scholarly journals Simulation in Canadian postgraduate emergency medicine training – a national survey

CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 132-141 ◽  
Author(s):  
Evan Russell ◽  
Andrew Koch Hall ◽  
Carly Hagel ◽  
Andrew Petrosoniak ◽  
Jeffrey Damon Dagnone ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
National Survey ◽  
Simulation Training ◽  
Survey Question ◽  
Resident Participation ◽  
Residency Programs ◽  
Training Strategy ◽  
Content Assessment ◽  
Simulation Based ◽  
National Organizations

AbstractObjectivesSimulation-based education (SBE) is an important training strategy in emergency medicine (EM) postgraduate programs. This study sought to characterize the use of simulation in FRCPC-EM residency programs across Canada.MethodsA national survey was administered to residents and knowledgeable program representatives (PRs) at all Canadian FRCPC-EM programs. Survey question themes included simulation program characteristics, the frequency of resident participation, the location and administration of SBE, institutional barriers, interprofessional involvement, content, assessment strategies, and attitudes about SBE.ResultsResident and PR response rates were 63% (203/321) and 100% (16/16), respectively. Residents reported a median of 20 (range 0–150) hours of annual simulation training, with 52% of residents indicating that the time dedicated to simulation training met their needs. PRs reported the frequency of SBE sessions ranging from weekly to every 6 months, with 15 (94%) programs having an established simulation curriculum. Two (13%) of the programs used simulation for resident assessment, although 15 (94%) of PRs indicated that they would be comfortable with simulation-based assessment. The most common PR-identified barriers to administering simulation were a lack of protected faculty time (75%) and a lack of faculty experience with simulation (56%). Interprofessional involvement in simulation was strongly valued by both residents and PRs.ConclusionsSBE is frequently used by Canadian FRCPC-EM residency programs. However, there exists considerable variability in the structure, frequency, and timing of simulation-based activities. As programs transition to competency-based medical education, national organizations and collaborations should consider the variability in how SBE is administered.

scholarly journals LO064: Simulation in Canadian postgraduate emergency medicine training — a national survey

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S52-S52 ◽  
Author(s):  
E. Russell ◽  
C. Hagel ◽  
A. Petrosoniak ◽  
D. Howes ◽  
D. Dagnone ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
National Survey ◽  
Simulation Training ◽  
Neonatal Resuscitation ◽  
Residency Programs ◽  
Training Strategy ◽  
Pediatric Resuscitation ◽  
Simulation Based ◽  
Resident Assessment

Introduction: Simulation-based medical education (SBME) is an important training strategy in emergency medicine (EM) postgraduate programs yet the extent of its use is variable. This study sought to characterize the use of simulation in FRCP-EM residency programs across Canada. Methods: A national survey was administered to residents (PGY2-5) and program representatives (PR), either a program director or simulation lead at all Canadian FRPC-EM programs. Residents completed either paper or electronic versions of the survey, and PR surveys were conducted by telephone. Results: The resident and PR response rates were 60% (187/310) and 100% (16/16), respectively. All residency programs offer both manikin-based high fidelity and task trainer simulation modalities. Residents reported a median of 20 (range 0-150) hours participating in simulation training annually, spending a mean of 16% of time in situ, 55% in hospital-based simulation laboratories, and 29% in off-site locations. Only 52% of residents indicated that the time dedicated to simulation training met their training needs. All PRs reported having a formal simulation curriculum with a frequency of simulation sessions ranging from weekly to every 6 months. Only 3/16 (19%) of programs linked their simulation curriculum to their core teaching. Only 2/16 programs (13%) used simulation for resident assessment, though 15/16 (93%) PRs indicated they would be comfortable with simulation-based assessment. The most common PR identified barriers to administering simulation by were a lack of protected faculty time (75%) and a lack of faculty experience with simulation (56%). Both PRs and residents identified a desire for more simulation training in neonatal resuscitation, pediatric resuscitation, and obstetrical emergencies. Multidisciplinary involvement in simulations was strongly valued by both residents and PRs, with 76% of residents indicating that they would like greater multidisciplinary involvement. Conclusion: Among Canadian FRCP-EM residency programs, SBME is a frequently used training modality, however, there exists considerable variability in the structure, frequency and timing of simulation exposure for residents. Several common barriers were identified that impact SBME implementation. The transition to competency-based medical education will require a national, standardized approach to SBME that includes a unified strategy for training and assessment.

scholarly journals LO096: Comfortable with your thoracotomy skills? An innovative simulation-based curriculum to teach rare procedures in emergency medicine

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S63-S63
Author(s):  
S.H. Gray ◽  
J. Owen ◽  
A. Petrosoniak
Keyword(s):  
Emergency Medicine ◽  
Experiential Education ◽  
Deliberate Practice ◽  
Technical Skills ◽  
Skills Training ◽  
Residency Programs ◽  
Ongoing Work ◽  
Life Saving ◽  
Simulation Based ◽  
Technical Skills Training

Introduction / Innovation Concept: Emergency medicine (EM) residents must demonstrate proficiency in several rare, life-saving procedures but few clinical opportunities exist to practice and master these skills. Currently no standardized curricula exist for the instruction of these skills during EM residency. Accordingly, many residents graduate without the experience to perform these critical procedures confidently. We developed a novel, simulation-based curriculum for six rare, life-saving, EM skills that integrates deliberate practice and Kolb’s theory of experiential education. Methods: We used existing EM training objectives and a recent national resident needs assessment to develop a simulation-based technical skills curriculum. The six station curriculum was underpinned by the pedagogical framework of experiential education and deliberate practice. Instructor and participant feedback directed subsequent curriculum modifications. Curriculum, Tool, or Material: This one-day intensive curriculum was successfully implemented at two Canadian EM residency programs for 54 EM residents, from both CCFP-EM and FRCP-EM streams. Participant feedback was highly favorable. An iterative approach to curriculum implementation at two separate residency programs effectively allowed educators to respond to participant needs. Conclusion: A novel simulation-based curriculum for rare procedures in EM is feasible, practical, and highly valued by participants. Ongoing work is underway to refine the curriculum and assess its efficacy in creating competence. Deliberate practice and Kolb’s theory of experiential education provide useful frameworks for technical skills training.

