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A22 The use of simulation in paediatric emergency medicine: a scoping review 模拟在儿科急诊医学中的应用:范围综述
Laura Lee
The use of simulation in healthcare has increased in recent years. It is frequently used for replicating clinical scenarios and allows for the acquisition of skills in a safe environment. Whilst enabling candidates to make mistakes and learn from them without fear of harming patients is used across many specialities including paediatric emergency medicine for a range of teaching across all professional groups, Lateef [1] identifies that in order for it to reach its maximum potential, it needs to be integrated in traditional training programmes. This is becoming more commonplace. In order to know how to fully integrate it into practice, an understanding of how it is currently being used is essential. This scoping view aims to explore how simulation training is being used and what it is used for within paediatric emergency medicine (PEM), as reported by the literature. This review followed a five-step scoping review framework outlined by Arksey and O’Malley [2]. Literature searches were conducted in Medline and CINAHL with no limitation applied. Sixty-six studies were screened. Reference lists were also screened. Of the screened studies, 25 were subject to full test review and 19 were included in the final review. Articles were screened at all levels by one reviewer. Data extraction was also carried out by one reviewer. No papers focused on the delivery of simulation within paediatric emergency medicine in the UK, with the majority of papers originating from the USA. There was also no paper that outlined the varied uses of simulation in PEM. Many of the papers described and evaluated single scenarios that were used in varying settings or simulation courses that were not specific to PEM. Both high and low fidelity simulations were reported with much of the focus on high-fidelity simulation. Delivered through either simulation suite-based learning or This scoping review reveals that the extent to which simulation is used within PEM is largely unknown and requires further investigation. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
近年来,模拟在医疗保健领域的应用有所增加。它经常用于复制临床场景,并允许在安全的环境中获得技能。虽然使候选人能够犯错误并从中吸取教训而不必担心伤害患者,但在许多专业中,包括所有专业群体的儿科急诊医学的一系列教学中,Lateef[1]指出,为了发挥其最大潜力,需要将其整合到传统的培训计划中。这正变得越来越普遍。为了了解如何将其完全整合到实践中,了解当前如何使用它是必不可少的。这一范围界定的观点旨在探讨模拟训练是如何被使用的,以及它在儿科急诊医学(PEM)中的用途,正如文献所报道的那样。该综述遵循Arksey和O 'Malley[2]提出的五步范围综述框架。在Medline和CINAHL中进行文献检索,没有限制。筛选了66项研究。还筛选了参考名单。在筛选的研究中,25项研究进行了全面的测试审查,19项研究纳入了最终审查。文章由一名审稿人在各级进行筛选。数据提取也由一名审稿人进行。没有论文关注在英国儿科急诊医学中提供模拟,大多数论文来自美国。也没有一篇论文概述了PEM中模拟的各种用途。许多论文描述和评估了在不同设置或模拟课程中使用的单一场景,而这些场景并非特定于PEM。高保真度仿真和低保真度仿真均有报道,其中高保真度仿真的报道较多。通过基于模拟套件的学习或此范围审查交付,揭示了在PEM中使用模拟的程度在很大程度上是未知的,需要进一步调查。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
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引用次数: 0
A88 Designing a Multidisciplinary Chest Drain Course A88设计多学科胸腔引流课程
Jane Doherty, Eirini Kasfiki, Dave Wright, Andrew Blackmore
In 2008 the National Patient Safety Agency reported 12 patient deaths directly related to chest drain insertion over a 3-year period. Since then there have been calls from publications highlighting the need for better education for clinicians [1]. Simulation has been shown to improve chest drain insertion technique [2], and multi-disciplinary simulation can encourage teamwork and communication skills [3]. Given that this procedure is an essential requirement for anaesthetic, intensive care, emergency medicine and internal medicine trainees, we decided to introduce a multi-disciplinary simulation course for the insertion of chest drains. A basic needs analysis was carried out with stakeholders. Initially the course was designed to run for half a day, with a maximum of 12 candidates and a minimum of 3 faculty. A course timetable, course