HealthySimulation.com is dedicated to providing free resources to healthcare educators considering or utilizing simulation to educate and train professional providers. Here is a list of our most-read medical simulation articles from the first half of 2013:

1. Video Update from Laerdal SUN Indianapolis 2013 - The April 2013 Laerdal SUN Indianapolis meeting held its opening ceremonies yesterday providing over 230 Simulation Champions from around the World with the training they need to start or expand their healthcare simulation program. Learn more about Medical Simulation by watching this event video recap.
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2. Collaborative Simulation Program Development Session Provided with FREE HealthySim Subscription - Gain access to a 2-Hour HD recorded stream from the HealthySimAdmin event which covers collaborative program development across disciplines and institutions by subscribing to HealthySimulation.com’s free monthly newsletter, summarizing all the best articles straight to your email inbox!
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3. HealthStream Provides Free WhitePaper “Right Time for Simulation” - Are you associated with a hospital system looking to start or expand a medical simulation based program?  HealthStream just released a free white paper entitled “It’s the Right Place and Right Time for Simulation” on their blog which can help demonstrate the serious benefits of clinical simulation. You can also check out my comprehensive Demonstration of the HealthStream SimManager platform developed to administer simulation staff, equipment, rooms, learners and outcomes.
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4. Learn How Simulation Has Been Fully Adopted & Integrated in both the Airline Industry and the Nuclear Power Industry – While medical simulation is rapidly expanding, the adoption of the methodology does not even begin to compare to the aviation or nuclear industries. Learn how simulation works in these sectors to better learn why simulation is the future of healthcare education.
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5. Learn How to Identify Key Drivers for Simulation Training - Key drivers are “an effective tool for breaking down complex questions or improvement goals and structuring them into smaller, addressable pieces”. Learn more about this workshop and download free tools that can clarify simulation needs and appropriate intervention designs for simulation training.
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6. Increase Realism to Your Simulations Through Background Noise and Advanced Moulage Makeup Kits – By creating the most realistic simulation scenarios learners become fully immersed in the experiential educational experience. Small considerations for the design and display of your simulation lab can dramatically increase learner buy-in!
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7. The Sim Tech Hands-On Training event ‘SimGHOSTS’ is Hosting their 3rd Annual Event this August - Join over 200 other Healthcare Simulation Technicians at the San Antonio College Nursing and Allied Health Complex this August 6th – 9th for the global healthcare simulation event designed to provide a meeting place for Technicians to exchange ideas and network with technical peers as well as receive specialized training in manikin hardware repair & software programming, audiovisual equipment debugging, IT infrastructures, moulage makeup, team communication & leadership techniques, medical physiology and much more.
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8. Consider Why & How to Build a Website For Your Medical Simulation Program, and How to Add Multimedia to Increase Marketing to Community & External Businesses – Benefits of creating a Simulation Program Website include: Community public relations, recruitment advertising and promotional marketing, providing contact information and capturing donations, as well as hosting student, staff, clinical educator/faculty resources. In the second article, learn how to add multimedia to further support these objectives!
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9. Designing Prehospital Medical Simulation Scenarios - This guest author paper outlines the four stages that should be considered by tutors before their students are exposed to clinical simulation scenarios for educational purposes. These stages of paramedic education are relatively unique since the teaching and understanding of logistical considerations are not necessarily a significant concern to other clinicians from wider health disciplines.
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10. How To Evaluate Effectiveness of Medical Simulations – Learn why simulation scenario design requires ongoing review, how healthcare can make tiny improvements for continued success, and gain free evaluation tools from CAE Healthcare.

*BONUS Link* – For even more great content check out the Top 50 “Best Of 2012″ Medical Simulation Articles!

Yesterday HealthySimulation.com took part in HealthBeat 2013, a new event dedicated to exploring where new technology is disrupting healthcare. The meeting was organized by media outlet VentureBeat, which covers the Tech, People and Money of new ventures across the globe.  The meeting continues today in San Francisco combining clinicians, hospital administrators, entrepreneurs, and funding groups from around the world.

“HealthBeat 2013 is a new event exploring “Smart Hospitals” and “Smart Practices,” the focal point of where technology is disrupting health care. The event also covers how “Smart Patients” fit in. Patients are now equipped with a library of web stats and tools, giving them more control over how they get medical care.

HealthBeat will help decision makers — CIOs at hospitals, physicians, 
providers, insurers — understand what technologies are most effectively 
transforming health care in 2013 and beyond. It will also help business leaders 
assess the multi-billion dollar market opportunities in this sector.”

