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Showing results for tags 'Simulation'.
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Content ArticleA fire at the University Hospital of Leicester in 2023 led to the recommendation of a full evacuation of the tertiary neonatal unit. The incident was ultimately stood down—however, it highlighted the lack of inter-agency understanding regarding the difficulty and complexity of moving critically unwell and premature babies in the event of a major incident. In response, the Leicester Royal Infirmary and other agencies staged a simulation exercise to enable teams to prepare for possible future incidents. This HSJ article describes the simulation exercise and the lessons it revealed about managing neonatal unit evacuations during major incidents. It highlights key learnings around the two themes of communication and estates.
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Content ArticleThis JAMA Network Open study aimed to explore whether standardised patients in a simulated environment can be effectively used to explore racial implicit bias and communication skills among doctors. For this cross-sectional study, 60 doctors were placed in an environment calibrated with cognitive stressors common to clinical environments. The results reflected expected communication patterns based on prior research (performed in actual clinical environments) on racial implicit bias and physician communication. The authors believe that this simulation and the process of its development can inform interventions that provide opportunities for skills development and assessment of skills in addressing racial implicit bias.
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- Health inequalities
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Content ArticleOver the past decade, the implementation of simulation education in health care has increased exponentially. Simulation-based education allows learners to practice patient care in a controlled, psychologically safe environment without the risk of harming a patient. Facilitators may identify medical errors during instruction, aiding in developing targeted education programs leading to improved patient safety. However, medical errors that occur during simulated health care may not be reported broadly in the simulation literature. This study in the Journal of Patient Safety aimed to identify and categorise the type and frequency of reported medical errors in healthcare simulation.
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Content ArticleHealthcare students are at high risk of sharps injuries, which can negatively impact their confidence and wellbeing. This study audited three clinical skills simulation wards at a UK university to determine the incidence of sharps injuries in this educational setting. The authors found that sharps injuries were the most common type of incident in clinical skills simulation wards, with student nurses being at highest risk. They suggest that intervention is needed to improve safety in this educational setting, including sharps handling training, with greater focus on existing regulations.
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Content ArticleOperating room black boxes are a way to capture video, audio, and other data in real time to prevent and analyse errors. This article from Campbell et al. presents the results of two studies on operating room staff's perspectives of black boxes. Quality improvement, patient safety, and objective case review were seen as the greatest potential benefits, while decreased psychological safety and loss of privacy (both staff and patient) were the most common concerns.
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- Simulation
- Technology
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Content ArticleInnovation in the education and training of healthcare staff is required to support complementary approaches to learning from patient safety and everyday events in healthcare. Debriefing is a commonly used learning tool in healthcare education but not in clinical practice, but little is known about how to implement debriefing as an approach to safety learning across a health system. After action review (AAR) is a debriefing approach designed to help groups come to a shared mental model about what happened, why it happened and to identify learning and improvement. This paper describes a digital-based implementation strategy adapted to the Irish healthcare system to promote AAR uptake. The digital strategy aims to assist implementation of national level incident management policies and was collaboratively developed by the RCSI University of Medicine and Health Sciences and the National Quality and Patient Safety Directorate of the Health Service Executive. During the Covid-19 pandemic, a well-established in-person AAR training programme was disrupted and this led to the development of a series of open access videos on AAR facilitation skills (which can be accessed via the link to the paper). These provide: an introduction to the AAR facilitation process a simulation of a facilitated formal AAR techniques for handling challenging situations that may arise in an AAR reflection on the benefits of the AAR process. These have the potential to be used widely to support learning from patient safety and everyday events including excellent care.
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- Training
- After action review
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Content ArticleAuthors of this study, aim to describe the development of a post-simulation reflective learning conversations model in which a number of contributing factors to achieve clinical reasoning optimization were addressed.
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Content ArticleThis article explains the emerging role of simulation in improving quality and safety. It is part of the Cambridge University Press 'Elements of Improving Quality and Safety in Healthcare' series. The article covers: Healthcare Simulation as an Improvement Technique Definition and Description of Healthcare Simulation How Simulation Became Integrated into Approaches to Improve Quality and Safety Simulation in Action Exploring Working Environments and the Practices and Behaviours of Those in Them Improving Clinical Performance and Outcomes Testing Planned Interventions and Infrastructural Changes Helping Healthcare Professionals to Learn about and Embed a Culture of Improvement Critiques of Simulation Is Simulation an Effective Technique for Improvement? How Should We Integrate Simulation into Healthcare Improvement? Can We Build a Business Case for Simulation?