manual, equipment list and pre- and post-course feedback questionnaires were created. The course begins with a lecture, followed by three simulation-based workshops, which the candidates rotate between. These cover seldinger and surgical chest drain insertion, and the basics of chest ultrasound, using ultrasoundable chest drain manikins. Feedback from the first course in July 2022 suggested that there should be a designated faculty team leader and healthy volunteers for the ultrasound workshop. We implemented this feedback and ran the course again in December 2022. Candidates were asked to rate their post course confidence at performing the procedure, with a score ranging between 1 and 7 (each number was assigned a qualitative value with 1 being unable to perform the procedure and 7 being extremely confident in performing the procedure). After the first course, the average score was 5 points. After the second, the average increased to 5.5. The course ran for a third time in April 2023, during which the duration of the workshops was increased and a lecture on aftercare was added. The average post course confidence score was 5.7. All candidates felt that the session fully met the learning objectives and would recommend the course to others. After implementing changes to our course including assigning a faculty team leader, recruiting healthy volunteers, increasing the time spent in workshops and adding a session on aftercare, there has been an improvement in the candidates’ average post course confidence at performing chest drains and qualitative candidate feedback was positive. We would recommend our course structure to others designing a chest drain course. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
2008年,国家病人安全局报告说,在3年的时间里,有12名病人的死亡与胸腔引流术直接相关。从那时起,出版物一直在呼吁对临床医生进行更好的教育[1]。模拟已被证明可以改善胸腔引流插入技术[2],多学科模拟可以促进团队合作和沟通技巧[3]。鉴于这一过程是麻醉学、重症监护学、急诊医学和内科实习生的基本要求,我们决定引入一门多学科的胸腔引流术模拟课程。与利益相关者进行了基本需求分析。最初,该课程设计为半天,最多有12名候选人,至少有3名教师。制作了课程时间表、课程手册、设备清单和课前、课后反馈问卷。课程以讲座开始,随后是三个基于模拟的研讨会,候选人在其间轮换。这些包括seldinger和外科胸腔引流插入,以及胸部超声的基础知识,使用超声波胸腔引流模型。2022年7月第一期课程反馈,超声工作坊应指定一名教师组长和健康志愿者。我们实现了这个反馈,并在2022年12月再次运行了该课程。候选人被要求评价他们在完成手术后的信心,得分范围在1到7之间(每个数字被分配一个定性值,1表示无法完成手术,7表示对完成手术非常有信心)。第一节课结束后,平均成绩为5分。第二轮过后,平均得分上升到5.5分。该课程于2023年4月第三次举办,期间增加了讲习班的时间,并增加了关于善后的讲座。课程结束后的平均信心得分为5.7分。所有考生都认为该课程完全符合学习目标,并会向其他人推荐该课程。我们对课程进行了一些改变,包括指派一名教师团队领导、招募健康志愿者、增加在研讨会上的时间,并增加了一个关于善后护理的环节,在课程结束后,候选人对胸腔引流的平均信心有所提高,定性的候选人反馈是积极的。我们会把我们的课程结构推荐给其他设计胸腔引流课程的人。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
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引用次数: 0
A113 A pilot course amalgamating the benefits of psychological safety, civility, and human factors in a structured debriefing model in simulation-based education A113一门试点课程,在基于模拟的教育中,将心理安全、文明和人为因素的好处结合在结构化汇报模式中
Radha Brown, Rajesh Lall, Laura Askins
Simulation-based education (SBE) is one of the leading teaching methods in healthcare. Debriefing is the cornerstone of effective simulation-based medical education. Debriefing is considered vital part to learning from simulation, and for the transfer of learning so that it can be applied to other situations [1]. Feedback from four simulation faculty development days identified that debriefers lacked the confidence to address conflict or use the principles of civility to enhance their debriefs. Teaching which has structured debrief covering civility and human factors are the cornerstone to deliver sessions that instil confidence and patient safety within the organization [2]. Human factor principles that employ psychological safety were introduced in the debriefing course with the purpose of upskilling the debriefers. There are various models of debriefing however, the focus was to provide the three-phase conversation structure. The course covered human factor principles alongside debriefing techniques using the three-phase conversation structure and interactive