David Levin, MD and Chief Medical Information Officer of Cleveland Clinic Health System helped open yesterday morning’s session highlighting the changes coming to the U.S. Healthcare system and what that will mean for technology-based entrepreneurs. David reminded us that from the dawn of humankind until 2003, our collective data output was equivalent to about 5 exobytes of data (thats a 5 with 18 zeros after it). Highlighting why we are “at the beginning of the beginning” David then shared “but since 2003, we now create about 5 exobytes of data every 2 days”!

Thus, “We are all immigrants entering a new country and a new age. Change is coming as we transition from a volume-based system to a value-based system, where people get paid based on the results, quality of care, efficiency, and how satisfied our patients are.” Paralleling the continual tension of simulation technology in healthcare settings, David shared that Cleveland Clinic desired a “stable use for ongoing operational use of technology but expected a continuous disruption through constant innovation”.  I agree as I have experienced first-hand how running a simulation based learning environment always requires disruptions since technology changes so rapidly.

You can read the rest of Rebecca Grant’s coverage of David’s session including his breakdown of the 3 P’s for the future of Healthcare: Personalization, Population-Based, and Pervasive.

When asked if there was a generational gap with the utilization of technology in healthcare Gunnar Trommer VP of Marketing at Sotera Wireless did not believe so suggesting “It can be done. Integrating technology requires a culture of patient safety from the administrative level”. To approach such utilization Gunner recommended further “Drive the behavior by not just explaining the what, but the why – and publicly post outcomes of technology use so that everyone can see the benefits”.

Yesterday primarily covered big-data analysis opportunities, risks and regulations as well as mobile app business ventures in the space. Sean Cassidy VP and GM, Premier Data Alliance at Premier suggested that EHRs will soon become recommendation tools with datasets available across multiple-platforms – providing assistance to both healthcare providers and patients.

I was surprised to see that medical simulation did not have more of a presence at the event and made the recommendation to consider our rapidly expanding community for future HealthBeat meetings.

A post for those who love to engineer and tinker with medical simulation technology! HealthySim spent this weekend at the wonderful candyland of home-made gadgets and their “makers” on showcase at the Maker Faire which took place just outside San Francisco.

Part science fair, part county fair, and part something entirely new, Maker Faire is an all-ages gathering of tech enthusiasts, crafters, educators, tinkerers, hobbyists, engineers, science clubs, authors, artists, students, and commercial exhibitors. All of these “makers” come to Maker Faire to show what they have made and to share what they have learned.

Maker Faire is a gathering of fascinating, curious people who enjoy learning and who love sharing what they can do. It’s a venue for makers to show examples of their work and interact with others about it. Many makers say they have no other place to share what they do. DIY (Do-It-Yourself) is often invisible in our communities, taking place in shops, garages and on kitchen tables. It’s typically out of the spotlight of traditional art or science or craft events. Maker Faire makes visible these projects and ideas that we don’t encounter every day.

After soldering my own LED pin, building an air-powered rocket, screen printing a t-shirt, watching a life-size version of mousetrap, and designing a 3d printer object, I checked out the following Maker Projects:

• Underwater Video Controlled Exploration Robot - OpenROV
• LaserCut Animatronic Robot – RoeMotion
• Echo-Reflecting Environmental Detection Helmet Prototype – TheSonicEye
• HomeMade Jellyfish Aquariums – PBnJellies
• How to Build Your Own R2D2 – R2Builders
• iPhone Microscope Photo Adapters - SkyLightScope
• And many more…

Education-based support is a huge component of Makers, with classroom kits and other lesson plans for technology training found throughout the faire grounds. Check out the upcoming dates for a Maker Faire near you, because they are all over the world!

Do you have a “Do It Yourself (DIY)” Medical Simulation Technology Project?

Take part in the simulation technology training conference SimGHOSTS and enter your DIY project video to win up to $1000 in prizes! Simply record how your project increased realism or efficiency in your sim lab and enter today.

Check out Fritz Sticht’s Grand Prize Winning Video for an affordable DIY Cervix Model from last year’s event:

Learn more about the August Gathering of Healthcare Simulation Technology Specialists today before tickets sell out!

SimChamps - This month, HealthySimulation.com celebrates its 3rd year of operation. Since that time this website has provided the following services to the international simulation community:

1. 66,008 Unique Visitors from more than
   
2. 177 Countries from Around the World (picture above) have viewed more than
3. 196,543 Page Views of simulation content through
4. 315 Online Articles and
5. 53 Youtube Videos to more than
6. 1,576 Free Monthly Newsletter Subscribers and
7. 450 HealthySim Linkedin Group Members

Back in 2010 I was posting about two stories a week to audiences of about 200 a month.  This year we have steadily been supporting you and 5,500 other unique visitors a month! The world of medical simulation is rapidly expanding, and the amount of online content now available continues to double. Thus, we are going to do our best to bring you more content throughout the week that is designed to support your simulation career and program.

