Remote US skills can be taught equally effectively by using a variety of telemedicine technologies. Smartphones represent a viable option for US training in resource-challenged settings.

No abstract

Simulation is an important training tool used in a variety of influential fields. However, development of simulation scenarios - the key component of simulation – occurs in isolation; sharing of scenarios is almost non-existent. This can make simulation use a costly task in terms of the resources and time and the possible redundancy of efforts. To alleviate these issues, the goal is to strive for an open communication of practice (CoP) surrounding simulation. To facilitate this goal, this report describes a set of guidelines for writing technical reports about simulation use for educating health professionals. Using an accepted set of guidelines will allow for homogeneity when building simulation scenarios and facilitate open sharing among simulation users. In addition to optimizing simulation efforts in institutions that are currently using simulation as an educational tool, the development of such a repository may have direct implications on developing countries, where simulation is only starting to be used systematically. Our project facilitates equivalent and global access to information, knowledge, and highest-caliber education - in this context, simulation – collectively, the building blocks of optimal healthcare.

ObjectivesTo examine perceived communication barriers between urban consultants and rural family physicians practising routine and emergency care in remote subarctic Newfoundland and Labrador (NL).DesignThis study used a mixed-methods design. Quantitative and qualitative data were collected through exploratory surveys, comprised of closed and open-ended questions. The quantitative data was analysed using comparative statistical analyses, and a thematic analysis was applied to the qualitative data.Participants52 self-identified rural family physicians and 23 urban consultants were recruited via email. Rural participants were also recruited at the Family Medicine Rural Preceptor meetings in St John's, NL.SettingRural family physicians and urban consultants in NL completed a survey assessing perceived barriers to effective communication.ResultsData confirmed that both groups perceived communication difficulties with one another; with 23.1% rural and 27.8% urban, rating the difficulties as frequent (p=0.935); 71.2% rural and 72.2% urban as sometimes (p=0.825); 5.8% rural and 0% urban acknowledged never perceiving difficulties (p=0.714). Overall, 87.1% of participants indicated that perceived communication difficulties impacted patient care. Primary trends that emerged as perceived barriers for rural physicians were time constraints and misunderstanding of site limitations. Urban consultants' perceived barriers were inadequate patient information and lack of native language skills.ConclusionsBarriers to effective communication are perceived between rural family physicians and urban consultants in NL.

Introduction / Innovation Concept: Skillful performance is central to the provision of quality healthcare. Well-organized, deliberate practice with instruction and feedback leads to the best learning and patient outcomes. Professionals in rural/remote locations often face significant challenges in maintaining procedural proficiency and delivering acute care medical services. This is especially important with low-frequency high-stakes procedures. Simulation can play an important role in skills maintenance but limited access to simulation labs and resources in rural areas due to time, cost and distance are often prohibitive. Mobile telesimulation has the potential to facilitate high-quality instruction and overcome these barriers. Our goal is to develop a mobile simulation unit (MSU) that uses acute-care telemedicine mentoring techniques to meet the needs of rural physicians. Methods: The MSU design process is a prototype development series with qualitative results from each prototype (A and B) informing design and development of the next. This serves as an assessment of the functionality and set-up of the MSU for housing the simulation equipment/mannequin and providing an acceptable learning environment. The final design (C) will be evaluated for educational effectiveness. Medical students will be taught endotracheal intubation on a mannequin in the MSU under one of 2 conditions. The experimental group will receive instruction, demonstration and feedback from an expert in the telesimulation lab at Memorial University. The control group will receive the same instructions and feedback face-to-face from an expert located in the MSU. Participants will complete a retention test 1 week after the intervention. Performance between the 2 groups will be compared and user satisfaction will be assessed. Curriculum, Tool, or Material: The MSU will be a portable, inflatable structure equipped with telecommunication equipment to provide efficient interaction between the rural/remote learner and their instructor at a different site. The design and components of the MSU will facilitate easy transport and deployment for telesimulation in rural/remote areas. A combination of fixed and wearable cameras will facilitate instruction, demonstration and feedback to the learner. Conclusion: Mobile telesimulation may play an important role in overcoming the barriers of geography, cost and access to expert instruction. Implications of this research are far reaching and extend beyond healthcare education and training.