bearman M, Nestel D. “Thinking on your feet”—a qualitative study of debriefing practice. Advances in Simulation. 2016;1(1):1­11. 

Ep. 6 - Fellowship of the Sim - Training to be a Simulationista

Learning to be an effective simulation educator is a challenge. Education theory and practice, technical aspects and leadership are just some of the knowledge and skills involved. 

In this episode of Simulcast we were joined by Demian Szyld, (pronounced ‘shield’…….. “like the weapon” he told me).  Demian (@demianszyld)  is the Senior Director of the Institute for Medical Simulation at CMS in Boston, where he works with previous Simulcast guests Jenny Rudolph and Walter Eppich. 

He is involved in many aspects of simulation, including  as Chair of the Formal Training programs Affinity Group with the Society for Simulation in Healthcare, so we thought he’d offer some great insights into this question of how to train to be an effective simulation educator. 

Demian is also a simulation podcaster – in Spanish. Check out Simulacion de Sur a Norte (Simulation from South to North)  

So we structured our discussion around 2 case studies 

Case study one 

An experienced ED nurse has been given some protected time to ‘do sim’. He doesn’t have much formal education background, but is into ‘tech and toys’ and has helped run sims in the past at his previous job. He’s enthusiastic, and has a couple of docs in the department keen too. Keen to learn more so he can run the sims better and considering is doing a formal course 

Where should he start? 

We discussed the importance of making friends – locally and across simulation networks - and getting an idea of the knowledge and skills required. Going to conferences like IMSH (in Los Angeles next year), the Australasian Simulation Congress, SESAM and the INACSL (International Nursing Association for Clinical Simulation and Learning) conference – and joining workshops and networking. 

Online resources like NHET Sim and practically focused websites like HealthySimulation.com and even You tube can be great resources. SSIH now runs formal certification programs.  

 

Case study 2 

An anaesthetic trainee is nearing the end of her clinical training, and wants to make sim a big part of her career, and is prepared to invest time and money in gaining qualifications. She may have opportunity to be deputy sim director of her local sim program in a year or so. 

What options does she have? 

There are many options for Masters programs and simulation Fellowships. Demian reinforced just how important it is to be a great educator to be an effective simulation leader. He strongly supports formal structured training, and described some the work of his group in looking at the common domains of practice of formal programs. 

We were grateful Demian could spare the time to chat and would welcome other suggestions and resources in the comments. 

 vb 

Simulcast Journal Club Podcast 2

In our February journal club podcast Ben and Vic discuss the paper of the month “Communication in interdisciplinary teams: exploring closed-loop communication during in situ trauma team training”. We shared some highlights from the online discussion, and Ben’s pdf summary is also included here. In short, it seems there’s more to communication skills training than recipes!  

We then reviewed 3 recent papers (all Open Access, and links below)  #FOAMsim [Symbol]  

Design of simulation-based medical education and advantages and disadvantages of in situ simulation versus off-site simulation.  Sørensen et al. BMC Medical Education (2017) 17:20 

Observer roles that optimise learning in healthcare simulation education: a systematic review O’Regan et al. Advances in Simulation (2016) 1:4 

A systematic review: Children & Adolescents as simulated patients in health professional education. Gamble et al. Advances in Simulation (2016) 1:1 

And Ben gave us a taster for next month’s paper - 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 

Lots of practical points in the podcast for simulation practitioners, and also lessons for those of us embarking on research looking for methods expertise. 

 

Simulcast Journal Club Podcast 1

Happy New Year from Simulcast

We’ve really enjoyed the Journal Club at Simulcast over the last 6 months. A great array of articles, insightful comments from readers and nice perspectives from expert contributors, and brilliantly curated by Ben Symon.

We hope it’s another way to bring the healthcare simulation community together, and discuss and dissect the increasing volume of published literature in our field.

We want to make it even better, and in 2017 we’ll be doing a monthly podcast wrap of the JC – with a summary of the online discussion of our paper, and a brief review of some of the latest papers from the sim literature.

Th podcast will come out in the regular Simulcast iTunes feed, so if you already subscribe – there’s nothing to do.

In our first episode of ‘Simulcast JC’ Ben and Vic run through some highlights from Journal club over the last 6 months, and give a sneak preview into what’s ahead in 2017.

We give a quick shout out to #IMSH2017 highlights in Orlando, and how to follow on social media, including the Twitter handle @ssih.

11 - APMSH Day 2 with Lance Baily

Day 2 of the Asia Pacific Meeting for Simulation in Healthcare (APMSH) with Lance Baily 

 

On Day 2 of APMSH I attended a fascinating workshop with Lance Baily of SimGhosts and Healthy Simulation fame. Lance works in Las Vegas and has established a global reputation in the technical aspects of conducting simulation, for maximal learning effect.  

Some of these skills are drawn from his previous life working in Hollywood, and our workshop was based on some of those  

• Getting the right camera angle  
• Using tripods 
• Thinking about sound 

Lance explains more in his brief chat with me after the workshop 

The short workshop was eye opening and I suggest you go to Healthy Simulation and Sim Ghosts (subscription required) to see the resources on offer. There are details of workshops there if you are interested.

10 - APMSH Day 1

Day 1 of the Asia Pacific Meeting for Simulation in Healthcare (APMSH) with Kathy Adams and Jesika Gavilanes 

 A couple of weeks ago, I went to the Asia Pacific Meeting for Simulation in Healthcare (APMSH) in Singapore. I gave a talk on some of the in situ ‘translational’ simulation work I’ve been involved with, and it was great to see what other sim educators are doing in our region, and to network across geography and culture. 

In this pause and discuss episode I spoke to Kathy Adams, the Director of Continuing Education at the Society for Simulation in Healthcare.  If you haven’t looked before – their website has many resources for simulation educators, and membership of the society (which is reciprocal with the Australian Society) offers even more. 

I also spoke with  Jesika Gavilanes, one fo the co-Chairs for the upcoming IMSH meeting in Orlando Florida in January 28 – Feb 1st.