Want to write for HealthySimulation? Do you have a passion for posting articles to help others with simulation? Email HealthySim and apply to join the team today!

Do you have a story to share on HealthySimulation? Anything from center launches to one page template tools, research findings, new products and/or services, innovative simulation techniques, operational guidelines, video tutorials and tours, or any other simulation-related item you can think of! If you want to share it, we want to post it! Email us today with your links.

So keep coming back to HealthySimulation.com daily for all the latest in Medical Simulation!

Evaluating the effectiveness of your medical simulations is a crucial component of building a successful long-term program.  On numerous occasions, the raw data we captured at the Clinical Simulation Center of Las Vegas over a period of many years eventually became critically important for arguments when requesting operational changes our lead administrators.  Not only this, but the use of a tool to gauge how simulations have performed is a necessary step in molding and shaping future experiential learning experiences.

Simulation scenarios should not ever be considered “final drafts” for the following reasons:

1) New clinical procedures or information may shift scenario goals.
2) New faculty may wish to modify existing templates to better angle their learning objectives.
3) Annual review by a simulation committee may provide for refined scenario designs which further empower learners.

The last point is best explained through the Japanese philosophy of Kaizen, which means “never-ending improvement”, a passion for making things better, the drive for perfection. In his book, “Kaizen”, Masaaki Imai says, “It means continuing improvement in personal life, homelife, social life, and working life. When applied to the workplace Kaizen means continuing improvement involving everyone–managers and workers alike.” Healthcare is a dynamic process, one that is always changing and reaching for improvement – and so should our simulation scenarios!

Check out this book I’m reading on Healthcare Kaizen:

“Healthcare Kaizen focuses on the principles and methods of daily continuous improvement, or Kaizen, for healthcare professionals and organizations. Kaizen is a Japanese word that means “change for the better,” as popularized by Masaaki Imai in his 1986 book Kaizen: The Key to Japan’s Competitive Success and through the books of Norman Bodek, both of whom contributed introductory material for this book.

In 1989, Dr. Donald M. Berwick, founder of the Institute for Healthcare Improvement and former administrator of the Centers for Medicare & Medicaid Services, endorsed the principles of Kaizen in the New England Journal of Medicine, describing it as “the continuous search for opportunities for all processes to get better.” This book shows how to make this goal a reality.”

So how to evaluate our healthcare simulations? Check out this free Simulation Effectiveness Tool Template from CAE Healthcare!

Simple surveys like this that are handed out to your concluding simulation participants can help track the effectiveness of the engagement from the learners perspective. Use CAE Healthcare’s tool as a guide to building your own surveys which reflect the specific evolutionary needs of your program.

To really measure effectiveness, however, your program will need to invest in a learning management or audiovisual system that integrates real-time performance analysis software.  Most of the major simulation product companies provide for some level of performance tracking in their recording systems, but unless your simulation educators are actively recording this data while it occurs there will be no long-term program effectiveness evaluation.  Administrators MUST understand the importance of capturing data as much as possible with everything possible in their simulation programs.

The types of data and how to capture them were covered really well during the 1.5 hour “Research” session of HealthySimAdmin – an HD-recorded two day event which sought to provide solutions for the “how-to” of managing a simulation program. You can still watch this and the remaining 13 hours of administrative content straight to your office or home. Get instant access to the opening session by subscribing to HealthySimulation.com’s free newsletter, and learn more about how HealthySimAdmin can guide your program today!

Do you have another way to evaluate medical simulation effectiveness? Leave a comment at the bottom of this post’s webpage!

In 2011 at the National League for Nurses (NLN) Summit a Simulation-based ‘Debra L. Spunt Lecture’ session was recorded between Sharon Decker, PhD, RN, ACNS-BC, ANEF, Janet L. Grady, DrPH, RN, FAAN, ANEF, Pamela Jeffries, PhD, RN, FAAN, ANEF and Suzan Kardong-Edgren, PhD, RN, ANEF, which was entitled “Leadership in Simulation: Looking Back, Looking Forward”. Theory-Practice gaps are identified as problems not just in nursing, but in all higher learning communities.  These speakers cover the challenges of developing simulation research and utilization in nursing, and although from 2011 still has huge relevance for our community today. You can watch the 1-hour session below and visit the NLN website for more information.