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- Quality improvement
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Content ArticleSimulation is traditionally used to reduce errors and their negative consequences. But according to modern safety theories, this focus overlooks the learning potential of the positive performance, which is much more common than errors. The authors of this article describe the learning from success (LFS) approach to simulation and debriefing. Drawing on several theoretical frameworks, they suggest supplementing the widespread deficit-oriented, corrective approach to simulation with an approach that focuses on systematically understanding how good performance is produced in frequent simulation scenarios.
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Content ArticleThis systematic review and meta-analysis from Mazzone et al. confirms that proficiency-based progression training in comparison to conventional or quality assured training improved trainees' performances, by decreasing procedural errors and procedural time, while increasing the number of correct steps taken when compared to standard simulation-based training.
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Content ArticleThis article, published in Simulation and Gaming proposes a strategy for ensuing simulation training following the implementation of a thorough Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) training initiative. The strategies include observing Teams in the workplace to facilitate the construction of organisation-wide, follow-on simulation training.
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- Safety culture
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Content ArticleThis article, published in the American Journal of Medical Quality, examines pragmatic applications of simulation and human factors to support the Quadruple Aim of health system performance during the Covid-19 era.
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EventuntilThis year’s conference theme has been selected to help all of us focus on becoming more mindful of how we develop, use and succession plan within our healthcare simulation services. We want to focus on sustainability to help support quality in simulation activity that enhances patient and team safety. This means we need to think about how we undertake service and learning needs analyses, how we plan our training and how to invest in our resources including staff, patients and colleagues, networking and educational equipment and software. And how we build our knowledge base, through the use of simulation as a research tool. The really exciting part is that you are invited to join the ASPiH through abstract submissions to share your work, and by attending and joining in the conference events including keynote presentations and breakout sessions. The conference content and discussions will shape additional conversations that will form future healthcare simulation practices amongst the ASPiH network and beyond. Register
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Content ArticleSimulation for non-pedagogical purposes has begun to emerge. Examples include quality improvement initiatives, testing and evaluating of new interventions, the co-designing of new models of care, the exploration of human and organisational behaviour, comparing of different sectors and the identification of latent safety threats. However, the literature related to these types of simulation is scattered across different disciplines and has many different associated terms, thus making it difficult to advance the field in both recognition and understanding. This paper, therefore, aims to enhance and formalise this growing field by generating a clear set of terms and definitions through a concept taxonomy of the literature.
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Community Post
Using simulation to test processes
Phil Gurnett posted a topic in Process improvement
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Hi I have been working in a presentation we are giving at ASPiH in November around the work we have done using simulation to test systems and processes. we have done this in two ways. Firstly as a by-product of an educational in situ simulation in s clinical environment where a latent threat has been identified. In this case we will work with the area in looking at just what contributes to the threat and ways that may help. The second way (and with my HF head on, more exciting) has been setting out to test a process. We have done this several times now and have had some real successes in demonstrating the work as done v work as imagined theory. has anyone else used simulation in this way? looking forward to your replies. Phil- Posted
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Content ArticleIn this blog, interdisciplinary humanistic, systems and design practitioner Dr Stephen Shorrock explores the dangers of project leaders relying on assumptions about work-as-imagined, detached from the reality of contextualised work-as-done. He describes his experience working on a project in which he discovered that operational staff felt anxious and unprepared for the major changes to come. This was unacknowledged by management, and he ascribes their lack of awareness to a failure to physically and empathetically engage with the workers in the reality of the processes and systems management had designed. He highlights the importance of empathy and asks the question, "In your worlds, how connected are managers and other non-operational specialists with operational staff and the operational environment, where changes ultimately end up? Those who wish to support operational staff through change must take the role of pupil, or apprentice – not master."
