1
|
Bray L, Krogh TB, Østergaard D. Simulation-based training for continuing professional development within a primary care context: a systematic review. EDUCATION FOR PRIMARY CARE 2023; 34:64-73. [PMID: 36730551 DOI: 10.1080/14739879.2022.2161424] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Given the increasing complexity of tasks transferred to primary care, discipline-specific educational opportunities are required for those working within this context. Simulation-based training (SBT) is widely applied within a hospital setting, underpinned by extensive research. However, little is known about the transfer of simulations' utility to primary care. This systematic review sought to determine which SBT approaches are adopted for continuing professional development within primary care and appraise their impact. METHODS Medline, Embase, CINAHL and Web of Science databases were searched, with additional articles obtained through secondary searching. Eligible studies employed and evaluated a simulation-based educational intervention for fully qualified healthcare professionals, working within primary care. Included studies were quality assessed using the Mixed Methods Appraisal Tool (v18) and their findings narratively synthesised. RESULTS Forty-nine studies were included, sampling 4,601 primary care health professionals. Studies primarily adopted a quantitative design and demonstrated variable quality. Simulation approaches comprised standardised patients (n = 21), role-play (n = 14), virtual (n = 6), manikin (n = 5) and mixed manikin/standardised patients (n = 3). Efficacy was evaluated across Kirkpatrick levels and demonstrated a positive impact for knowledge-, skills- and attitude-based outcomes, though this was limited in select studies. DISCUSSION SBT has been adopted in the education of the spectrum of health professionals working within primary care, with the most common approach being standardised patients. Simulation delivers an acceptable and effective educational method, demonstrating a positive impact across various learning objectives. Further research assessing the impact at an organisational- and patient-level is required.
Collapse
Affiliation(s)
- Lucy Bray
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR and Education, Copenhagen, Denmark
| | - Tobias Browall Krogh
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR and Education, Copenhagen, Denmark
| | - Doris Østergaard
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR and Education, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
2
|
Tavares W, Piquette D, Luong D, Chiu M, Dyte C, Fraser K, Clark M. Exploring the Study of Simulation as a Continuing Professional Development Strategy for Physicians. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2022; 43:188-197. [PMID: 36728972 DOI: 10.1097/ceh.0000000000000470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Practicing physicians have the responsibility to engage in lifelong learning. Although simulation is an effective experiential educational strategy, physicians seldom select it for continuing professional development (CPD) for reasons that are poorly understood. The objective of this study was to explore existing evidence on simulation-based CPD and the factors influencing physicians' engagement in simulation-based CPD. METHODS A scoping review of the literature on simulation-based CPD included MEDLINE, Embase, and CINAHL databases. Studies involving the use of simulation for practicing physicians' CPD were included. Information related to motivations for participating in simulation-based CPD, study objectives, research question(s), rationale(s), reasons for using simulation, and simulation features was abstracted. RESULTS The search yielded 8609 articles, with 6906 articles undergoing title and abstract screening after duplicate removal. Six hundred sixty-one articles underwent full-text screening. Two hundred twenty-five studies (1993-2021) were reviewed for data abstraction. Only four studies explored physicians' motivations directly, while 31 studies described incentives or strategies used to enroll physicians in studies on simulation-based CPD. Most studies focused on leveraging or demonstrating the utility of simulation for CPD. Limited evidence suggests that psychological safety, direct relevance to clinical practice, and familiarity with simulation may promote future engagement. DISCUSSION Although simulation is an effective experiential educational method, factors explaining its uptake by physicians as a CPD strategy are unclear. Additional evidence of simulation effectiveness may fail to convince physicians to participate in simulation-based CPD unless personal, social, educational, or contextual factors that shape physicians' motivations and choices to engage in simulation-based CPD are explored.
Collapse
Affiliation(s)
- Walter Tavares
- Dr. Tavares: Assistant Professor and Scientist, Wilson Centre for Health Professions Education, Temerty Faculty of Medicine, Institute for Health Policy Management and Evaluation, University Health Network, University of Toronto, Toronto, Ontario, Canada, and York Region Paramedic and Senior Services, Community Health Services Department, Regional Municipality of York, Newmarket Ontario, Canada. Dr. Piquette: Assistant Professor, Inter-Department Division of Critical Care Medicine, University of Toronto, Staff Physician, Sunnybrook Health Sciences Centre, Centre Researcher, The Wilson Centre, Toronto, Ontario, Canada. Ms. Luong: Research Associate II, KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada. Dr. Chiu: Associate Professor, Department of Anesthesiology and Pain Medicine, Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. Dr. Dyte: Clinical Lecturer and Anesthesiologist, Department of Anesthesia, Perioperative and Pain Medicine, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada. Dr. Fraser: Clinical Professor of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Dr. Clark: Clinical Associate Professor of Surgery, Cumming School of Medicine University of Calgary, Calgary, Alberta, Canada
| | | | | | | | | | | | | |
Collapse
|
3
|
Eismann H, Breuer G, Flentje M. Further development of crew resource management training : Needs assessment by means of teamwork-context analysis in anesthesia and intensive care teams. DIE ANAESTHESIOLOGIE 2022; 71:180-189. [PMID: 35925183 PMCID: PMC9266080 DOI: 10.1007/s00101-022-01170-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 06/05/2022] [Accepted: 06/13/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Teams in anesthesia and intensive care work as high responsibility teams (HRT). Success in this environment partly depends on the use of nontechnical skills which can be learned through simulation-based training. A teamwork context analysis could help to identify training requirements for crew resource management training. MATERIAL AND METHODS We used a multicentric observational cross-sectional study design utilizing survey methodology to evaluate the teamwork context of different work environments, using the 62-item TAKAI inventory. We surveyed anesthesia and intensive care staff from nine hospitals in Germany which provide varying levels of care. RESULTS In total, 128 people (44.5% male, 53.9% female) from 9 German hospitals participated in the study. The topics "interconnectedness: departments", "interconnectedness: information flow", "dynamics", "polytely", "velocity of the team's movement", "velocity of system changes", "hierarchy" and "hierarchy: leadership", "shared task mental model", "shared team mental model" and all aspects of the scale "adaptive behaviors" were identified as focal aspects to be implemented into Crew-Resource-Management (CRM) training for the evaluated work environments. CONCLUSION The TAKAI scales meet quality criteria (Cronbach's alpha > 0.6) and are appropriate for use in the analysis of the teamwork environment. The results indicate many similarities between the work contexts surveyed but also slight differences. TAKAI can be an additional method to design an appropriate simulation training program for HRT in anesthesia and intensive care medicine as there does not seem to be a one-size-fits-all simulation concept. For a special focus on the needs of a work context, the easy to perform TAKAI analysis in the needs analysis step is worthwhile.
