Simulcast

This month we discussed “Leung, J.S., Brar, M., Eltorki, M. et al. Development of an in situ simulation-based continuing professional development curriculum in pediatric emergency medicine. Adv Simul 5, 12 (2020).  Ben and I recap on the paper and the online discussion, Including the expert contributions from James Leung, the first author  An we reviewed 3 extra papers – two looking at different ways healthcare simulation has been adapted to deal with the pandemic.  Dubé, M., Kaba, A., Cronin, T. et al. COVID-19 pandemic preparation: using simulation for systems-based learning to prepare the largest healthcare workforce and system in Canada. Adv Simul 5, 22 (2020).  Cheng, A., Kolbe, M., Grant, V. et al. A practical guide to virtual debriefings: communities of inquiry perspective. Adv Simul 5, 18 (2020).    And one looking at how bomb defusal can help interprofessional learning !  Tidbury L, Jarvis K, Bridge P. Initial evaluation of a virtual reality bomb-defusing simulator for development of undergraduate healthcare student communication and teamwork skills BMJ Simulation and Technology Enhanced Learning 2020;6:229-231.    And finally – Ben gave us an invitation for the September Journal Club.  Calhoun, Aaron W. Pian-Smith, May. Shah, Anjan et. al. Guidelines for the Responsible Use of Deception in Simulation, Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: August 2020 - Volume 15 - Issue 4 - p 282-288    Please come along and join the conversation …       

This episode is a recording of Ben Symon’s APLS PAC 2019 (Advanced Paediatric Life Support Paediatric Acute Care Conference) in Perth on ‘Simulation Self Sabotage’.   Through exploring 4 journal articles, Ben shares reflections on the negative impacts we can have as sim educators on our intended learning outcomes and the ways in which we unintentionally shoot our educational goals in the foot.  Many thanks to APLS, who were kind enough to give their recording to Simulcast to share with our listeners.  References :   1. Purdy E, Alexander C, Caughley M et al. Identifying and Transmitting the Culture of Emergency Medicine Through Simulation. AEM Education and Training 2019;3:118-128. doi:10.1002/aet2.10325    2. Fraser K, Meguerdichian M, Haws J et al. Cognitive Load Theory for debriefing simulations: implications for faculty development. Advances in Simulation 2018;3. doi:10.1186/s41077-018-0086-1    3. Roussin C, Weinstock P. SimZones. Academic Medicine 2017;92:1114-1120. doi:10.1097/acm.0000000000001746    4. Marshall S. Sink or swim? The difficulty of finding the correct level of independence and support for trainees. British Journal of Anaesthesia 2015;114:724-725. doi:10.1093/bja/aev032   

  This month we discussed “How to include medical students in your healthcare simulation centre workforce” by Viggers et. Al. We have already recorded a wonderful episode with Sandra on this paper that can be found here….  Ben and I recap on the paper and the online discussion, as well as the expert opinion from two medical students undertaking their simulation-based education rotation at present.  We also reviewed 4 extra papers – one focused on reopening simulation facilities in the COVID era:-   Ingrassia, P.L., Capogna, G., Diaz-Navarro, C. et al. COVID-19 crisis, safe reopening of simulation centres and the new normal: food for thought. Adv Simul 5, 13 (2020).   and three papers with a with a simulated patient methodology theme: -  Smith CM, Sokoloff LG, Alsaba N. Collaborative framework for working with older simulated participants (SP). BMJ Simulation and Technology Enhanced Learning Published Online First: 16 June 2020. ( and this one makes reference to the ASPE Standards of Best practice that can be read here.)  Budd, Natasha PhD; Andersen, Patrea PhD; Harrison, Penny BA; Prowse, Nycole Engaging Children as Simulated Patients in Healthcare Education, Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: June 2020 - Volume 15 - Issue 3 - p 199-204  Naismith, Laura M. PhD; Kowalski, Christopher et al. Participant Perspectives on the Contributions of Physical, Psychological, and Sociological Fidelity to Learning in Interprofessional Mental Health Simulation, Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: June 2020 - Volume 15 - Issue 3 - p 141-146   And finally – Ben gave us a heads up for the August Journal Club.  Leung, J.S., Brar, M., Eltorki, M. et al. Development of an in situ simulation-based continuing professional development curriculum in pediatric emergency medicine. Adv Simul 5, 12 (2020).  Please come along and join the conversation …       

