Simulation in Canadian postgraduate emergency medicine training – a national survey

Russell, Elizabeth M.; Hall, Andrew K.; Hagel, Carly; Petrosoniak, Andrew; Dagnone, Jeffrey Damon; Howes, Daniel

doi:10.1017/cem.2017.24

Cited by 37 publications

(39 citation statements)

References 27 publications

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“…At several sites across Canada, this urgency has helped overcome typical barriers to simulation-based education, such as faculty buy-in, time, and resource allocation. As a result, EDs across the country are shifting resources, equipment, and personnel from existing programs of simulation-based education 4,5 and implementing COVID-19-focused simulation-based training for their clinical teams at an unprecedented pace (e.g., some locations are conducting daily simulations within their departments).…”

Section: Simulation For Educationmentioning

confidence: 99%

“Building the plane as you fly”: Simulation during the COVID-19 pandemic

Chaplin

McColl

Petrosoniak

et al. 2020

CJEM

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The 2019 coronavirus disease pandemic is challenging our Canadian emergency departments (EDs) in unparalleled ways. As part of the frontline response, EDs have had to adapt to the unique clinical difficulties associated with the constant threat of COVID-19, developing protocols and pathways in the setting of limited and evolving information. In addition to the disruption of routine clinical care practices, an underlying perception of danger has resulted in a challenging clinical environment in which to make time-sensitive, high-stakes decisions. This has created an urgent need for targeted and adaptive training for all members of the emergency medicine healthcare team. The following commentary reflects the perspective of four emergency medicine simulation educators during the Canadian response to COVID-19. Recognizing that local needs and resources will vary, we highlight three key roles that simulation can play in the adaptive response to COVID-19: protocol development and system testing, provider education, and team-based training. The disruption to our practice as a result of COVID-19 has required us to "build the plane as we fly," and we believe simulation to be a key tool in this process. SIMULATION FOR PROTECTED PROTOCOL DEVELOPMENT AND TESTINGThis pandemic has brought us to uncharted waters and has required the creation of new processes and protected protocols for intubation, code blue responses, and workflows within the ED. Our familiar and reliable system 1 thinking (fast, automatic, unconscious thought processes) frequently applied during high risk events has been supplanted by system 2 thinking (slow, effortful, and deliberate thought processes) due to team safety risks related to viral exposure and infection. 1 For example, the cognitive load required to perform common tasks, such as endotracheal intubation, has increased considerably, creating opportunities for error. In order to support system 2 thinking and mitigate error, protocols and corresponding checklists are required. Simulation allows for a safe, controlled, and iterative approach to protocol design and is well established in this context. 2,3 It seems only natural to apply our experience using simulation for systems testing to ED preparedness for COVID-19.Much like crash testing a car, simulation affords an opportunity for ED and simulation leaders to observe, reflect, and refine proposed protocols without risking harm to the healthcare team (or patient). This process is important to ensure a consistent approach and anticipate downstream implications prior to operationalization. Integrating the Plan-Do-Study-Act conceptual framework for systems improvement into pandemic simulation activities allows for a rapid analysis of novel protocol development. In turn, this enhanced simulation strategy serves to identify the safest and most efficient and pragmatic approach to various emergent situations. Novel pandemic-related protocols and various critical event checklists (e.g., COVID-19 intubation checklist) are From the

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Section: Simulation For Educationmentioning

confidence: 99%

“Building the plane as you fly”: Simulation during the COVID-19 pandemic

Chaplin

McColl

Petrosoniak

et al. 2020

CJEM

Self Cite

View full text Add to dashboard Cite

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“…Simulation has played an increasing role in medical education and provides opportunities to practice high-risk scenarios in a low-risk, high-fidelity environment. [10][11][12] Although residents are unable to attend sessions at simulation centres due to COVID-19 restrictions, simulation continues to play an important role in resident education. Many departments have accelerated their in situ simulation programs in response to COVID-19 for protocol development and revision, provider training, and teambased training.…”

Section: Simulationmentioning

confidence: 99%

Resident learning during a pandemic: Recommendations for training programs

Mok

Schouela

Thurgur

et al. 2020

CJEM

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Resident education in emergency medicine (EM) relies upon a variety of teaching platforms and mediums, including real-life clinical scenarios, simulation, academic day (lectures, small group sessions), journal clubs, and teaching learners. However, the coronavirus disease 2019 (COVID-19) pandemic has disrupted teaching and learning, forcing programs to adapt to ensure residents can progress in their training.1 Suddenly, academic days cannot be held in person, emergency department (ED) volumes are dynamically changing, and the role of residents in ED procedures has been questioned. Furthermore, medical student rotations through the ED have been cancelled, decreasing resident exposure to undergraduate teaching. These changes to resident education threaten resident wellness and will have downstream effects on training and personal professional development. In response, programs must develop strategies to ensure that residents continue receiving high-quality training in a safe learning environment. In this review, we will cover recommended strategies put forth by two large EM programs in Ontario (Table 1).

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“…In U.S. and Canadian paediatric emergency medicine, SBMT was being provided by 97% of residency programmes in the 2011–2012 academic year [9]. Recent surveys showed that SBMT is used by more than 90% of U.S., Canadian and English-language-based emergency medicine residency programmes, even though a considerable variability in the accreditation and certification, and frequency and timing of SBMT has been highlighted [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Simulation-based medical training for paediatric residents in Italy: a nationwide survey

et al. 2019

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Background A prompt start to an appropriate neonatal and paediatric resuscitation is critical to reduce mortality and morbidity. However, residents are rarely exposed to real emergency situations. Simulation-based medical training (SBMT) offers the opportunity to improve medical and non-technical skills in a controlled setting. This survey describes the availability and current use of SBMT by paediatric residents in Italy with the purpose of understanding residents’ expectations regarding neonatal and paediatric emergency training, and identifying gaps and potential areas for future implementation. Methods A survey was developed and distributed to Italian residents. SBMT was defined as any kind of training with a mannequin in a contextualised clinically realistic scenario. Results The response rate was 14.4%, covering the 71% of Italian paediatric residency programmes. Out of the 274 residents, 88% stated that they received less than 5 h of SBMT during the past training year, with 66% not participating in any kind of simulation activity. In 62% of the programmes no simulation training facility was available to residents. Among those who received SBMT, 46% used it for procedures and skills, 30% for clinical scenarios, but only 24% of them reported a regular use for debriefing. Of the overall respondents, 93% were interested in receiving SBMT to improve decision-making abilities in complex medical situations, to improve technical/procedural skills, and to improve overall competency in neonatal and paediatric emergencies, including non-technical skills. The main barriers to the implementation of SBMT programmes in Italian paediatric residencies were: the lack of experts (57%), the lack of support from the school director (56%), the lack of organisation in planning simulation centre courses (42%) and the lack of teaching materials (42%). Conclusions This survey shows the scarce use of SBMT during paediatric training programmes in Italy and points out the main limitations to its diffusion. This is a call to action to develop organised SBMT during paediatric residency programs, to train qualified personnel, and to improve the quality of education and care in this field. Electronic supplementary material The online version of this article (10.1186/s12909-019-1581-3) contains supplementary material, which is available to authorized users.

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Simulation in Canadian postgraduate emergency medicine training – a national survey

Cited by 37 publications

References 27 publications

“Building the plane as you fly”: Simulation during the COVID-19 pandemic

“Building the plane as you fly”: Simulation during the COVID-19 pandemic

Resident learning during a pandemic: Recommendations for training programs

Simulation-based medical training for paediatric residents in Italy: a nationwide survey

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