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Stapleton SN, Cassara M, Roth B, Matulis C, Desmond C, Wong AH, Cardell A, Moadel T, Lei C, Munzer BW, Moss H, Nadir NA. The MIDAS touch: Frameworks for procedural model innovation and validation. AEM EDUCATION AND TRAINING 2024; 8:S24-S35. [PMID: 38774824 PMCID: PMC11102942 DOI: 10.1002/aet2.10980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/01/2024] [Accepted: 02/12/2024] [Indexed: 05/24/2024]
Abstract
Background Simulation-based procedural practice is crucial to emergency medicine skills training and maintenance. However, many commercial procedural models are either nonexistent or lacking in key elements. Simulationists often create their own novel models with minimal framework for designing, building, and validation. We propose two interlinked frameworks with the goal to systematically build and validate models for the desired educational outcomes. Methods Simulation Academy Research Committee and members with novel model development expertise assembled as the MIDAS (Model Innovation, Development and Assessment for Simulation) working group. This working group focused on improving novel model creation and validation beginning with a preconference workshop at 2023 Society for Academic Emergency Medicine Annual Meeting. The MIDAS group sought to (1) assess the current state of novel model validation and (2) develop frameworks for the broader simulation community to create, improve, and validate procedural models. Findings Workshop participants completed 17 surveys for a response rate of 100%. Many simulationists have created models but few have validated them. The most common barriers to validation were lack of standardized guidelines and familiarity with the validation process.We have combined principles from education and engineering fields into two interlinked frameworks. The first is centered on steps involved with model creation and refinement. The second is a framework for novel model validation processes. Implications These frameworks emphasize development of models through a deliberate, form-follows-function methodology, aimed at ensuring training quality through novel models. Following a blueprint of how to create, test, and improve models can save innovators time and energy, which in turn can yield greater and more plentiful innovation at lower time and financial cost. This guideline allows for more standardized approaches to model creation, thus improving future scholarship on novel models.
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Affiliation(s)
- Stephanie N. Stapleton
- Department of Emergency MedicineBoston University School of Medicine, Boston Medical CenterBostonMassachusettsUSA
| | - Michael Cassara
- Department of Emergency MedicineNorth Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health Patient Safety Institute/Emergency Medical InstituteHempsteadNew YorkUSA
| | - Benjamin Roth
- Department of Emergency MedicinePrisma Health Upstate University of South Carolina School of Medicine at GreenvilleGreenvilleSouth CarolinaUSA
| | - Christina Matulis
- Division of Emergency MedicineNorthShore University Health SystemEvanstonIllinoisUSA
| | - Clare Desmond
- Division of Emergency MedicineNorthShore University Health SystemEvanstonIllinoisUSA
| | - Ambrose H. Wong
- Department of Emergency MedicineYale School of MedicineNew HavenConnecticutUSA
| | | | - Tiffany Moadel
- Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellHempsteadNew YorkUSA
| | - Charles Lei
- Department of Emergency MedicineHennepin County Medical CenterMinneapolisMNUSA
| | - Brendan W. Munzer
- Department of Emergency MedicineTrinity Health Ann ArborAnn ArborMichiganUSA
| | - Hillary Moss
- Department of Emergency MedicineMontefiore Medical Center Moses Campus, Einstein College of MedicineBronxNew YorkUSA
| | - Nur Ain Nadir
- Department of Clinical SciencesKaiser Permanente Bernard Tyson School of MedicinePasadenaCaliforniaUSA
- Department of Emergency MedicineKaiser Permanente Central ValleyModestoCaliforniaUSA
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Alexandrino H, Martinho B, Ferreira L, Baptista S. Non-technical skills and teamwork in trauma: from the emergency department to the operating room. Front Med (Lausanne) 2023; 10:1319990. [PMID: 38116034 PMCID: PMC10728672 DOI: 10.3389/fmed.2023.1319990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023] Open
Abstract
Management of a trauma patient is a challenging process. Swift and accurate clinical assessment is required and time-sensitive decisions and life-saving procedures must be performed in an unstable patient. This requires a coordinated response by both the emergency room (ER) and operating room (OR) teams. However, a team of experts does not necessarily make an expert team. Root cause analysis of adverse events in surgery has shown that failures in coordination, planning, task management and particularly communication are the main causes for medical errors. While most research is focused on the ER trauma team, the trauma OR team also deserves attention. In fact, OR team dynamics may resemble more the ER team than the elective OR team. ER and OR trauma teams assemble on short notice, and their members, who are from different specialties and backgrounds, may not train regularly together or even know each other beforehand. And yet, they have to perform high-risk