workshops. We enlisted the services of a specialist human factor/civility lecturer, simulation lead and a simulation lecturer to deliver the course. At the end of the course, the participants had to undertake a debrief to consolidate their learning in a supportive environment and immediate evaluation was obtained using a structured questionnaire (see Evaluation themed responses Additionally, a pilot study of five participants who had attended the course were randomly selected for a face-to-face interview twenty-four hours after the course. Three open-ended questions were asked. These focussed on whether the application of psychological safety and human factors enhanced their debriefing skills and suggestions for further course development. The results highlighted the value of the inclusion of human factor principles. Both evaluation methods were positive. Attendees commented on the value-added to their simulation training and wanted these principles to be adapted as a structured course. Acknowledging the fact that the sample recruited was small and may not be statistically significant, a future study will include a bigger sample size. Currently, this is the only organization within the North-East of England that offers standalone debriefing course. There was an overwhelming demand for a course aimed at educators who are engaged in SBE with emphasis on debriefing to consolidate learners’ experience. This course is intended to be delivered to all educators across the North-East region and beyond. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
基于模拟的教育(SBE)是医疗保健领域的主要教学方法之一。汇报是有效的模拟医学教育的基石。汇报被认为是从模拟中学习的重要部分,也是将所学知识转移到其他情况中的重要部分[1]。来自四个模拟教师发展日的反馈表明,汇报员缺乏解决冲突或使用文明原则来加强汇报的信心。包括文明和人为因素的结构化汇报的教学是在组织内灌输信心和患者安全的基础[2]。在述职过程中引入了运用心理安全的人因原理,目的是提高述职员的技能。汇报有各种各样的模型,但重点是提供三阶段对话结构。该课程涵盖了人的因素原则以及使用三阶段对话结构和互动研讨会的汇报技术。我们聘请了一位专业的人为因素/文明讲师、模拟主管和模拟讲师来讲授这门课程。在课程结束时,参与者必须进行汇报,以巩固他们在支持性环境中的学习,并使用结构化问卷(见评估主题回答)立即进行评估。此外,在一项试点研究中,随机选择五名参加过课程的参与者在课程结束后24小时进行面对面访谈。他们问了三个开放式问题。这些问题集中在心理安全和人为因素的应用是否提高了他们的述职技巧以及对进一步课程发展的建议。结果突出了纳入人因原则的价值。两种评价方法均为阳性。与会者评论了他们模拟培训的增值,并希望将这些原则改编为结构化课程。承认这一事实,即招募的样本很小,可能没有统计学意义,未来的研究将包括更大的样本量。目前,这是英格兰东北部唯一一家提供独立汇报课程的机构。针对从事SBE的教育工作者的课程需求非常大,强调汇报以巩固学习者的经验。本课程旨在提供给东北地区及其他地区的所有教育工作者。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
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引用次数: 0
A87 Live Virtual Placements: An alternative to traditional ‘in person’ placements A87实时虚拟位置:传统的“面对面”位置的替代方案
Richard Ward, Antony Freeman, Tom Davidson, David Brown, Charles Everard, Alex Martin-Verdinos, Catherine O’Leary
The role of the paramedic is diversifying, and universities need to respond by developing curriculums that support paramedic graduates to meet future workforce needs. Placements are key to our students developing the necessary competencies to become qualified paramedics and the pressure is on universities to offer a wide range of placements to reflect professional diversification. In addition, Health and Care Professions Council’s new standards of proficiency acknowledge that paramedics of the future are likely to consult patients in the virtual world [1]. As universities strive to meet this demand, they are often faced with placement capacity issues. Rising student numbers, staff retention issues and competition for placements from other healthcare students can make it extremely challenging to secure placements, especially in desirable areas such as primary care. The author, with the support from colleagues, was successful in obtaining funding from Health Education England to pilot a series of live virtual placement experiences, the first of which was successfully delivered on 20th April. On this date, 30 learners from our paramedic degree apprenticeship programme, in a classroom on our Lancaster campus, virtually attended a live clinic in a primary care setting in the south of England. The clinic was rigged with