The Society in Europe for Simulation Applied to Medicine
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21st Annual Meeting of THE SOCIETY IN EUROPE FOR SIMULATION APPLIED TO MEDICINE 21st Annual Meeting of THE SOCIETY IN EUROPE FOR SIMULATION APPLIED TO MEDICINE THE WATERFRONT | BELFAST | NORTHERN IRELAND | 24–26 JUNE ORAL PRESENTATION ABSTRACTS THE WATERFRONT / BELFAST / NORTHERN IRELAND / 24TH–26TH JUNE / WWW.SESAMBELFAST2015.COM 1 21st Annual Meeting of THE SOCIETY IN EUROPE FOR SIMULATION APPLIED TO MEDICINE KEYNOTES AND STATE OF THE ART LECTURES THE WATERFRONT / BELFAST / NORTHERN IRELAND / 24TH–26TH JUNE / WWW.SESAMBELFAST2015.COM 2 21st Annual Meeting of THE SOCIETY IN EUROPE FOR SIMULATION APPLIED TO MEDICINE Michael Good, M.D. Dean, College of Medicine Professor of Anesthesiology University of Florida Title: Planning for an Unknowable Future Abstract: For several decades, innovative clinician educators have used human patient simulators and related technologies and curricula to help clinicians prepare for rare, unplanned events and situations which threaten the safety of their patients. Prior to the wide-spread adoption of simulator-based education, it was difficult to plan for these unknowable future events. While it is anticipated that active, experiential learning approaches will continue, the highly dynamic state of health care globally makes it is difficult to predict and therefore plan for the as of yet unknowable changes in health care delivery systems and venues, and similarly, the educational strategies that will emerge going forward. The experiential learning theater is one approach that allows the innovative clinician educator the ability to plan for unknowable futures in health care and health care professional education. THE WATERFRONT / BELFAST / NORTHERN IRELAND / 24TH–26TH JUNE / WWW.SESAMBELFAST2015.COM 3 21st Annual Meeting of THE SOCIETY IN EUROPE FOR SIMULATION APPLIED TO MEDICINE Michael Good, M.D. Dean, College of Medicine Professor of Anesthesiology University of Florida Title: Planning for an Unknowable Future Abstract: For several decades, innovative clinician educators have used human patient simulators and related technologies and curricula to help clinicians prepare for rare, unplanned events and situations which threaten the safety of their patients. Prior to the wide-spread adoption of simulator-based education, it was difficult to plan for these unknowable future events. While it is anticipated that active, experiential learning approaches will continue, the highly dynamic state of health care globally makes it is difficult to predict and therefore plan for the as of yet unknowable changes in health care delivery systems and venues, and similarly, the educational strategies that will emerge going forward. The experiential learning theater is one approach that allows the innovative clinician educator the ability to plan for unknowable futures in health care and health care professional education. THE WATERFRONT / BELFAST / NORTHERN IRELAND / 24TH–26TH JUNE / WWW.SESAMBELFAST2015.COM 4 21st Annual Meeting of THE SOCIETY IN EUROPE FOR SIMULATION APPLIED TO MEDICINE State of the art lecture SESAM 205 Presentation Jan-Joost Rethans, Professor of Human Simulation Title Building bridges by using Simulated and Standardized Patients: why would you want to use them? Facts and fantasies about the use of Simulated and Standardized patients as educational tools for the delivery of quality in health care. More than 50 years ago Barrows and Abrahamson introduced the use of ‘the programmed patient’, soon thereafter named the simulated patient. A simulated patient (SP) is defined as a ‘normal person who has been carefully coached to accurately portray the characteristics of a specific patient’. Originally SPs were exclusively used in medical schools but nowadays they are used in many other areas as for example in nursing, physiotherapy, dentistry, pharmacy, dietetics, veterinary medicine and also outside the medical domain. Despite SPs long history and it’s widespread use there are still many issues to be clarified or resolved in the use of SPs. Ignorance about the use of SPs leads to myths and fantasies about SPs, whereas in modern teaching one should focus on facts. Amongst the issues to be clarified in the use of SPs are: where do SPs have a place in simulation?, what is the link between human simulation and non-human simulation?, what is the difference between simulated and standardized patients?; are SPs only useful in the teaching of communication?; how does feedback by SPs compare with feedback of staf?, how does the use of SPs compare to the use of real patients?, and ‘SPs can only be used in small schools, isn’t it?’