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Costello LL, Cho DD, Daniel RC, Dida J, Pritchard J, Pardhan K. Emergency medicine resident perceptions of simulation-based training and assessment in competence by design. CAN J EMERG MED 2023; 25:828-835. [PMID: 37665550 DOI: 10.1007/s43678-023-00577-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/09/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVES With the launch of competence by design (CBD) in emergency medicine (EM) in Canada, there are growing recommendations on the use of simulation for the training and assessment of residents. Many of these recommendations have been suggested by educational leaders and often exclude the resident stakeholder. This study sought to explore their experiences and perceptions of simulation in CBD. METHODS Qualitative data were collected from November 2020 to May 2021 at McMaster University and the University of Toronto after receiving ethics approval from both sites. Eligible participants included EM residents who were interviewed by a trained interviewer using a semi-structured interview guide. All interviews were recorded, transcribed, coded, and collapsed into themes. Data analysis was guided by constructivist grounded theory. RESULTS A total of seventeen residents participated. Thematic analysis revealed three major themes: 1) impact of CBD on resident views of simulation; 2) simulation's role in obtaining entrustable professional activities (EPAs) and filling educational gaps; and 3) conflicting feelings on the use of high-stakes simulation-based assessment in CBD. CONCLUSIONS EM residents strongly support using simulation in CBD and acknowledge its ability to bridge educational gaps and fulfill specific EPAs. However, this study suggests some unintended consequences of CBD and conflicting views around simulation-based assessment that challenge resident perceptions of simulation as a safe learning space. As CBD evolves, educational leaders should consider these impacts when making future curricular changes or recommendations.
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Affiliation(s)
- Lorne L Costello
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada.
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
| | - Dennis D Cho
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Emergency Medicine, University Health Network, Toronto, ON, Canada
| | - Ryan C Daniel
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Joana Dida
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Jodie Pritchard
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
| | - Kaif Pardhan
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Division of Pediatric Emergency Medicine, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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Harley JM, Hin-Hei Lau C, Bilgic E, Moran RM, Fried GM, Bhanji F. Identifying Royal College-accredited simulation centre research priorities across Canada. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:89-93. [PMID: 37719392 PMCID: PMC10500412 DOI: 10.36834/cmej.73911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
To advance the field of health sciences simulation, research must be of high quality and would benefit from multi-institutional collaboration where centres can leverage and share expertise as well as work together to overcome limits to the generalizability of research findings from single-institution studies. A needs assessment in emergency medicine simulation has illustrated the importance of identifying research priorities in Canada. The main purpose of this study was to identify simulation research priority directions for Canadian simulation centres. The current survey study drew on 16 research priorities developed through a two-round internal Delphi study at McGill University that 15 of 17 simulation centre advisory board members participated in. The final 16 research priorities were then rated by a total of 18 of 24 simulation centre directors and/or delegates contacted from 15 of 19 Royal College of Physicians and Surgeons of Canada-accredited simulation centres in Canada. Results revealed nine common research priorities that reached 70% or higher agreement for all respondents. We anticipate that our findings can contribute to building a shared vision of priorities, community, and collaboration to enhance health care simulation research quality amongst Canadian simulation centres.
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Affiliation(s)
- Jason M Harley
- Department of Surgery, McGill University, Quebec, Canada
- Research Institute of the McGill University Health Centre, Quebec, Canada
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Quebec, Canada
- Institute for Health Sciences Education, McGill University, Quebec, Canada
| | | | - Elif Bilgic
- Department of Surgery, McGill University, Quebec, Canada
- Department of Pediatrics, McMaster University, Ontario, Canada
| | - Ricky Muller Moran
- Department of Surgery, McGill University, Quebec, Canada
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Quebec, Canada
- Department of Surgery, University of Manitoba, Manitoba, Canada
| | - Gerald M Fried
- Department of Surgery, McGill University, Quebec, Canada
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Quebec, Canada
- Institute for Health Sciences Education, McGill University, Quebec, Canada
| | - Farhan Bhanji
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Quebec, Canada
- Institute for Health Sciences Education, McGill University, Quebec, Canada
- Department of Pediatrics, McGill University, Quebec, Canada
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Truchot J, Boucher V, Li W, Martel G, Jouhair E, Raymond-Dufresne É, Petrosoniak A, Emond M. Is in situ simulation in emergency medicine safe? A scoping review. BMJ Open 2022; 12:e059442. [PMID: 36219737 PMCID: PMC9301797 DOI: 10.1136/bmjopen-2021-059442] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To provide an overview of the available evidence regarding the safety of in situ simulation (ISS) in the emergency department (ED). DESIGN Scoping review. METHODS Original articles published before March 2021 were included if they investigated the use of ISS in the field of emergency medicine. INFORMATION SOURCES MEDLINE, EMBASE, Cochrane and Web of Science. RESULTS A total of 4077 records were identified by our search strategy and 2476 abstracts were screened. One hundred and thirty full articles were reviewed and 81 full articles were included. Only 33 studies (40%) assessed safety-related issues, among which 11 chose a safety-related primary outcome. Latent safety threats (LSTs) assessment was conducted in 24 studies (30%) and the cancellation rate was described in 9 studies (11%). The possible negative impact of ISS on real ED patients was assessed in two studies (2.5%), through a questionnaire and not through patient outcomes. CONCLUSION Most studies use ISS for systems-based or education-based applications. Patient safety during ISS is often evaluated in the context of identifying or mitigating LSTs and rarely on the potential impact and risks to patients simultaneously receiving care in the ED. Our scoping review identified knowledge gaps related to the safe conduct of ISS in the ED, which may warrant further investigation.
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Affiliation(s)
- Jennifer Truchot
- Département de médecine familiale et de médecine d'urgence, Université Laval Faculté de médecine, Quebec, Quebec, Canada
- Emergency Department, CHU de Québec-Université Laval, Quebec, Quebec, Canada
- Emergency Department, CHU Cochin- Université de Paris, APHP, Paris, France
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Quebec, Quebec, Canada
| | - Valérie Boucher
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Quebec, Quebec, Canada
- Centre d'excellence sur le vieillissement de Québec, Québec, Quebec, Canada
| | - Winny Li
- 5Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Guillaume Martel
- Département de médecine familiale et de médecine d'urgence, Université Laval Faculté de médecine, Quebec, Quebec, Canada
| | - Eva Jouhair
- Département de médecine familiale et de médecine d'urgence, Université Laval Faculté de médecine, Quebec, Quebec, Canada
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Quebec, Quebec, Canada
| | - Éliane Raymond-Dufresne
- Département de médecine familiale et de médecine d'urgence, Université Laval Faculté de médecine, Quebec, Quebec, Canada
- Emergency Department, CHU de Québec-Université Laval, Quebec, Quebec, Canada
| | - Andrew Petrosoniak
- 5Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Emergency Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Marcel Emond
- Département de médecine familiale et de médecine d'urgence, Université Laval Faculté de médecine, Quebec, Quebec, Canada
- Emergency Department, CHU de Québec-Université Laval, Quebec, Quebec, Canada
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Quebec, Quebec, Canada
- Centre d'excellence sur le vieillissement de Québec, Québec, Quebec, Canada
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