procedures and make high stake decisions, in a time-sensitive manner. The airline industry has long recognized the role of team training and non-technical skills (NTS) in reducing hazards. The implementation of the so called crew resource management or crisis resource management (CRM) has significantly made airline travel safer and the transposition to the medical context, with specific training in non-technical skills, has also brought great benefits. In fact, it is clear that adoption of non-technical skills (NTS) in healthcare has led to an increase in patient safety. In this narrative review we recapitulate some of the key non-technical skills and their relevance in trauma, with a focus on both the emergency department (ER) and the operating room (OR) teams, as well as on the transition of care from one to the other. Also, we explore the use of debriefing the team, as well as the roles of NTS training in both undergraduate and postgraduate settings. We review some of the existing trauma training courses and their roles in developing NTS. Finally, we briefly address the challenges posed by the development of trauma hybrid operating rooms.
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Affiliation(s)
- Henrique Alexandrino
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Department of Surgery, Coimbra University Hospital Center, Coimbra, Portugal
- Lusitanian Association for Trauma and Emergency Surgery, Coimbra, Portugal
| | - Bárbara Martinho
- Department of Surgery, Coimbra University Hospital Center, Coimbra, Portugal
| | - Luís Ferreira
- Lusitanian Association for Trauma and Emergency Surgery, Coimbra, Portugal
- Hospital Dr. Nélio Mendonça, Funchal, Madeira, Portugal
| | - Sérgio Baptista
- Lusitanian Association for Trauma and Emergency Surgery, Coimbra, Portugal
- Medio Tejo Hospital Center, Tomar, Portugal
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Abstract
Virtual simulation (VS) education involves the use of virtual reality, augmented reality, mixed reality and screen-based platforms, collectively referred to as extended reality, to provide education and assessment. This novel simulation modality supports experiential learning and increases access to practice opportunities, supplementing manikin-based simulation. VS has been used successfully for neonatal resuscitation training in high and low resource settings. Virtual simulators can be used to objectively assess learner performance in neonatal resuscitation knowledge and skills. When implementing VS for neonatal resuscitation training, key considerations include matching learning objectives with suitable technology, pre-session preparation, supporting learners, and debriefing. Additional research is needed to evaluate the impact of VS applications on clinical practice and patient outcomes.
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Bhangu A, Notario L, Pinto RL, Pannell D, Thomas-Boaz W, Freedman C, Tien H, Nathens AB, da Luz L. Closed loop communication in the trauma bay: identifying opportunities for team performance improvement through a video review analysis. CAN J EMERG MED 2022; 24:419-425. [PMID: 35412259 PMCID: PMC9002216 DOI: 10.1007/s43678-022-00295-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/09/2022] [Indexed: 01/17/2023]
Abstract
Objectives Communication among trauma team members in the trauma bay is vulnerable to errors, which may impact patient outcomes. We used the previously validated trauma-non-technical skills (T-NOTECHS) tool to identify communication gaps during patient management in the trauma bay and to inform development strategies to improve team performance. Methods Two reviewers independently assessed non-technical skills of team members through video footage at Sunnybrook Health Sciences Centre. Team performance was measured using T-NOTECHS across five domains using a five-point Likert scale (lower score indicating worse performance): (1) leadership; (2) cooperation and resource management; (3) communication and interaction; (4) assessment and decision making; (5) situation awareness/coping with stress. Secondary outcomes assessed the number of callouts, closed loop communications and parallel conversations. Results The study included 55 trauma activations. Injury severity score (ISS) was used as a measure of trauma severity. A case with an ISS score ≥ 16 was considered severe. ISS was ≥ 16 in 37% of cases. Communication and interaction scored significantly lower compared to all other domains (p < 0.0001). There were significantly more callouts and completed closed loop communications in more severe cases compared to less severe cases (p = 0.017 for both). Incomplete closed loop communications and parallel conversations were identified, irrespective of case severity. Conclusion A lower communication score was identified using T-NOTECHS, attributed to incomplete closed loop communications and parallel conversations. Through video review of trauma team activations, opportunities for improvement in communication can be identified by the T-NOTECHS tool, as well as specifically identifying callouts and closed loop communication. This process may be useful for trauma programs as part of a quality improvement program on communication skills and team performance. Supplementary Information The online version contains supplementary material available at 10.1007/s43678-022-00295-z.