Abstract P38: Just-In-Time Simulation Training Improves ICU Physician Trainee Airway Resuscitation Participation without Compromising Procedural Success or Safety

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Akira Nishisaki ◽  
Shawn Colborn ◽  
Christine Watson ◽  
Dana Niles ◽  
Susan Ferry ◽  
...  
Keyword(s):  
Simulation Training ◽  
Orotracheal Intubation ◽  
Healthcare Research ◽  
Just In Time ◽  
Resident Participation ◽  
Exact Test ◽  
Time Simulation ◽  
Simulation Based ◽  
Physician Trainee ◽  
Procedural Success

Introduction : Competence in orotracheal intubation is a requirement for Pediatric residency. However, opportunities for residents are limited. We hypothesize Just-in-Time simulation-based multi-disciplinary team training for acute airway resuscitation in a pediatric ICU (PICU) would improve physician trainee intubation participation and success, and decrease undesired T racheal I ntubation A ssociated E vents ( TIAE ) such as esophageal intubation, or mainstem intubation. Methods : With IRB approval, on-call residents in a tertiary PICU received 30 minute airway resuscitation multidisciplinary simulation training before 24 hour on-call duties. Airway resuscitation performance was captured in both simulated and real airway resuscitations using a validated airway registry (NEAR-4-KIDS) tool. Resident participation, success, first attempt success, and the incidence of TIAE were compared before and after this intervention (Pre: Jan 2005–Jun11, 2007; Post: Jun12, 2007–May2008). Analysis by time series analysis, and Fisher’s exact test. Results : 150 simulation training sessions were conducted, and 123 consecutive real orotracheal intubations were evaluated. Resident participation significantly increased: Pre 23 % vs Post 36 % (p=0.016). Overall resident airway resuscitation success (58% vs. 68%, p=0.39) and first attempt success (44% vs. 56%, p= 0.30) improvement were not statistically significant. Despite the increased participation by resident trainees, there was no increase in TIAE (23% vs. 21%, p=0.78) in real airway resuscitation. Conclusion : Simulation-based “Just-in-Time” multidisciplinary training for pediatric advanced airway resuscitation improved actual resident trainee participation in real ICU intubations, but did not compromise airway resuscitation procedural success or patient safety. Supported by Agency for Healthcare Research and Quality (AHRQ), and CHOP Endowed Chair, Critical Care Medicine

scholarly journals National Growth in Simulation Training within Emergency Medicine Residency Programs, 2003-2008

2008 ◽  
Vol 15 (11) ◽  
pp. 1113-1116 ◽  
Author(s):  
Yasuharu Okuda ◽  
William Bond ◽  
Gary Bonfante ◽  
Steve McLaughlin ◽  
Linda Spillane ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Simulation Training ◽  
Residency Programs ◽  
National Growth

scholarly journals Simulation-based team training in time-critical clinical presentations in emergency medicine and critical care: a review of the literature

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Jesper Weile ◽  
Mette Amalie Nebsbjerg ◽  
Stig Holm Ovesen ◽  
Charlotte Paltved ◽  
Mads Lind Ingeman
Keyword(s):  
Emergency Medicine ◽  
Cardiac Arrest ◽  
Critical Care ◽  
Simulation Training ◽  
Technical Skills ◽  
Team Training ◽  
Clinical Presentations ◽  
Simulation Based ◽  
Time Critical ◽  
Level 2

Abstract Background The use of simulation-based team training has increased over the past decades. Simulation-based team training within emergency medicine and critical care contexts is best known for its use by trauma teams and teams involved in cardiac arrest. In the domain of emergency medicine, simulation-based team training is also used for other typical time-critical clinical presentations. We aimed to review the existing literature and current state of evidence pertaining to non-technical skills obtained via simulation-based team training in emergency medicine and critical care contexts, excluding trauma and cardiac arrest contexts. Methods This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Before the initiation of the study, the protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database. We conducted a systematic literature search of 10 years of publications, up to December 17, 2019, in the following databases: PubMed/MEDLINE, EMBASE, Cochrane Library, and CINAHL. Two authors independently reviewed all the studies and extracted data. Results Of the 456 studies screened, 29 trials were subjected to full-text review, and 13 studies were included in the final review. None of the studies was randomized controlled trials, and no studies compared simulation training to different modalities of training. Studies were heterogeneous; they applied simulation-training concepts of different durations and intensities and used different outcome measures for non-technical skills. Two studies reached Kirkpatrick level 3. Out of the remaining 11 studies, nine reached Kirkpatrick level 2, and two reached Kirkpatrick level 1. Conclusions The literature on simulation-based team training in emergency medicine is heterogeneous and sparse, but somewhat supports the hypothesis that simulation-based team training is beneficial to teams’ knowledge and attitudes toward non-technical skills (Kirkpatrick level 2). Randomized trials are called for to clarify the effect of simulation compared to other modalities of team training. Future research should focus on the transfer of skills and investigate improvements in patient outcomes (Kirkpatrick level 4).

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