As well, the NLN has provided free downloadable content for educating the care of older adults through innovations in nursing education, called ACES – which stands for Advancing Care Excellence for Seniors. This grant-funded initiative was developed to foster gerontological nursing education for pre-licensure nursing programs. The ACES website is the go-to place for gerontological resources for faculty and students, classroom-ready teaching tools and strategies, and information about upcoming faculty development events related to integration of care of older adults into nursing program curricula.

The ACES free downloadable cases include:

• A first-person monologue that introduces the individual or couple and the complex problems to be addressed.
• Simulation scenarios designed to help students practice assessing function and expectations of their patient(s), with links to appropriate evidence-based assessment tools, including those from the Try This® and How to Try This® Series.
• An innovative final assignment that asks students to finish the story.
• An instructor toolkit with suggestions on how to use the various components of the unfolding cases and incorporate them into the curriculum.

Visit the NLN ACES website to get these resources today!

Gaumard announced today an update to their S575 Noelle Birthing Manikin. Check out some of the new features below and visit Gaumard.com to learn more!

Realistic fetal palpation Realistic amniotic sac inside palpation abdominal cover creates a natural and realistic feel when practicing palpation exercises
	Precision delivery system NOELLE’s fetus rotates and moves down the birth canal in response to commands from a wireless tablet PC; it also dips and rises as it traverses the natural sculpted pelvic opening.
Two fetuses One fetus for vertex and one for breech delivery. New vertex fetus has a smooth head (no connection port) making vacuum deliveries more realistic.
	Lifelike birth canal New lifelike birth canal simulates human tissue. Birth canals are removable and are designed to withstand more than 75 deliveries.
Epidural procedures Practice epidural procedures on a spinal cord insert with skin layer, subcutaneous layer, connective tissue, and lumbar vertebrae.
	Practice C-Sections Use real surgical instruments for incision, dissection, and suturing. Abdominal inserts have simulated blood incorporated into the subcutaneous layer.
Episiotomy repair Episiotomy repair inserts simulate human tissue that can be sutured repeatedly. Inserts have been redesigned for maximum realism, in both look and feel.
	Postpartum Hemorrhage Use the postpartum uterus and program PPH, perform a fundal massage, and insert and inflate a Bakri Balloon. 1.5 liter blood reservoir and programmable bleeding levels.
Includes Newborn 40 week tetherless newborn with breathing, pulses, color and vital signs that are responsive to hypoxic events and interventions. Also includes trending, crying, convulsions, oral and nasal intubation, airway sounds and extra tablet PC for control.

Learn more at Gaumard’s Noelle webpage.

Continuing to showcase learning from other industries that have already fully adopted simulation, today we are sharing a link to a report recently published by the Advancing Safety in Medical Technology (AAMI) group entitled “Risk and Reliability in Healthcare and Nuclear Power: Learning from Each Other“. This monograph covers a 2-day event which brought together nuclear and healthcare industry representatives in July of 2012. This 120-page PDF, free for members, features eight chapters written by respected industry experts, who examine the similarities and differences between the fields in four topic areas:

• Dependability of safety-critical software
• Diagnostic and prognostic technologies
• Human factors
• Event analysis and corrective action

The AAMI website explains:

While nuclear power and healthcare might not appear to be complementary industries, they both are “complex, tightly coupled, high-hazard sociotechnical systems that serve a public good.” Furthermore, they both “rely on highly trained and skilled professionals working in interdisciplinary teams,” the publication read.

In terms of regulatory oversight and organizational structure, however, there are a number of differences, as detailed by David Gaba, MD, professor of anesthesia and associate dean for Immersive and Simulation-based Learning at the Stanford School of Medicine, in a chapter titled “Thorniest Issues in Healthcare.” There are about 100 nuclear power reactors owned by 30 to 40 firms in the United States, and they face intense scrutiny by the U.S. Nuclear Regulatory Commission, particularly since the 1979 incident at Three Mile Island. By contrast, there are 4,000–6,000 hospitals, owned by 1,000–2,000 firms, as well as a large number of standalone surgical centers and physician’s offices. Unlike the nuclear power industry, healthcare lacks a single regulatory entity; oversight is spread across state and federal bodies.

“It is true that healthcare cannot strive for the same level of standardization within a facility, or especially between facilities having the same basic technology, as is achieved in nuclear power or the aviation industry,” Gaba wrote. “However, as for many things in healthcare, the pendulum is currently too far to the side of insufficient standardization.”

