Some interesting simulation studies have recently been published. Thanks to Tim Willet (@SIMtim_one) for highlighting these and many more research articles for medical simulation! Follow Tim for continuous links to the latest medical simulation research!
Status of simulation in health care education: an international survey. (Qayumi K, Pachev G, Zheng B, Ziv A, Koval V, Badiei S, Cheng A.) – Simulation is rapidly penetrating the terrain of health care education and has gained growing acceptance as an educational method and patient safety tool. Despite this, the state of simulation in health care education has not yet been evaluated on a global scale. In this project, we studied the global status of simulation in health care education by determining the degree of financial support, infrastructure, manpower, information technology capabilities, engagement of groups of learners, and research and scholarly activities, as well as the barriers, strengths, opportunities for growth, and other aspects of simulation in health care education. We utilized a two-stage process, including an online survey and a site visit that included interviews and debriefings. Forty-two simulation centers worldwide participated in this study, the results of which show that despite enormous interest and enthusiasm in the health care community, use of simulation in health care education is limited to specific areas and is not a budgeted item in many institutions. Absence of a sustainable business model, as well as sufficient financial support in terms of budget, infrastructure, manpower, research, and scholarly activities, slows down the movement of simulation. Specific recommendations are made based on current findings to support simulation in the next developmental stages.
We recommend that educational and health care authorities, as well as accreditation and licensing bodies, support the integration of simulation into health care education for all learner groups. This can be achieved by:
Recognizing simulation-based education as a central modality in the maintenance of competencies in health care
Setting standards on the expected proficiencies of health care professionals, and identifying how simulation can assist in achieving and maintaining those standards
Designing and delivering simulation curriculum for patient safety, professionalism and advocacy-related competencies
Encouraging collaboration between and within institutions to promote sharing of existing and new curriculum and expertise.
To promote the growth of simulation-based research on a global scale, we recommend the development of improved opportunities for collaboration and networking. These opportunities will enhance expertise, expand potential for multicenter simulation studies, and further the quality of future simulation-based research. Here, Visit our HealthySimAdmin pages to gain free access to eight administrative sessions.
Central venous access by trainees: a systematic review and meta-analysis of the use of simulation to improve success rate on patients. (Madenci AL, Solis CV, de Moya MA.) – Simulation training for invasive procedures may improve patient safety by enabling efficient training. This study is a meta-analysis with rigorous inclusion and exclusion criteria designed to assess the real patient procedural success of simulation training for central venous access. We identified 550 studies, of which 5 (3 randomized controlled trials, 2 prospective 2-group cohort studies) studies of central venous catheter (CVC) insertion were included in the meta-analysis, composed of 407 medical trainees. The simulation group had a significantly larger proportion of trainees who successfully placed CVCs (RR, 1.09; 95% confidence interval [CI], 1.03-1.16, P<0.01). In addition, the simulation group had significantly fewer mean attempts to CVC insertion (weighted mean difference, -1.42; 95% CI, -2.34 to -0.49, P<0.01). There was no significant difference in the rate of adverse events between the groups (RR, 0.50; 95% CI, 0.19-1.29; P=0.15). CONCLUSIONS: Training programs should consider adopting simulation training for CVC insertion to improve the real patient procedural success of trainees.
Emergency medicine resident crisis resource management ability: a simulation-based longitudinal study. (Clarke S, Horeczko T, Carlisle M, Barton JD, Ng V, Al-Somali S, Bair AE.) – Simulation has been identified as a means of assessing resident physicians’ mastery of technical skills, but there is a lack of evidence for its utility in longitudinal assessments of residents’ non-technical clinical abilities. We evaluated the growth of crisis resource management (CRM) skills in the simulation setting using a validated tool, the Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS). We hypothesized that the Ottawa GRS would reflect progressive growth of CRM ability throughout residency. Ottawa GRS scores increased over time, and the domains of leadership, problem solving, and resource utilization, in particular, were predictive of overall performance. There was a significant gain in all Ottawa GRS components between postgraduate years 1 and 2, but no significant difference in GRS performance between years 2 and 3. CONCLUSIONS: In summary, CRM skills are progressive abilities, and simulation is a useful modality for tracking their development. Modification of this tool may be needed to assess advanced learners’ gains in performance.
From Time-Based to Competency-Based Standards: Core Transitional Competencies in Plastic Surgery. (Lutz K, Yazdani A, Ross D.) – Competency-based medical education is becoming increasingly prevalent and is likely to be mandated by the Royal College in the near future. The objective of this study was to define the core technical competencies that should be possessed by plastic surgery residents as they transition into their senior (presently postgraduate year 3) years of training. Overall, 26 competencies have been identified as “core” for plastic surgery residents to possess as they begin their senior, on-service years. The nature of these skills makes them suitable for teaching in a formal, simulated environment, which would ensure that all plastic surgery trainees are competent in these tasks as they transition to their senior years of residency.