various cameras and microphones, with real patients consenting to being filmed. The experience comprised of 5 patients, with the lead clinician providing a brief to the learners before each patient arrived for their consultation. Afterwards, the clinician would complete their clinical documentation before engaging in a two-way conversation with our learners and academic staff via Microsoft teams. Following the clinic, our apprentices had the opportunity to consolidate their learning via case study driven seminars which linked to the mornings experience. Overall, student feedback was supportive, with the majority stating they found the experience enjoyable and engaging. The video stream of the placement was recorded for reuse in the programme’s curriculum, and we hope that future live virtual placements will see other professions, such as physiotherapy and nursing, take part. Eventually, we want to develop the model for other disciplines and placement settings The academic team are looking forward to the second of three experiences, in May, with the view to contributing to the growing evidence base in this area, to reflect the value that we believe ‘Live Virtual Placement’ experiences have in the development of our future workforce. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
护理人员的角色正在多样化,大学需要通过开发课程来支持护理人员毕业生满足未来的劳动力需求。实习是培养学生成为合格护理人员的必要能力的关键,大学面临着提供广泛实习的压力,以反映专业的多样化。此外,健康和护理专业委员会的新熟练程度标准承认,未来的护理人员可能会在虚拟世界中咨询患者[1]。随着大学努力满足这一需求,他们经常面临安置能力问题。不断增加的学生人数、员工保留问题以及来自其他医疗保健专业学生的实习竞争,使得获得实习极具挑战性,尤其是在初级保健等理想领域。在同事的支持下,提交人成功地获得了英国健康教育的资助,以试行一系列现场虚拟实习体验,其中第一个于4月20日成功交付。在这一天,来自我们的护理学位学徒计划的30名学习者,在我们兰开斯特校区的一间教室里,在英格兰南部的一个初级保健机构参加了一个现场诊所。诊所安装了各种摄像机和麦克风,真正的病人同意被拍摄。该体验由5名患者组成,在每位患者到达会诊之前,首席临床医生向学习者提供简要说明。之后,临床医生将完成他们的临床文件,然后通过微软团队与我们的学习者和学术人员进行双向对话。在诊所之后,我们的学徒有机会通过案例研究驱动的研讨会巩固他们的学习,这些研讨会与早晨的经验有关。总的来说,学生们的反馈是支持的,大多数人表示他们觉得这段经历很愉快,很吸引人。实习的视频流被记录下来,以便在该项目的课程中重复使用,我们希望未来的实时虚拟实习能看到其他职业的参与,比如物理治疗和护理。最终,我们希望为其他学科和安置设置开发模型。学术团队期待着5月份的第三次体验,以期为该领域不断增长的证据基础做出贡献,以反映我们认为“实时虚拟安置”体验在我们未来劳动力发展中的价值。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
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引用次数: 0
A95 UCLH Simulation Centre - Let us show you around: A digital hybrid approach to simulation environment familiarization A95 UCLH模拟中心-让我们带您参观:一种数字混合方法来模拟环境熟悉
Luke Nash, Rochelle Findley, Daniel Paschoud
It is well established that familiarization with the simulation environment is integral to the pre-brief [1]. This fosters psychological safety and creates optimal learning conditions for participants and faculty. We sought to enrich our visitors’ psychological safety by providing a digital preview of our simulated environment, prior to the face-to-face familiarization they receive when attending a course. Combining 360 and 2D video production techniques we have produced an online experience hosted on the CenarioVR platform. This gives visitors an opportunity to explore the simulated environment, patient and equipment, in their own time, while introducing aspects of the fiction contract. We believe accessibility is key to the utilization of this resource. So we have ensured it can be used on a range of devices including: Virtual Reality Headsets (HTC/Meta) Desktops/ Laptops Mobiles/ Tablets (enhanced with accelerometer controls) The content is cloud-based and accessed via an internet browser across all platforms, requiring no additional app. One limitation is that the experience requires a stable internet connection. A link to the tour was embedded in our pre-simulation communication to participants and faculty, and its usage and impact was evaluated over a period of 2 months using additional questions in our post-course questionnaire. 50 feedback responses to CenarioVR were received. 24 delegates viewed it 26 did not. Of the 24 that viewed 58.3% agreed virtual tour strengthened their experience, 12.5% strongly agreed, 20.8% neutral, 4.2% disagreed and 4.2% strongly disagreed. From our data we concluded that over 70% of delegates that viewed the virtual familiarization found it to be beneficial to their simulation experience. With simulation being used more in education it is imperative that those with less experience in this setting are provided with resources they need to feel psychologically safe. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
