Training clinician educators to use simulation
technology: a Simulation Educators Course
Victoria Brazil, MBBS, FACEM, Mark Baldwin, MBBS,
Kristy Jackman, B.Nurs, Royal Brisbane Hospital, Herston, Qld, Australia
Introduction
Medical simulation is gaining widespread acceptance as a
useful learning modality in many areas of medical education.1 As technology
continues to advance, simulation hardware has become accessible to more
institutions. However the educational effectiveness of this modality is
dependent on instructional factors such as providing feedback, curriculum
integration and defined outcomes.2
Fig. 1. Simulation technology facilitates team
training in emergency medicine
The preparation and training for clinicians and educators
using this technology is extremely variable. It ranges from strictly technical
education provided by equipment manufacturers, to ‘high end’ CRM instruction
offered by established simulation centers. At many institutions the investment
in this aspect of a simulation program is lacking, resulting in staffing by
enthusiastic amateurs.
Program Objective
How can a targeted intervention assist clinician
educators in preparing for their role as simulation educators?
The objective of the program was to provide clinician
educators with technical and educational experience specific to simulation
modalities, and to provide them with experiences that demonstrate the importance
of learning objectives, learning styles, scenario design, fidelity of clinical
environment and facilitation skills. Significant emphasis in the objectives was
on integration of simulation based learning into existing educational frameworks
and on organizational constraints to curriculum implementation.
The further objective was to model multi-disciplinary
instruction, and use experiential and participatory activities to emulate the
nature of simulation based learning activities that participants will be aiming
to provide with the knowledge gained. Statement of the problem and program
objectives
Fig. 2. Scenarios can be
‘facilitator-led’, requiring patience and timing in knowing when to intervene.
Description of the Program
The program consists of a 2 day workshop, offered to
participants from medical, nursing and paramedical backgrounds. Group size is
limited to ten.
The workshop consists of eight modules.
- Introduction to Crisis Resource Management –
attendees experience a simulation workshop as participants, to reflect upon
and draw conclusions for both their clinical practice and their simulation
educator roles.
- Overview of medical simulation. A review of
principles, concepts and current applications of this learning modality.
- Technical aspects of the mannequin. Designed to
provide educators with insight into the limitations and opportunities of the
hardware and software.
- Creating a clinical environment.
- Principles of medical education. Revision of
adult learning principles and practice as they apply to simulation modalities.
- Scenario development. Principles discussed and
participants design a scenario in small groups.
- Facilitation skills. Experiential session focused
on debriefing skills and small group discussion leading.
- Audiovisual adjuncts. Illustration of the
opportunities for video-assisted review of performance.
Participants are asked to share their plans and aspirations
for incorporating this modality into their existing teaching and learning
activities. This occurs at the beginning of the first day, the beginning of the
second day and at the conclusion of the workshop.
Fig. 3. Specialised equipment and experienced
facilitators are required to make the workshop ‘mobile’.
Evaluation
The workshop has been delivered on site at two institutions – Royal Darwin
Hospital, and the Mt Isa Centre for Rural and Remote Health.
Participants included emergency physicians, anesthesiologists, rural general
practitioners, critical care nursing staff and paramedics.
Participants were asked to complete an evaluation instrument at the
conclusion of the workshop. Specific questions were asked as detailed in
table 1, and opportunity given for free form feedback
Fig 4. Facilitators
need experience in the use of audiovisual adjuncts for performance review
Evaluation Summary (n=20)
Fig. 6 Even
SIMMAN needs time to relax !
Key
lessons learned so far and next steps
Overall the Simulation Educators Course has been very well received. Most
participants either agreed or strongly agreed that the content was relevant
and that the delivery was appropriate and interesting.
Most also felt that the workshop location ‘on site’ and the local group
composition was important. The qualitative feedback expanded further on the
value of working with a group of clinician educators from their own
institution as one of the key elements of the course
Summary
Like simulation technology itself,
appropriate training or accreditation for clinician educators
working in this area is yet to be well established. Our
educationally focused preparatory workshop appears well received by
participants but longer term, and system based outcomes are yet to
be evaluated. This is likely to be part of the ‘future vision’ for
simulation in health care.3
Literature cited
1. Cooper, J.B., Taqueti, V.R.,
A brief history of the
development of mannequin simulators for clinical education and
training. Qual Saf Health Care 2004, 13 (supp 1): i11-i18
2. Issenberg, S.B., McGaglie, W.C.,
Petrusa, E.R., Gordon, D.L., Scalera, R.J., Features and Uses of
High Fidelity medical simualtions that lead to effective learning: a
BEME systematic review. Med Teach., 2005, 27 (1): 10-28.
3. Gaba D.M., The future vision of
simulation in health care. Qual Saf Health Care 2004, 13:
2-10
