Regional EMS Cadet Competition Utilizes Simulation For Recognition of Leading Students

South Orange Rescue Squad Cadets Bring Home Gold

Shouldnt all EMS programs utilize simulation for demonstration and training to new recruits on the lessons of first responding? Village Green NJ recently reported how last Saturday the South Orange Rescue Squad won the 5th Annual Bayshore EMS Cadet Competition in Keyport, New Jersey at the Keyport First Aid Squad. What a great way to utilize simulations to encourage healthcare professionals of tomorrow!

This event brought Emergency Medical Services cadet teams from New York and New Jersey together for a two day event that combines EMS skill competitions, educational experiences, training, and socializing with like-minded peers. Many volunteer ambulance squads across the state have cadet programs where teenagers train alongside adult members to provide emergency medical care to their community. Explained South Orange Rescue Squad President Troy Balog, “these cadet groups are valuable feeder programs to help critical volunteer shortages in squads.”

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He added, “we’ve had our cadet program for three years and many former cadets are now active adult members, including our current 1st Lieutenant! We are all volunteer, do not charge for our services and exist on donations, so people who give so much of their time are highly valued.” Competing against 35 other cadet teams, the South Orange Rescue Squad team won both first place in the “Advanced Team” category as well as the “Grand Champion” award for highest all around score. This is the first time the South Orange squad has entered the competition. “I wasn’t sure what to expect.” said team member EMT Cole Fitzsimmons, “we train a lot at South Orange so I felt that we were ready for it.”

Cadet teams could enter the “Basic” level competition or the “Advanced” level. Basic teams consisted of CPR or first aid trained cadets and were evaluated in stations consisting of Vital Sign, CPR, and bleeding control. The “Advanced” teams had to have at least two Emergency Medical Technicians and their three stations consisted of a simulated fall down to flights of stairs with two broken legs, a Heart Attack/Cardiac Arrest simulation, and a serious car accident where two critical patients were entrapped in the vehicle. “For the car accident station we had to work with the fire department to use the Jaws of Life to remove doors from the vehicle,” shared EMT team member Victor Rothstein. The victims in each of the scenarios were either role played by a volunteer with medical make-up or a high-tech simulator mannequin. Cadets were evaluated in each station by Paramedics, EMT Instructors, or Physicians who provided detailed feedback to the teens after each test.

Sponsored Advertisement: Article Shares How “Simulation Builds Skills” in OB/GYN & Surgery

medical simulation statistics

Today a recent article from two Doctors on covering the fact that Simulation Builds Skills in Contemporary OB/Gyn & Surgery departments from Dr. Levine, clinical fellow, and Dr. Goldschlag, Assistant Professor of Clinical Reproductive Medicine, both from the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at the Weill Cornell Medical College at New York Presbyterian Hospital.

Excerpt from the Article:

In 1999, the Institute of Medicine (IOM) issued the report To Err Is Human. In it, the IOM’s Committee on Quality of Health Care in America stated that not only did preventable medical errors cause more deaths than such feared threats as motor-vehicle accidents, breast cancer, and AIDS, but also that errors with serious consequences were most likely to occur in intensive care units, emergency departments, and operating rooms. Although some operating room-associated complications can be attributed to wrong-site surgeries and equipment malfunctions, countless patients are harmed because of physician skill deficiencies.

It is sad but true that many ob/gyn residents are still trained using a Halstedian approach that can be boiled down to the infamous “See one, do one, teach one.” Contrary to this philosophy of surgical education, surgery is not something that is  best taught by seeing, or best mastered by attempting on live subjects. There is an unavoidable practical element to effective surgical education, but no patient wants to be the “one” for a resident attempting to master a surgical procedure, especially in a fast-paced, high-stress clinical learning environment.

Even though surgery is a key part of ob/gyn training, a survey of residency programs found that only 74% formally evaluate surgical skills, with the majority reporting subjective faculty evaluations as the primary method of assessing skill proficiency. This occurs despite the availability of thoroughly vetted measures such as the objective structured assessment of technical skills (OSATS), the observational clinical human reliability assessment (OCHRA), and the operative performance rating system (OPRS).

One question that remains is how to procure simulator training experience in the current environment. As the AAMC survey revealed, many hospitals and medical schools have simulation core facilities. Scheduling training time may be as simple as calling the administrator of education in your ob/gyn department. For clinicians in community or private practices who do not have access to academic centers, national and district meetings such as those of ACOG and AAGL offer wonderful training sessions that are taught by our nation’s leading teachers using realistic simulators. Many surgical instrument sales representatives have access to simulation facilities. Simulation is an important part of surgical training and maintenance of skills and for those who want the training, the resources are available.

Read the full article on!

What Healthcare Simulation Can Learn from The Nuclear Power Industry

nuclear power simulator

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.

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WATS Aviation Simulation Conference Demonstrates the Potential to Healthcare

wats 2013

Recently I was invited to Halldale Media‘s 2013 World Aviation Training Conference and Expo event took place in Orlando, Florida with over 1,000 pilots, flight attendants, mechanics, students and vendors in attendance. I have produced what I consider to be a ‘must-view’ video and article covering the event, which more than demonstrated the parellels between aviation simulation training and healthcare simulation training.

Being the first simulation training conference I have attended outside of the healthcare sector, I was very impressed to witness an industry which has wholeheartedly accepted simulation. Absent from the event were sessions dedicated to convincing users about the need to invest in simulation training programs. Instead, keynote speakers addressed the latest data findings pointing to unexplored training gaps such as lithium-ion laptop battery fires and auto-pilot engaged high-altitude stall recovery protocol changes.

Watch the video above and view the rest of this must-read article by clicking the link below.

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