Enhancing departmental preparedness for COVID-19 using rapid-cycle in-situ simulation

Dharamsi, Alia; Hayman, Kate; Yi, Seung Eun; Chow, Roger; Yee, Cheah Kit; Gaylord, E.; Tawadrous, Davy; Chartier, Lucas B.; Landes, Megan

doi:10.1016/j.jhin.2020.06.020

Cited by 22 publications

(27 citation statements)

References 10 publications

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“…Leveraging simulation as a tool for the rapid dissemination and evaluation of new clinical processes is highly relevant in the realm of knowledge translation, as the mastery achieved by participants translates to improved patient outcomes [ 1 , 11 ]. Simulation-facilitated implementations such as ours offer a chance to work with new concepts in a deliberate way, receiving coaching and feedback from experts and peers to gain comfort and proficiency [ 2 , 3 , 8 ]. This study also illustrates that simulation can be pragmatically implemented even when stripped of technology, mannequins, and training environments.…”

Section: Discussionmentioning

confidence: 99%

“…Simulation is an effective modality for health professions education [ 1 ] and in recent years has emerged as an important tool in Emergency Medicine for knowledge dissemination [ 2 , 3 ], system design [ 4 – 6 ], quality improvement [ 7 , 8 ], and continuing professional development [ 9 – 11 ]. Simulation offers, through deliberate practice, coaching, and feedback, an opportunity for healthcare professionals to undertake mastery learning, improving downstream outcomes that contribute to safer patient care [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Rapid deployment of a virtual simulation curriculum to prepare for critical care triage during the COVID-19 pandemic

et al. 2022

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Background During the COVID-19 pandemic in Ontario, Canada, an Emergency Standard of Care for Major Surge was created to establish a uniform process for the “triage” of finite critical care resources. This proposed departure from usual clinical care highlighted the need for an educational tool to prepare physicians for making and communicating difficult triage decisions. We created a just-in-time, virtual, simulation-based curriculum and evaluated its impact for our group of academic Emergency Physicians. Methods Our curriculum was developed and evaluated following Stufflebeam’s Context-Input-Process–Product model. Our virtual simulation sessions, delivered online using Microsoft Teams, addressed a range of clinical scenarios involving decisions about critical care prioritization (i.e., Triage). Simulation participants completed a pre-course multiple-choice knowledge test and rating scales pertaining to their attitudes about using the Emergency Standard of Care protocol before and 2–4 weeks after participating. Qualitative feedback about the curriculum was solicited through surveys. Results Nine virtual simulation sessions were delivered over 3 weeks, reaching a total of 47 attending emergency physicians (74% of our active department members). Overall, our intervention led to a 36% (95% CI 22.9–48.3%) improvement in participants’ self-rated comfort and attitudes in navigating triage decisions and communicating with patients at the end of life. Scores on the knowledge test improved by 13% (95% CI 0.4–25.6%). 95% of participants provided highly favorable ratings of the course content and similarly indicated that the session was likely or very likely to change their practice. The curriculum has since been adopted at multiple sites around the province. Conclusion Our novel virtual simulation curriculum facilitated rapid dissemination of the Emergency Standard of Care for Major Surge to our group of Emergency Physicians despite COVID-19-related constraints on gathering. The active learning afforded by this method improved physician confidence and knowledge with these difficult protocols. Supplementary Information The online version contains supplementary material available at 10.1007/s43678-022-00280-6.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rapid deployment of a virtual simulation curriculum to prepare for critical care triage during the COVID-19 pandemic

et al. 2022

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“…Several studies utilized ISS to enhance hospital preparedness for the expected surge of COVID-19 patients. These studies identified and tested the readiness of the hospitals for the potential threats and risks imposed by COVID-19 and uncovered areas for improvement and timely staff training in the workplace [27][28][29][30]. Furthermore, the literature reports the advantages of ISS training for airway management of COVID-19 patients conducted for interprofessional teams training in EDs, critical care units, and operating rooms [31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

A Newly Developed Interprofessional In-Situ Simulation-Based Training for Airway Management of COVID-19 Patients: Identification of Challenges and Safety Gaps, and Assessment of the Participants’ Reaction

et al. 2022

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Background: Healthcare providers performing aerosol-generating procedures like airway management are at the highest risk for contamination with coronavirus disease 2019 . We developed an in-situ simulation (ISS) airway management training in confirmed or suspected COVID-19 patients for emergency and anesthesiology staff, evaluated participants' reactions, and identified perceived challenges. Methods:We used a cross-sectional study design incorporating a quantitative questionnaire to describe participants' reaction to the ISS and a qualitative group interview using the plus-delta debriefing modality to explore participants' challenges in acquiring the knowledge and skills required for each learning objective. Data were analyzed using descriptive statistics and deductive content analysis.Results: Two hundred and ninety-nine healthcare providers participated in 62 ISS training sessions. Over 90% of our study participants agreed or strongly agreed that: they understood the learning objectives; the training material appropriately challenged them; the course content was relevant, easy to navigate, and essential; the facilitators' knowledge, teaching, and style were appropriate; the simulation facilities were suitable; and they had ample opportunities to practice the learned skills. The main challenges identified were anticipating difficult airways, preparing intubation equipment, minimizing the number of personnel inside the room, adhering to the proper doffing sequence, preparing needed equipment outside the intubation room, speaking up, and ensuring closed-loop communication. Conclusion:The newly developed ISS training was feasible for busy healthcare practitioners to safely perform airway management procedures for suspected or confirmed COVID-19 patients without affecting bedside care. Anticipation of difficult airways and speaking up were the most frequent challenges identified across all specialties in this study.

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“…A tertiary care center reported using rapid-cycle in situ simulation (ISS) to enhance departmental preparedness for COVID-19. [ 28 ] This simulation model aims to improve teamwork, identify latent safety threats, address informing processes, and guide clinical protocols and care. Participants reported that concerns were addressed after participating in the simulation and ultimately reinforced the significance that rapid-cycle ISS training can meet the need to improve preparedness during pandemics.…”

Section: Simulations and Covid-19mentioning

confidence: 99%

“…Participants reported that concerns were addressed after participating in the simulation and ultimately reinforced the significance that rapid-cycle ISS training can meet the need to improve preparedness during pandemics. [ 28 ]…”

Section: Simulations and Covid-19mentioning

confidence: 99%

A review on the evolution of simulation-based training to help build a safer future

Bienstock¹,

Heuer²

2022

Medicine

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Throughout history, simulation has been used to demonstrate various techniques, acquire skills, and maintain best practices in healthcare. Simulation has evolved significantly, primarily because of the extent to which it can enhance both clinical proficiency and patient care. Although simulation-based training (SBT) in healthcare has grown exponentially in the 21st century, it has been around for centuries. This paper aims to reflect on the history and evolution of simulation in healthcare and review its current applications in order to provide a foundation for developing new applications for future expanded use.

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Enhancing departmental preparedness for COVID-19 using rapid-cycle in-situ simulation

Cited by 22 publications

References 10 publications

Rapid deployment of a virtual simulation curriculum to prepare for critical care triage during the COVID-19 pandemic

Rapid deployment of a virtual simulation curriculum to prepare for critical care triage during the COVID-19 pandemic

A Newly Developed Interprofessional In-Situ Simulation-Based Training for Airway Management of COVID-19 Patients: Identification of Challenges and Safety Gaps, and Assessment of the Participants’ Reaction

A review on the evolution of simulation-based training to help build a safer future

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