GENESISS 1-Generating Standards for In-Situ Simulation project: a scoping review and conceptual model

Assessing the Effectiveness of Simulation-Based Education in Emerging Infectious Disease Management: A Systematic Review and Meta-analysis

SUMMARY STATEMENT

This systematic review and meta-analysis aimed to thoroughly examine the effectiveness of simulation-based education in the management of emerging infectious diseases, focusing on educational content and methods. Studies published between 2000 and 2022 were identified, and a meta-analysis was conducted using a random-effects model. The findings revealed that simulation-based education significantly enhances various competencies related to managing emerging infectious diseases, encompassing cognitive, negative-affective, positive-affective, and psychomotor outcomes. Subgroup analysis indicated that methods effective in improving competencies include the use of equipment with limited or full patient interaction, simulated or in situ settings, and scenarios involving some interruptions by educators or independent participation of trainees. This review underscores the importance of appropriate methodological considerations in simulation-based education, including equipment, settings, and scenario designs, to optimize educational outcomes in the management of emerging infectious diseases.

Translational simulation revisited: an evolving conceptual model for the contribution of simulation to healthcare quality and safety

The simulation community has effectively responded to calls for a more direct contribution by simulation to healthcare quality and safety, and clearer alignment with health service priorities, but the conceptual framing of this contribution has been vague. The term 'translational simulation' was proposed in 2017 as a "functional term for how simulation may be connected directly with health service priorities and patient outcomes, through interventional and diagnostic functions" (Brazil V. Adv Simul. 2:20, 2017). Six years later, this conceptual framing is clearer. Translational simulation has been applied in diverse contexts, affording insights into its strengths and limitations. Three core concepts are identifiable in recently published translational simulation studies: a clear identification of simulation purpose, an articulation of the simulation process, and an engagement with the conceptual foundations of translational simulation practice. In this article, we reflect on current translational simulation practice and scholarship, especially with respect to these three core concepts, and offer a further elaborated conceptual model based on its use to date.

Exploring the safety and quality of mobile X-ray imaging in a new infectious disease biocontainment unit: an in situ simulation and video-reflexive study

OBJECTIVES

During a precommissioning inspection of a new biocontainment centre, radiographers noted structural features of quarantine rooms that could compromise staff and patient safety and the X-ray image quality, even after significant modifications had been made to an earlier radiography protocol. The aim of this study was to explore the safety and effectiveness of the modified protocol, in the new space, and identify improvements, if required.

DESIGN

A qualitative study using in situ simulation and video-reflexive methods.

SETTING

A newly built biocontainment centre, prior to its commissioning in 2021, in a large, tertiary hospital in Sydney, Australia.

PARTICIPANTS

Five radiographers, and a nurse and a physician from the biocontainment centre, consented to participate. All completed the study.

INTERVENTIONS

Two simulated mobile X-ray examinations were conducted in the unit prior to its commissioning; simulations were videoed. Participants and other stakeholders analysed video footage, collaboratively, and sessions were audio recorded, transcribed and analysed thematically. Problems and potential solutions identified were collated and communicated to the hospital executive, for endorsement and actioning, if possible.

RESULTS

Four themes were identified from the data: infection exposure risks, occupational health and exposure risks, communication and X-ray image quality. Facilitated group reviews of video footage identified several important issues, across these four areas of risk, which had not been identified previously.

CONCLUSIONS

In situ simulation is used, increasingly, to evaluate and improve healthcare practices. This study confirmed the added value of video-reflexive methods, which provided experienced participants with a richer view of a familiar protocol, in a new setting. Video footage can be examined immediately, or later if required, by a broader group of stakeholders, with diverse experience or expertise. Using video reflexivity, clinicians identified potential safety risks, which were collated and reported to the hospital executive, who agreed to implement modifications.

Faculty development for translational simulation: a qualitative study of current practice

BACKGROUND

Translational simulation is focused directly on healthcare quality, safety, and systems. Effective translational simulation design and delivery may require knowledge and skills in areas like quality improvement and safety science. How translational simulation programs support their faculty to learn these skills is unknown. We aimed to explore current faculty development practices within translational simulation programs, and the rationale for the approaches taken.