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Affiliation(s)
- Avneesh Bhangu
- School of Medicine, Faculty of Health Sciences, Queen's University, Unit 505 - 91 King Street East, Kingston, ON, K7L 2Z8, Canada.
| | - Lowyl Notario
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Ruxandra L Pinto
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Dylan Pannell
- Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Will Thomas-Boaz
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Corey Freedman
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Homer Tien
- Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,, Ornge, Mississauga, ON, Canada
| | - Avery B Nathens
- Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Luis da Luz
- Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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5
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Wong AH, Ahmed RA, Ray JM, Khan H, Hughes PG, McCoy CE, Auerbach MA, Barach P. Supporting the Quadruple Aim Using Simulation and Human Factors During COVID-19 Care. Am J Med Qual 2021; 36:73-83. [PMID: 33830094 PMCID: PMC8030878 DOI: 10.1097/01.jmq.0000735432.16289.d2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The health care sector has made radical changes to hospital operations and care delivery in response to the coronavirus disease (COVID-19) pandemic. This article examines pragmatic applications of simulation and human factors to support the Quadruple Aim of health system performance during the COVID-19 era. First, patient safety is enhanced through development and testing of new technologies, equipment, and protocols using laboratory-based and in situ simulation. Second, population health is strengthened through virtual platforms that deliver telehealth and remote simulation that ensure readiness for personnel to deploy to new clinical units. Third, prevention of lost revenue occurs through usability testing of equipment and computer-based simulations to predict system performance and resilience. Finally, simulation supports health worker wellness and satisfaction by identifying optimal work conditions that maximize productivity while protecting staff through preparedness training. Leveraging simulation and human factors will support a resilient and sustainable response to the pandemic in a transformed health care landscape.
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Affiliation(s)
- Ambrose H. Wong
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
| | - Rami A. Ahmed
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Jessica M. Ray
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
| | - Humera Khan
- Department of Internal Medicine, Central Michigan University College of Medicine, Mount Pleasant, MI
| | - Patrick G. Hughes
- Department of Emergency Medicine, Florida Atlantic University College of Medicine, Boca Raton, FL
| | | | - Marc A. Auerbach
- Department of Pediatrics, Yale School of Medicine, New Haven, CT
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
| | - Paul Barach
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI
- College of Population Health, Thomas Jefferson University, Philadelphia, PA
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6
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Design, build, train, excel: using simulation to create elite trauma systems. Int Anesthesiol Clin 2021; 59:58-66. [DOI: 10.1097/aia.0000000000000312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Catchpole K, Bowie P, Fouquet S, Rivera J, Hignett S. Frontiers in human factors: embedding specialists in multi-disciplinary efforts to improve healthcare. Int J Qual Health Care 2021; 33:13-18. [PMID: 32901812 PMCID: PMC7499639 DOI: 10.1093/intqhc/mzaa108] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/19/2020] [Accepted: 09/02/2020] [Indexed: 01/26/2023] Open
Abstract
Despite the application of a huge range of human factors (HF) principles in a growing range of care contexts, there is much more that could be done to realize this expertise for patient benefit, staff well-being and organizational performance. Healthcare has struggled to embrace system safety approaches, misapplied or misinterpreted others, and has stuck to a range of outdated and potentially counter-productive myths even has safety science has developed. One consequence of these persistent misunderstandings is that few opportunities exist in clinical settings for qualified HF professionals. Instead, HF has been applied by clinicians and others, to highly variable degrees-sometimes great success, but frequently in limited and sometimes counter-productive ways. Meanwhile, HF professionals have struggled to make a meaningful impact on frontline care and have had little career structure or support. However, in the last few years, embedded clinical HF practitioners have begun to have considerable success that are now being supported and amplified by professional networks. The recent coronavirus disease of 2019 (COVID-19) experiences confirm this. Closer collaboration between healthcare and HF professionals will result in significant and ultimately beneficial changes to both professions and clinical care.