A recent copy of Inside Stanford Medicine includes a Q&A with David Gaba, MD, ‘Godfather of Simulation’ and professor of anesthesia and the associate dean for immersive and simulation-based learning at the School of Medicine, discussing his participation in this meeting from last year and what health-care providers can learn from the nuclear industry.  Gaba suggests:

“One big one is the need for standard operating procedures, where possible, which also retain flexibility as needed. A major spinoff of this principle, used extensively in nuclear power, is to provide graphically enhanced written protocols for emergency situations. It is long recognized that nuclear power operators cannot remember everything they need to know in managing an adverse event in a nuclear plant — memory is too fallible. Thus, the use of written procedures is a mainstay in this setting. Health care has long depended largely on the individual skill and memory of physicians and nurses. Protocols and checklists or emergency manuals were decried as cheat sheets or cribs. We now know that the best people use these kinds of supports — not because they are stupid but because that is the best way to get the best results in tough situations. My lab and other colleagues at Stanford have been working for some time on written cognitive aids and emergency manuals for anesthesia professionals. These have now been disseminated to all the anesthetizing locations in Stanford’s hospitals and those of its close affiliates. This lesson has clearly come from the nuclear industry and from others such as aviation.

Another lesson from the nuclear industry is the importance of the safety culture in an organization. When the organization favors throughput so heavily that people cut corners on safety, or when personnel are afraid to speak up when they see something unsafe, the risk climbs.”

Read the rest of the Stanford Q&A with Dr. Gaba, and the AAMI Publication Highlighting Similarities, Differences In Healthcare and Nuclear Industries.

Simulation Champion Jim Rowland emailed me this week to let me know about a new simulation center in Illinois!

“Lance, I thought you might like to hear what’s happening at Jump Trading Simulation and Education Center of Peoria, IL. Jump is a new 67,000 square foot simulation center, located on the campus of OSF Healthcare, which is scheduled to open on April 24th. Yesterday, Jump received a new ambulance, which was donated by Advanced Medical Transport of Peoria, for our Regional Transport Center, an indoor training facility which features a mock one-bedroom house for extrication and home health training. Jump is a collaboration of OSF Healthcare and the University of Illinois College of Medicine at Peoria.”

You can learn more about the new grand opening and this wonderful new facility at the Jump Simulation Website.

Early next month the University of Pittsburgh’s WISER center will be hosting their 6th annual meeting to support simulation in nursing. Registrations for this June event are still available at $400 per person here.

The Peter M. Winter Institute for Simulation, Education, and Research (WISER) of the University of Pittsburgh, allied with the UPMC Health System, is dedicated to healthcare education and educational research. The Institute features advanced instructional technologies and methods to develop innovative healthcare education programs that are ultimately targeted towards improving the public welfare and safety

Dr. Paul Phrampus, current President of the Society for Simulation in Healthcare and Director of WISER will be providing this year’s keynote address.  Paul let me know that this year the meeting will provide a blend of didactic learning at the hotel and more interactive based sessions across the street at the WISER center itself.  I am also happy to report that WISER has invited HealthySimulation.com out to cover the event with video, so stay tuned!

Remember, there is still time to Register so learn more about the event at the WISER Nursing Symposium website.

Simulation-based Learning Highlights include:

• Best practices
• Leadership skills
• Assessment methods
• Program development
• Interactive workshops
• Debriefing methods and practices
• Practical pointers and demonstrations
• Use of supplemental educational technology
• Internationally recognized simulation experts
• Overcoming problems and pitfalls in building your simulation program
• Developing competencies through simulation
• Networking opportunities

*10.75 CNE contact hours will be awarded to individuals that complete this 1.5 day symposium.*

AGENDA:

Thursday, June 6th

• Building the Simulation Bridge: Past, Present & Future
• Simulation-The Bridge to Patient Safety
• Crossing the Bridge from Simulation to Publishing
• Breakout sessions (Select 3 choices. Participant will be added to their top two choices. Third choices is a back-up. Sessions will be filled on a first come first serve bases.):
  • Creating Simulation Policies & Procedures
  • Building Simulation Projects & Papers
  • Obstetrics and Pediatric Simulation
  • Structured and Supported Debriefing: How to Reinforce Your Students Learning
  • Curriculum Development & Integration

Friday, June 7th

• Climbing the Bridge to the Top Ten Simulation Articles
• Simulation on the Cheap: Making the Most of Your Resources
• Becoming a Certified Simulation Instructor
• Assessment in Simulation: Making it Fun
• Question and Answer Town Hall Meeting

Learn more about the event at the WISER Nursing Symposium website.