众所周知,熟悉模拟环境是预简报不可或缺的一部分[1]。这促进了心理安全,并为参与者和教师创造了最佳的学习条件。我们试图通过提供模拟环境的数字预览来丰富访客的心理安全,在他们参加课程时接受面对面的熟悉之前。结合360和2D视频制作技术,我们在CenarioVR平台上制作了一个在线体验。这让参观者有机会在自己的时间里探索模拟的环境、病人和设备,同时介绍虚构合同的各个方面。我们认为,无障碍是利用这一资源的关键。所以我们确保它可以在一系列设备上使用,包括:虚拟现实耳机(HTC/Meta)台式机/笔记本电脑手机/平板电脑(增强加速度计控制)内容是基于云的,通过所有平台的互联网浏览器访问,不需要额外的应用程序。一个限制是,体验需要稳定的互联网连接。我们在模拟前与参与者和教师的沟通中嵌入了参观的链接,并在课程结束后的问卷调查中使用附加问题对其使用情况和影响进行了2个月的评估。收到了50份对CenarioVR的反馈意见。24位代表看了,26位没有看。在24个观看者中,58.3%的人同意虚拟旅行增强了他们的体验,12.5%的人非常同意,20.8%的人表示中立,4.2%的人不同意,4.2%的人非常不同意。根据我们的数据,我们得出的结论是,超过70%的观看了虚拟熟悉的代表认为这对他们的模拟体验有益。随着模拟在教育中的应用越来越多,为那些在这方面经验较少的人提供他们需要的心理安全资源是必要的。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
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引用次数: 0
A102 Embedding Electronic Patient Records Into Routine Medical Simulation Training Across the South East of England, a Pioneering Regional Collaboration A102嵌入电子病历到整个英格兰东南部的常规医疗模拟培训,一个开创性的区域合作
Andy Buttery, Rosie Courtney, Alastair Kirby, Benjamin Repton, Charlotte Roberts, Arron Thind
Electronic patient record (EPR) systems are increasingly prevalent in clinical settings, yet UK medical simulation training continues to use outdated paper-based methods for training healthcare staff. While published literature has highlighted the training benefits of incorporating EPRs into medical simulation training [1, 2], the transition has previously been hampered by a lack of bespoke software. To address this, a novel educational EPR (named SimEPR) was created, a bespoke training software designed to be used on a computer at the manikin’s bedside, which features customizable clinical scenarios ( A preview of SimEPR, a novel educational electronic patient record system designed for UK medical simulation training This project aimed to incorporate SimEPR into routine medical simulation training in the South East of England, and report trainee experience using the software. Feedback data was collected from trainees who used SimEPR as part of their simulation training using an electronic feedback form. SimEPR was initially deployed in a medical school and two NHS trusts from 11th February 2021, before the project was scaled up to six additional educational centres (one university and five NHS trusts) from 3rd January 2023. Data from 209 trainees was collected, of which 16% were medical students, 82% were foundation doctors and 2% were post-foundation doctors. Out of these, 86% reported that, compared to using paper notes, the educational EPR created a more realistic training experience. Meanwhile, 83% reported that the use of SimEPR helped improve their clinical learning. Last, 87% reported that they would recommend the simulation department to continue using SimEPR. SimEPR is the first software of its kind designed specifically for UK medical education, and is the product of collaboration with a number of simulation leads and NHS-affiliated organizations. As well as data supporting a higher fidelity training experience, SimEPR incorporates digital skills into practical training, thus supporting the development of a digitally-ready workforce. In addition, by eliminating the use of paper, SimEPR contributes to the sustainable delivery of simulation-based education. Further evaluation work as part of this pioneering regional project aims to collect pre- and post-training feedback, feedback from medical educators and feedback from other healthcare disciplines. In the longer term, SimEPR offers to transform the delivery of simulation training for the NHS workforce. The software’s ‘scenario-sharing’ function allows sharing of simulated patient records between institutions, supporting the standardization of training while saving staff time in building training scenarios. Furthermore, features such as performance analytics for trainee feedback, and AI technology to generate interactive scenarios, are being explored. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms