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Affiliation(s)
- Ken Catchpole
- Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Paul Bowie
- NHS Education for Scotland, Institute of Health and Wellbeing, University of Glasgow G12 8RZ, UK
| | - Sarah Fouquet
- Improvement Institue, Children’s Mercy Hospital, Kansas City, MO, USA
| | - Joy Rivera
- Patient Relations & Spiritual Services, Froedtert Hospital, Milwaukee, WI, USA
| | - Sue Hignett
- Loughborough Design School, Loughborough University LE11 3TU, UK
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8
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Abstract
Resident education in emergency medicine (EM) relies upon a variety of teaching platforms and mediums, including real-life clinical scenarios, simulation, academic day (lectures, small group sessions), journal clubs, and teaching learners. However, the coronavirus disease 2019 (COVID-19) pandemic has disrupted teaching and learning, forcing programs to adapt to ensure residents can progress in their training.1 Suddenly, academic days cannot be held in person, emergency department (ED) volumes are dynamically changing, and the role of residents in ED procedures has been questioned. Furthermore, medical student rotations through the ED have been cancelled, decreasing resident exposure to undergraduate teaching. These changes to resident education threaten resident wellness and will have downstream effects on training and personal professional development. In response, programs must develop strategies to ensure that residents continue receiving high-quality training in a safe learning environment. In this review, we will cover recommended strategies put forth by two large EM programs in Ontario (Table 1).
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Wong AH, Ray JM, Auerbach MA, Venkatesh AK, McVaney C, Burness D, Chmura C, Saxa T, Sevilla M, Flood CT, Patel A, Whitfill T, Dziura JD, Yonkers KA, Ulrich A, Bernstein SL. Study protocol for the ACT response pilot intervention: development, implementation and evaluation of a systems-based Agitation Code Team (ACT) in the emergency department. BMJ Open 2020; 10:e036982. [PMID: 32606062 PMCID: PMC7328814 DOI: 10.1136/bmjopen-2020-036982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Emergency department (ED) visits for behavioural conditions are rising, with 1.7 million associated episodes of patient agitation occurring annually in acute care settings. When de-escalation techniques fail during agitation management, patients are subject to use of physical restraints and sedatives, which are associated with up to 37% risk of hypotension, apnoea and physical injuries. At the same time, ED staff report workplace violence due to physical assaults during agitation events. We recently developed a theoretical framework to characterise ED agitation, which identified teamwork as a critical component to reduce harm. Currently, no structured team response protocol for ED agitation addressing both patient and staff safety exists. METHODS AND ANALYSIS Our proposed study aims to develop and implement the agitation code team (ACT) response intervention, which will consist of a standardised, structured process with defined health worker roles/responsibilities, work processes and clinical protocols. First, we will develop the ACT response intervention in a two-step design loop; conceptual design will engage users in the creation of the prototype, and iterative refinement will occur through in situ simulated agitated patient encounters in the ED to assess and improve the design. Next, we will pilot the intervention in the clinical environment and use a controlled interrupted time series design to evaluate its effect on our primary outcome of patient restraint use. The intervention will be considered efficacious if we effectively lower the rate of restraint use over a 6-month period. ETHICS AND DISSEMINATION Ethical approval by the Yale University Human Investigation Committee was obtained in 2019 (HIC #2000025113). Results will be disseminated through peer-reviewed publications and presentations at scientific meetings for each phase of the study. If this pilot is successful, we plan to formally integrate the ACT response intervention into clinical workflows at all EDs within our entire health system.