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News ArticleA new training aid, developed in Fife, is helping to equip trainee medical staff from around the world with the skills to prevent late miscarriage and premature labour. It was invented by Dr Graham Tydeman, consultant in obstetrics and gynaecology at Kirkcaldy’s Victoria Hospital, in conjunction with the St Thomas’ Hospital, London, and Limbs and Things. The lifelike simulator allows trainees to perform hands on cervical cerclage in advance of a real-life emergency. The procedure involves an emergency stitching around the cervix and is necessary when the cervix shortens or opens too early during pregnancy, helping to prevent late miscarriage or extreme premature labour. It is not a common event and the simulator was developed by Dr Tydeman following a request from medical trainees across the UK. The device has already been warmly received by hospitals and training institutions across the world – with orders from countries including New Zealand and India. Dr Tydeman said: “The reason this was developed is that it is not a common procedure and is very difficult to teach trainees." “Increasingly women are understandably asking about the experience of their surgeon and anyone having this procedure understandably does not want it to be the first one that a doctor has ever done because if it goes wrong there could be tragic consequences with loss of the baby. However, if a trainee has shown suitable skills using this simulator, I would be able to confidently reassure women that the doctor had been adequately trained, although a more experienced person would always help during the actual operation for the first few procedures on real women." Read full story Source: The Courier, 19 December 2020
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EventuntilA triennial event featuring over 200 sessions all available on demand plus 800 papers on over 30 themes from healthcare ergonomics, organisational design and management to biomechanics and human modelling and simulation. The Executive Panel will address the Congress theme "HF/E in a Connected World" which raises urgent scientific and professional challenges concerning human interaction with technology in the era of automated and ubiquitous cyber-physical technologies. Register
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Event
Simulation in healthcare incident investigation
Sam posted an event in Community Calendar
untilThe NHS standards for patient safety investigation recognise a need to better train and professionalise incident investigation in the NHS. Simulation is commonly utilised to improve the technical and non-technical skills of clinical staff in the NHS and forms part of professional investigation training and practise within other safety critical industries. A scoping review has considered what published work exists in commenting on the use of simulation as a training or practical tool in healthcare incident investigation. There may now be opportunities for healthcare incident investigation to learn from clinical colleagues, and professional investigation colleagues in other safety critical industries, to utilise simulation to help professionalise incident investigation in the NHS. Further information -
Content ArticleFrom this Windmill 2009 simulation event, and discussions with policy-makers, regulators, commissioners and providers, managers and clinicians, an analysis was developed of what will be required if health and social care systems are to respond effectively to the major challenges that lie ahead. It identifies key themes and recommendations for action in each of these.
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Content ArticleOn 13 January 2018, a group of healthcare simulationists from around the world gathered at a summit held in Los Angeles, California to collaborate on a unifying code of ethics for healthcare simulation professionals. There are six aspirational values that are described in the Code of Ethics: Integrity Transparency Mutual respect Professionalism Accountability Results orientation
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Content ArticleThis letter to the editor published in The Journal of Biomedical Research outlines the ways in which simulation will be used in medical education in the future. The author highlights that: simulation is likely to become much more closely linked to assessment in the future. our vision of what constitutes simulation will change radically in the future, with access to simulation becoming easier and wider. the future of simulation in medical education will follow the same path as the future of healthcare—more primary care, management of long term conditions and patient self-management.
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Content ArticleSimulation is a training technique that replaces real experiences with guided experiences. These experiences replicate substantial aspects of the real world in a fully interactive manner. This article looks at the future of simulation in healthcare, categorising applications of simulation into 11 dimensions: The purpose and aims of the simulation activity The unit of participation in the simulation The experience level of simulation participants The healthcare domain in which the simulation is applied The healthcare disciplines of personnel participation in the simulation The type of knowledge, skill, attitudes of behaviour addressed in simulation The age of the patient being simulated The technology applicable or required for simulations The site of simulation participation The extent of direct participation in simulation The feedback method accompanying simulation
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Content ArticleNursing education has long utilised simulation in different forms to teach the principles and skills of nursing care, from anatomical models to computer-based learning. This chapter from Patient Safety and Quality: An Evidence-Based Handbook for Nurses looks at simulation training as a strategy to prevent healthcare errors. It explores the value of human patient simulation in nursing education programs.
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Content ArticleThis document outlines how Health Education England (HEE) hopes to expand the role of simulation and immersive learning technologies in the education and training of the NHS workforce. Simulation is defined as ‘a technique to replace or amplify real experiences with guided experiences, often immersive in nature, that evoke or replicate substantial aspects of the real world in a fully safe, instructive and interactive fashion’. This document considers how existing techniques and technologies can benefit wider policy and strategy goals in health and care, outlining HEE's intention to: promote and strengthen the dialogue between different system and stakeholder organisations, networks, and communities to enable and evaluate opportunities for sharing intelligence and innovation provide a platform for collaboration on common themes of work generate evidence of impact that will help support the transformation in health and care that is required for the future needs of patients and society.
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