In this latest episode in our collaboration with Advances in Simulation, Vic speaks with Sandra Viggers (@StarSkaterDk) about her recent paper and the program she describes for involving medial student sin the simulation mission at her institution in Copenhagen.  We were joined by South African anaesthetist Rowan Duys (@HealthThink) and discuss the recruitment, roles and professional development and training opportunities available for students. We ended up talking about broader issues related to the positioning of medical students in health services, and sandra offered some tips about how to get started.    vb 

This month’s paper was Lack of Diversity in Simulation Technology  by Conigliaro et al from Simulation in Healthcare. Vic and Ben were joined by Jess and our special guest Dr Karanjot Lall (@KaranjotLall) We spoke about the paper’s findings – the predominance of white skinned mannikins in advertising materials – and how simulation might instead be able to contribute to antiracism and better representation of traditionally marginalised groups. We also highlighted Debra’s Nestel’s recent SESAM keynote on a similar topic and recommend this as additional viewing !

The COVID intubation box, a hot topic on social media – is it safe or effective?     Jessica (not Jesse…) hosts her first podcast with guests Jonathan Begley, Albert Chan and Vic Brazil exploring a new paper in Anaesthesia – An aerosol box for intubation in COVID-19 patients: an in-situ simulation crossover study.      We cover why they conducted the study, the outcomes, the use of simulation and future direction. We also discussed some interesting topics like the MacGuyver Bias and the article that Albert wrote in Life in The Fast Lane about the intubation box.     MacGuyver Bias Article - https://link.springer.com/article/10.1007/s12630-019-01361-4  Albert’s Life in the Fast Lane Article - https://litfl.com/should-we-use-an-aerosol-box-for-intubation/  

  Ben and Vic discuss the paper of the month(s) - Cheng, A et al  A Conceptual Framework for the Development of Debriefing Skills.  - and attempt to summarise the brilliant discussion from the blog comments.  We discuss the elements of ‘good debriefing’, reflect on the value of having a conceptual framework for debriefing skill development, and take a deeper dive into the nature of ‘adaptive expertise’. We talk about Kris Krogh’s practice development triangle and draw on the wisdom of Booker’s rule of three and Hannah Gadsby’s Nanette. We agree to embrace the ‘rich palette’ of debriefing skills, but encourage first learning the rules about how to make purple…….    

Vic spoke with (Dr) Jess Stokes-Parish and Steph Barwick about the ‘Women in Simulation’ Initiative within Simulation Australasia. Diversity is important in professional communities and Steph and Jess explained a bit about the background to this initiative, the work so far and how this can positively influence policy and support diversity within simulation.  If you’re interested in the upcoming webinar series, find out more info or register here https://my.simaust.com/events - this Masterclass Series will run on June 4, June 18 and July 2 covering building confidence, kicking imposter syndrome to the curb and building a personal brand.   And the link to the FB page https://www.facebook.com/groups/285101322099769  

Can simulation be ‘too real’? Can this ‘hyper-reality’ actually have negative impacts on learning?  Vic takes a deep breath and dives into theory with the team from Queens University Belfast, including Jenny Johnston, Helen Reid and Gerry Gormley. We discuss their recent Medical Education article - Into the uncanny valley: simulation versus simulacrum?   Eve Purdy joined the chat to offer her unique anthropological perspectives.  If you’ve ever felt slightly uncomfortable with OSCEs or breaking bad news to a plastic mannequin, this might help you understand why….. 

This month Ben and Vic discuss 4 papers, in a bit of a variation to our usual format.  In the first paper, the authors compare VR and ‘live’ team-based simulation for interprofessional student groups, and suggest these modalities have the same outcome, as measured by performance on a team communication assessment. Next we discuss Natarajah and colleagues’ brilliant work in Myanmar, using a low cost simulator for training to use air enemas in paediatric intussusception, with measurably improved patient outcomes.  In our third paper, Brown and colleagues offers a new approach to debriefing large groups, such as might be needed in large scale trauma simulations - offer us ‘simultaneous successive debriefing’.  And finally – we discuss Laura Rock’s BMJ Opinion piece - Don’t answer feelings with facts.  Guidance for our conversations in the clinical and simulation contexts, and well beyond.  Join the conversation for next month, when we pick up the March JC paper and review. Leave your comments and thoughts here.  All the best  vb