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Affiliation(s)
- Ambrose H Wong
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Jessica M Ray
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Marc A Auerbach
- Department of Pediatrics and Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Arjun K Venkatesh
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Caitlin McVaney
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Danielle Burness
- Department of Emergency Medicine, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Christopher Chmura
- Department of Emergency Medicine, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Thomas Saxa
- Department of Emergency Medicine, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Mark Sevilla
- Department of Emergency Medicine, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Colin T Flood
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Amitkumar Patel
- Department of Emergency Medicine, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Travis Whitfill
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - James D Dziura
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States
| | - Kimberly A Yonkers
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States
- Departments of Psychiatry and Obstetrics & Gynecology, Yale University, New Haven, Connecticut, USA
| | - Andrew Ulrich
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Steven L Bernstein
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States
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10
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Dieckmann P, Torgeirsen K, Qvindesland SA, Thomas L, Bushell V, Langli Ersdal H. The use of simulation to prepare and improve responses to infectious disease outbreaks like COVID-19: practical tips and resources from Norway, Denmark, and the UK. Adv Simul (Lond) 2020; 5:3. [PMID: 32308988 PMCID: PMC7160610 DOI: 10.1186/s41077-020-00121-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/03/2020] [Indexed: 11/10/2022] Open
Abstract
In this paper, we describe the potential of simulation to improve hospital responses to the COVID-19 crisis. We provide tools which can be used to analyse the current needs of the situation, explain how simulation can help to improve responses to the crisis, what the key issues are with integrating simulation into organisations, and what to focus on when conducting simulations. We provide an overview of helpful resources and a collection of scenarios and support for centre-based and in situ simulations.
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Affiliation(s)
- Peter Dieckmann
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for Human Resources and Education, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, Opg. 1 - 25th floor, DK-2730 Herlev, Capital Region of Denmark Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - Kjetil Torgeirsen
- Stavanger Acute Medicine Foundation for Education and Research (SAFER), Stavanger, Norway
| | - Sigrun Anna Qvindesland
- Stavanger Acute Medicine Foundation for Education and Research (SAFER), Stavanger, Norway
- Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - Libby Thomas
- Emergency Department, Kings College Hospital NHS Foundation Trust, London, UK
- The Blizard Institute, Queen Mary University, London, UK
| | - Verity Bushell
- Postgraduate Medical and Dental Education Department, Kings College London, Denmark Hill, London, UK
| | - Hege Langli Ersdal
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway
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11
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Bentley S, Stapleton SN, Moschella PC, Ray JM, Zucker SM, Hernandez J, Rosenman ED, Wong AH. Barriers and Solutions to Advancing Emergency Medicine Simulation-based Research: A Call to Action. AEM EDUCATION AND TRAINING 2020; 4:S130-S139. [PMID: 32072117 PMCID: PMC7011408 DOI: 10.1002/aet2.10406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/04/2019] [Accepted: 10/24/2019] [Indexed: 05/08/2023]
Abstract
Simulation technology has successfully improved patient safety and care quality through training and assessment of individuals, teams, and health care systems. Emergency medicine (EM) continues to be a leader and pioneer of simulation, including administration of simulation-based fellowships and training programs. However, EM simulation-based research has been limited by low rates of publication and poor methodologic rigor. The Society for Academic Emergency Medicine (SAEM) Simulation Academy is leading efforts to improve the quality of scholarship generated by the EM simulation community and to foster successful research careers for future generations of EM simulationists. Through a needs assessment survey of our membership and a year-long consensus-based approach, we identified two main clusters of barriers to simulation-based research: lack of protected time and dedicated resources and limited training and mentorship. As a result, we generated four position statements with implications for education, training, and research in EM simulation and as a call to action for the academic EM community. Recommendations include expansion of funding opportunities for simulation-based research, creation of multi-institutional simulation collaboratives, and development of mentorship and training pathways that promote rigor in design and methodology within EM simulation scholarship.
