This morning at Taylor’s University, Dr. Hyun Soo Chung, Associate Professor in the Department of Emergency Medicine and Director of the Clinical Simulation Center at Yonsei University provided the opening plenary on the “AMEE Best Evidence Practical Guide on Simulation in Healthcare”. The objectives of the presentation were:
- Review an effective approach to curriculum integration of sim in health education
- Explain the import of feedback and deliberate practice to effective learning using sim
- Describe master learning as a tool for retention.
Dr. Chung reminded us of the winning Formula for simulation success.: Training resources x Trained educators x Curriculum institutionalization = Effective educational program. Hyun went on to explain the first six of nine key areas identified by the research.
Curriculum Integration: The Sim experience must be planned, scheduled, implemented and evaluated in the context of the broader curriculum”. Most powerful outcomes are achieved by having and organized and systematic approach to the incorporation of simulation in an existing or new curriculum.
Feedback in Simulation: Specific information given to the a trainee about the comparison between observed performance and a standard, given with the intent to improve the trainee’s performance. Without a post-event there is a greater chance for mis-learning.
Here, Dr. Chung explained that some of the main debriefing models which are western based do not work as well in Eastern countries like Korea. He suggested that a typical Korean student is submissive, passive and humble, having learned not to ask questions. Citing Hofstede’s Cultural Dimensions he shared that in Korea, healthcare students are usually scolded and do not ask questions — and debriefing does not work as traditionally expected in the west. Here, I suggested to Dr. Chung explore CRM communication tools developed in the aviation industry which have been adopted by the Korean Airlines industry have several accidents which stemmed from this very issue.
Deliberate Practice: Here we must prime healthcare students with the appropriate level of difficulty with focused repetitive practice on well-identified tasks. This produces reliable data used for informative feedback and the opportunity to correct errors.
Mastery Learning: Set clear target critical component of competency-based education. Goal is that all learners consistently achieve objective level of mastery performance. After establishing a base minimum build an assessment. Set objectives with increasing levels of difficultly and then test for competency.
Range of Difficulty: Cognitive load and competency of information must be target ed at the learner level.
Capturing Clinical Variation: Learning optimized with stepwise progression to increased level of difficultly.
In conclusion Dr. Chung shared ways on how simulation can be seen as a “solution”:
- Medical error reduction and patient safety
- Learner-centered, individualized learning
- Outcome-based education
- Needed exposure to range of clinical cases
- Studying human factors
- Supplant animal and live-tissue models (as technology & tissue fidelity continues to improve)
- Accreditation and Licensure