METHODS

We used a qualitative approach to explore faculty development in translational simulation programs. We conducted semi-structured interviews with representatives who have leadership and/or faculty development responsibilities in these programs and performed a thematic analysis of the data.

RESULTS

Sixteen interviews were conducted with translational simulation program leaders from nine countries. We identified three themes in our exploration of translational simulation faculty development practices: (1) diverse content, (2) 'home-grown', informal processes, and (3) the influence of organisational context. Collaboration beyond the historical boundaries of the healthcare simulation community was an enabler across themes.

CONCLUSION

Leaders in translational simulation programs suggest a diverse array of knowledge and skills are important for translational simulation faculty and report a range of informal and formal approaches to the development of these skills. Many programs are early in the development of their approach to faculty development, and all are powerfully influenced by their context; the program aims, structure, and strategy.

Recommendations for embedding simulation in health services

Aspirations to achieve quality and safety goals in health services through simulation have led to significant investments in simulation equipment, space and faculty. However, the optimal governance and operational models through which these resources are expertly applied in health services are not known. There is growing evidence supporting 'service' models for simulation. In these models, simulation activities are co-designed and delivered by a team of simulation experts in partnership with health service units, specifically targeting quality and safety goals. Embedded simulation specialist teams working within these programs offer benefits not fully captured by traditional models of health education or by traditional systems for quality and safety.In this article, we explore broad and specific recommendations for establishing a simulation consultancy service within an Australian metropolitan health service. We base these recommendations on a review of current Australian practice and healthcare simulation literature, and on a specific example within a large outer metropolitan health service. The broad domains discussed include (1) governance and leadership; (2) human resources; (3) principles and planning; (4) operationalise and evaluate and (5) look to the future.The recommendations recognise that healthcare simulation is moving beyond solely addressing individual learning outcomes. The value of simulation addressing organisation and system objectives through various simulation modalities is increasingly being explored and demonstrating value. There is a growing demand for translational simulation in these contexts, and a consequent requirement for organisations to consider how simulation services can be successfully operationalised. Recommendations included in this paper are discussed and described with the intent of facilitating a deeper appreciation of the complexities associated with, and opportunities afforded by, a well-integrated simulation service.

GENESISS 2-Generating Standards for In-Situ Simulation project: a systematic mapping review

BACKGROUND

In-situ simulation is increasingly employed in healthcare settings to support learning and improve patient, staff and organisational outcomes. It can help participants to problem solve within real, dynamic and familiar clinical settings, develop effective multidisciplinary team working and facilitates learning into practice. There is nevertheless a reported lack of a standardised and cohesive approach across healthcare organisations. The aim of this systematic mapping review was to explore and map the current evidence base for in-situ interventions, identify gaps in the literature and inform future research and evaluation questions.

METHODS

A systematic mapping review of published in-situ simulation literature was conducted. Searches were conducted on MEDLINE, EMBASE, AMED, PsycINFO, CINAHL, MIDIRS and ProQuest databases to identify all relevant literature from inception to October 2020. Relevant papers were retrieved, reviewed and extracted data were organised into broad themes.

RESULTS

Sixty-nine papers were included in the mapping review. In-situ simulation is used 1) as an assessment tool; 2) to assess and promote system readiness and safety cultures; 3) to improve clinical skills and patient outcomes; 4) to improve non-technical skills (NTS), knowledge and confidence. Most studies included were observational and assessed individual, team or departmental performance against clinical standards. There was considerable variation in assessment methods, length of study and the frequency of interventions.

CONCLUSIONS

This mapping highlights various in-situ simulation approaches designed to address a range of objectives in healthcare settings; most studies report in-situ simulation to be feasible and beneficial in addressing various learning and improvement objectives. There is a lack of consensus for implementing and evaluating in-situ simulation and further studies are required to identify potential benefits and impacts on patient outcomes. In-situ simulation studies need to include detailed demographic and contextual data to consider transferability across care settings and teams and to assess possible confounding factors. Valid and reliable data collection tools should be developed to capture the complexity of team and individual performance in real settings. Research should focus on identifying the optimal frequency and length of in-situ simulations to improve outcomes and maximize participant experience.