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Affiliation(s)
- Suzanne Bentley
- Departments of Emergency Medicine and Medical EducationIcahn School of Medicine at Mount SinaiNew YorkNY
- NYC Health + Hospital/ElmhurstElmhurstNY
| | | | | | - Jessica M. Ray
- Department of Emergency MedicineYale School of MedicineNew HavenCT
| | | | - Jessica Hernandez
- Department of Emergency MedicineUniversity of Texas Southwestern Medical CenterDallasTX
| | - Elizabeth D. Rosenman
- Department of Emergency MedicineUniversity of Washington School of MedicineSeattleWA
| | - Ambrose H. Wong
- Department of Emergency MedicineYale School of MedicineNew HavenCT
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12
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Sauter TC, Exadaktylos A, Krummrey G, Lehmann B, Brodmann-Maeder M, Hautz WE. Development, implementation and first insights of a time- and location-independent longitudinal postgraduate curriculum in emergency medicine. GMS JOURNAL FOR MEDICAL EDUCATION 2018; 35:Doc44. [PMID: 30539070 PMCID: PMC6278235 DOI: 10.3205/zma001190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 07/01/2018] [Accepted: 09/25/2018] [Indexed: 05/17/2023]
Abstract
Introduction, background and context: There have been few reports on the implementation of a structured curriculum for emergency medicine, as emergency medicine is not yet an established medical specialty for training in many European countries, including Switzerland and Germany. Because of the non-plannable workload in the emergency setting, common training approaches are often difficult to implement. Need-assessments of emergency medicine trainees commonly identify a need for interactive, time-independent ways of learning that integrate modern forms of knowledge transfer. Methods: In the present study, we assess the local needs of emergency medicine specialists and trainees for a curriculum in emergency medicine and elaborate possible solutions for the implementation of this curriculum, taking into account the special needs in a highly dynamic, unplannable environment, such as an interdisciplinary emergency department. Results: We describe the development of the emergency medicine curriculum on the basis of the six steps proposed by Kern for curriculum development in medical education, as well as the implementation, lessons learned and interval evaluation. Conclusions: The combination of multiple teaching formats, ranging from time- and location-independent solutions such as podcasted lectures to simulation-based training sessions, as well as small-group workshops and skill training sessions, might be a valuable approach to implementing a state-of-the-art curriculum in a busy emergency department.
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Affiliation(s)
- Thomas C. Sauter
- University of Bern, Bern University Hospital, Inselspital, Department of Emergency Medicine, Bern, Switzerland
- *To whom correspondence should be addressed: Thomas C. Sauter, University of Bern, Bern University Hospital, Inselspital, Department of Emergency Medicine, Freiburgstrasse 16C, CH-3010 Bern, Switzerland, Phone: +41 31 632 2111, E-mail:
| | - Aristomenis Exadaktylos
- University of Bern, Bern University Hospital, Inselspital, Department of Emergency Medicine, Bern, Switzerland
| | - Gert Krummrey
- University of Bern, Bern University Hospital, Inselspital, Department of Emergency Medicine, Bern, Switzerland
| | - Beat Lehmann
- University of Bern, Bern University Hospital, Inselspital, Department of Emergency Medicine, Bern, Switzerland
| | - Monika Brodmann-Maeder
- University of Bern, Bern University Hospital, Inselspital, Department of Emergency Medicine, Bern, Switzerland
| | - Wolf E. Hautz
- University of Bern, Bern University Hospital, Inselspital, Department of Emergency Medicine, Bern, Switzerland
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