电子病历(EPR)系统在临床环境中越来越普遍,但英国医学模拟培训继续使用过时的纸质方法来培训医疗保健人员。虽然已发表的文献强调了将epr纳入医学模拟培训的培训益处[1,2],但由于缺乏定制软件,这种过渡以前受到阻碍。为了解决这个问题,一种新型的教育EPR(名为SimEPR)被创建,这是一种定制的培训软件,设计用于人体模型床边的计算机上,具有可定制的临床场景(SimEPR预览,为英国医学模拟培训设计的新型教育电子病历系统)。该项目旨在将SimEPR纳入英格兰东南部的常规医学模拟培训中,并报告学员使用该软件的经验。反馈数据是通过电子反馈表格从使用SimEPR作为模拟训练一部分的受训者那里收集的。从2021年2月11日起,SimEPR最初在一所医学院和两个NHS信托基金部署,然后从2023年1月3日起,该项目扩大到另外六个教育中心(一所大学和五个NHS信托基金)。收集了209名学员的数据,其中16%为医学生,82%为基础医生,2%为基础后医生。其中,86%的人报告说,与使用纸质笔记相比,教育EPR创造了更真实的培训体验。同时,83%的患者表示使用SimEPR有助于改善他们的临床学习。最后,87%的人表示他们会建议模拟部门继续使用SimEPR。SimEPR是第一个专门为英国医学教育设计的同类软件,是与许多模拟领导和nhs附属组织合作的产品。除了支持更高保真度培训体验的数据外,SimEPR还将数字技能纳入实践培训,从而支持数字化劳动力的发展。此外,通过消除纸张的使用,SimEPR有助于可持续地提供基于模拟的教育。作为这一开创性区域项目的一部分,进一步的评估工作旨在收集培训前和培训后的反馈、医学教育者的反馈和其他保健学科的反馈。从长远来看,SimEPR将为NHS员工提供模拟培训。该软件的“场景共享”功能允许在机构之间共享模拟患者记录,支持培训的标准化,同时节省员工构建培训场景的时间。此外,正在探索诸如培训学员反馈的绩效分析和生成交互式场景的人工智能技术等功能。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
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引用次数: 0
A90 Virtual Reality Simulation for the Foundation Programme – Analysis of Phase Two A90虚拟现实仿真基础课程-第二阶段分析
Hannah Yang, Helen Higham, Jackie Knight, Anil Prabhu, Kapil Savjani, Sally-Anne Shiels
The COVID-19 pandemic has undoubtedly served as a catalyst for adaptation of effective delivery of medical education, paving the way for the adoption of novel teaching methods [1]. Simulation based education (SBE) has been no exception, with increased delivery of SBE through immersive, virtual mediums such as head mounted displays (HMD) to create a three-dimensional (3D) environment. Simulation is a vital part of the mandatory foundation programme (FP) learning requirement [2]. Our team incorporated synchronous in-person and online virtual reality simulation (VRS) sessions into the foundation doctor (FD) teaching programme at a single trust and supplemented this with additional, facilitated in-person small group 3D VRS sessions. Mixed quantitative and qualitative feedback was obtained from FD through online surveys, which included aspects of the SET-M tool [3]. Semi-structured interviews were then conducted with a purposeful group of FD attending facilitated small group VRS sessions. Interviews were conducted over a sixteen-week period at eight-weekly intervals, with a baseline interview conducted at week zero. Qualitative data obtained were analysed by thematic analysis. Learners expressed that VRS sessions improved their confidence in clinical assessment, decision-making, and management of similar real-life scenarios as well as in the provision of interventions which foster patient safety. Moreover, feedback highlighted that the VRS modality fits well into their current teaching programme, is a format that they wanted more regularly incorporated into their learning and one which they would prioritize attendance at. Feedback also outlined some challenges with this modality; namely accessibility and technological troubleshooting. Our work highlights the value and associated challenges of using VRS in FP education. There is a strongly positive reception amongst learners in our cohort, a call for more exposure and, vitally, a transferability of learning into real-life practice. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