Collapse
Affiliation(s)
- Hendrik Eismann
- Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Georg Breuer
- REGIOMED Kliniken, Ketschendorfer Straße 33, 96450 Coburg, Germany
| | - Markus Flentje
- Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| |
Collapse
|
4
|
Blaak MJ, Fadaak R, Davies JM, Pinto N, Conly J, Leslie M. Virtual tabletop simulations for primary care pandemic preparedness and response. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2021; 7:487-493. [PMID: 34422296 PMCID: PMC8327409 DOI: 10.1136/bmjstel-2020-000854] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/03/2021] [Indexed: 11/13/2022]
Abstract
Introduction The COVID-19 pandemic prompted widescale use of clinical simulations to improve procedures and practices. We outline our deployment of a virtual tabletop simulation (TTS) method in primary care (PC) clinics across Alberta, Canada. We summarise the quality and safety improvements from this method and report end users’ perspectives on key elements. Methods Our virtual TTS used teleconferencing software alongside digital whiteboards to walk clinic stakeholders through patient scenarios. Participants reviewed and rehearsed their workflows and care practices. The goal was for staff to take ownership over gaps and codesigned solutions. After simulation sessions, follow-up interviews were conducted to collect feedback. Results These sessions helped PC staff identify and codesign solutions for clinical hazards and threats. These included the flow of patients through clinics, communications, redesignation of physical spaces, and adaptation of guidance for cleaning and personal protective equipment use. End users reported sessions provided neutral spaces to discuss practice changes and built confidence in delivering safe care during the pandemic. Discussion TTS has not been extensively deployed to improve clinical practice in outpatient environments. We show how virtual TTS can bridge gaps between knowledge and practice by offering a guided space to rehearse clinical changes. We show that virtual TTS can be used in multiple contexts to help identify hazards, improve safety and build confidence in professional teams adapting to rapid changes in both policies and practices. While our sessions were conducted in Alberta, our results suggest this method may be deployed in other contexts, including low-resource settings.
Collapse
Affiliation(s)
- Marlot Johanna Blaak
- W21C Research and Innovation Centre, University of Calgary, Calgary, Alberta, Canada
| | - Raad Fadaak
- School of Public Policy, University of Calgary, Calgary, Alberta, Canada
| | - Jan M Davies
- W21C Research and Innovation Centre, University of Calgary, Calgary, Alberta, Canada.,Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Nicole Pinto
- School of Public Policy, University of Calgary, Calgary, Alberta, Canada
| | - John Conly
- W21C Research and Innovation Centre, University of Calgary, Calgary, Alberta, Canada.,Departments of Medicine, Microbiology, Immunology and Infectious Diseases, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,Infection Prevention and Control, Alberta Health Services, Calgary, Alberta, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Myles Leslie
- School of Public Policy, University of Calgary, Calgary, Alberta, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
5
|
Malfussi LBHD, Nascimento ERPD, Baptista RCN, Lazzari DD, Martini JG, Hermida PMV. IN SITU SIMULATION IN THE PERMANENT EDUCATION OF THE INTENSIVE CARE NURSING TEAM. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2020-0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to know the perception of nursing professionals about the in situ strategy in continuing education in intensive care. Method: a descriptive, exploratory and qualitative study, conducted with 15 nursing professionals from an Intensive Care Unit. Data was collected from December 2018 to February 2019, by means of semi-structured interviews, after in situ simulations that occurred in the work environment and involving two settings, one on septic shock and the other, cardiorespiratory arrest. For analysis, the collective subject discourse technique was applied using a software program. Results: from the 15 nursing professionals participating in the study, eight were nurses and seven were nursing technicians. Their age varied from 23 to 56 years old and their time in intensive care ranged from two months to 17 years. The in situ simulation was perceived as an opportunity to update and acquire professional knowledge, skills and competencies, especially for those without experience, favoring the gain of self-confidence, communication, decision-making and clinical reasoning. The simulated in situ strategy was also portrayed as a possibility of training in the professional practice and in real time, unlike traditional training, and also, as a safe environment to make mistakes of diverse magnitudes because it is a training setting. Conclusion: the professionals understand the in situ simulation as being valid for professional update and practical learning in a safe setting.
Collapse
|