. In this presentation I will try to get rid of the myths, while beholding some fantasies (one must always have a dream!) but foremost I will focus on the facts and experiences about the use of SPs. I hope I can inspire those of you who are in doubt about introducing SPs to start with them and thus bridge the gap between non-human and human simulation. Finally I hope to show you all that working with SPs and students in an inspiring educational atmosphere is great fun for all! THE WATERFRONT / BELFAST / NORTHERN IRELAND / 24TH–26TH JUNE / WWW.SESAMBELFAST2015.COM 5 21st Annual Meeting of THE SOCIETY IN EUROPE FOR SIMULATION APPLIED TO MEDICINE SESSION 1 THE WATERFRONT / BELFAST / NORTHERN IRELAND / 24TH–26TH JUNE / WWW.SESAMBELFAST2015.COM 6 21st Annual Meeting of THE SOCIETY IN EUROPE FOR SIMULATION APPLIED TO MEDICINE Low fidelity interdisciplinary ward simulation with limited staffing: how feasible and effective is it in undergraduate healthcare training? Authors: Kennedy J 1, Ellis A 1, Berragan E 2, Morgan J 1 Institution: North Bristol Academy, University of Bristol and the University of West England Introduction: It has been shown that 40% of UK medical students feel un-prepared for their foundation jobs. (1) A key reason for this is lack of experience in prioritisation and on-call skills. (2) This has been postulated as a contributing factor to increased death rates in patients presenting when new doctors start in august. (3) (4) Busy on-call shifts often result in friction between nursing and medical teams due to difficulties managing workloads and increased stress levels. Objectives: We have piloted a new collaborative program between Bristol University and the University of the West of England delivering multi-disciplinary ward based simulation teaching to a cohort of 70 final year medical and nursing students. The program aimed to improve prioritisation skills, management of on-call jobs and inter- disciplinary team work. We delivered this with realistic staffing levels to assess the feasibility of rolling the program. Material : A mock ward with eight simulated patients (4 acted 4 Manikin) was created. Medical and nursing students took turns to run the simulated ward together. Observing students acted as patients in the scenario. Facilitators acted in the scenario as a patient’s family member and as a ward manager and medical registrar. Handovers were given to students at the start of each session and between role changes. A maximum of twelve students took part in each half day session. Nursing students assessed patients, referred to the ‘doctor’ and initiating treatment. Medical students worked as the junior doctor on-call; triaging bleeps, undertaking a variety of ward jobs, and managing sick patients. At several ‘time out’ points during the ward simulation all students gathered to discuss issues that emerged and developed suggestions and solutions. Results: Students self-rated their confidence receiving handovers, prioritising tasks, and calling for help, on 10 point likert scales, before and after the simulation. THE WATERFRONT / BELFAST / NORTHERN IRELAND / 24TH–26TH JUNE / WWW.SESAMBELFAST2015.COM 7 21st Annual Meeting of THE SOCIETY IN EUROPE FOR SIMULATION APPLIED TO MEDICINE Students rated the session compared to previous sessions involving multidisciplinary learning. Qualitative data collected from students and staff overwhelmingly suggests that not only is on-call ward simulation an effective way of improving confidence in prioritisation and on-call skills, it is also a preferred method of understanding the roles of allied health care professionals and how to best support each other to promote patient safety. This pilot project also showed the effectiveness of students acting as patients in the scenarios which allowed them a fresh perspective, decreased running costs and promoted humour. This reduced nerves and encouraged a friendly learning environment. Conclusion: We hope to better equip medical and nursing students for the challenges of on-call shifts. By understanding co-workers roles, challenges and limitations we hope to foster more effective interdisciplinary communication and in turn improve patient safety. This project shows that on-call ward simulation is an effective and achievable way of delivering this. References: (1) Goldacre M et al (2003) Preregistration House officers views on whether their experience at medical school prepared them well for their jobs: national questionnaire survey THE WATERFRONT / BELFAST / NORTHERN IRELAND / 24TH–26TH JUNE / WWW.SESAMBELFAST2015.COM 8 21st Annual Meeting of THE SOCIETY IN EUROPE FOR SIMULATION APPLIED TO MEDICINE (2) Illing J et al (2008) How prepared are medical graduates to begin practice, A comparison of three diverse UK medical schools, Final report for the GMC Education Committee, General medical council/northern deanery (p17) (3) Jen M et al (2009) Early in-patient mortality following trainee