COVID-19大流行无疑是适应有效提供医学教育的催化剂,为采用新的教学方法铺平了道路[1]。基于模拟的教育(SBE)也不例外,越来越多的SBE通过沉浸式虚拟媒介(如头戴式显示器(HMD))来创建三维(3D)环境。模拟是强制性基础课程(FP)学习要求的重要组成部分[2]。我们的团队将同步的面对面和在线虚拟现实模拟(VRS)课程纳入了一个信托基金会的基础博士(FD)教学计划,并补充了额外的、便利的面对面小组3D VRS课程。FD通过在线调查获得了混合的定量和定性反馈,其中包括SET-M工具的各个方面[3]。然后进行半结构化访谈,由一组有目的的FD参加促进的小组VRS会议。访谈在16周内进行,每隔8周进行一次,在第0周进行一次基线访谈。获得的定性数据通过专题分析进行分析。学员们表示,VRS课程提高了他们在临床评估、决策和管理类似现实场景以及提供促进患者安全的干预措施方面的信心。此外,反馈强调,VRS模式非常适合他们目前的教学计划,是他们希望更经常地将其纳入学习的一种形式,也是他们优先考虑的一种出勤率。反馈还概述了这种模式的一些挑战;即可访问性和技术故障排除。我们的工作突出了在计划生育教育中使用VRS的价值和相关挑战。在我们的学生群体中,有一种强烈的积极接受,呼吁更多的接触,最重要的是,将学习转化为现实生活中的实践。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
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引用次数: 0
A86 Using Value Based Simulation to recruit high school students into the more difficult to fill roles within health and social care – contact author (Carla) A86使用基于价值的模拟来招募高中生进入更难以填补的健康和社会护理角色-联系作者(卡拉)
Jamie Dickson, Julie Mardon
Simulation based education (SBE) has been used to help attract school students into healthcare previously but commonly this is in a try it and see format using manikins to gain insight into history taking or physical examination. Also traditionally we tend to focus on more traditional healthcare professions such as nursing medicine and physiotherapy as common examples. In our region we have been working closely with our national youth academy looking at novel ways to attract and recruit our young people into more difficult to fill roles within health and social care such as home care roles and healthcare support worker roles. There are many good examples across the general workforce where simulation training can aid successful transition into the work place [1]. We are aware that certain areas of health and social care are more difficult to recruit to and wondered if values-based simulation could aid successful recruitment in this area? An immersive simulation session was designed based on 2 scenarios with space for reflection on who am I and what matters to me as a human. The first scenario was based on a reablement opportunity and focussed in on mutual goal setting giving space to express needs in the social care environment. The young learner was able to explore what skills they had and whether they were true to their own values. The second scenario was based in a hospital and looked at a health care support worker accompanying a patient to theatre. The school students had a chance to practice active listening and looking after a person who was anxious. It was amazing to see the skill set that the young people brought to both scenarios. The session has been delivered in schools, colleges and a national event. There are plans to bring the immersive simulation session to recruitment fairs. The take home messages from the sessions have been in alignment with the individuals and social care core values reflecting compassion, motivational techniques and mutual goal setting. Comments such as ‘I am astonished that I could make a difference to that person’ and ‘I hadn’t thought about a career in social care before but now I know how rewarding it feels I’m considering it’ reflect these findings. We will also look at the effect on recruitment as we roll out and scale up the work. Immersive simulation respects the young person’s core values when enabling them to make meaningful and lasting choices about careers in health and social care. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
以前,基于模拟的教育(SBE)被用来帮助吸引学生进入医疗保健行业,但通常这是一种试用的形式,使用人体模型来了解历史记录或身体检查。此外,传统上我们倾向于关注更传统的医疗保健专业,如护理医学和物理治疗作为常见的例子。在我们地区,我们一直在与我们的国家青年学院密切合作,寻找新的方法来吸引和招募我们的年轻人在卫生和社会护理领域担任更难以胜任的角色,例如家庭护理角色和卫生保健支持工作者角色。在一般劳动力中有许多很好的例子,其中模拟培训可以帮助成功过渡到工作场所[1]。我们意识到,保健和社会护理的某些领域更难招聘,我们想知道基于价值观的模拟是否有助于这一领域的成功招聘?一个沉浸式的模拟会话是基于2个场景设计的,其中有空间来反思我是谁以及作为一个人对我来说重要的是什么。第一个场景是基于一个可实现的机会,并侧重于共同目标的设定,在社会护理环境中给予表达需求的空间。年轻的学习者能够探索他们所拥有的技能,以及他们是否忠于自己的价值观。第二个场景以医院为基础,观察陪同病人去剧院的卫生保健支持人员。学校的学生有机会练习积极倾听和照顾一个焦虑的人。看到年轻人在这两种场景中所展现的技能,我感到很惊讶。该课程已在学校、大学和全国性活动中进行。他们计划在招聘会中引入这种身临其境的模拟会议。从课程中获得的信息与个人和社会关怀的核心价值观一致,反映了同情心、激励技巧和共同目标的设定。诸如“我很惊讶我能对那个人产生影响”和“我以前没有想过从事社会关怀事业,但现在我知道我正在考虑它是多么值得”之类的评论反映了这些发现。我们还将在开展和扩大这项工作的过程中考虑对招聘的影响。沉浸式模拟尊重年轻人的核心价值观,使他们能够在健康和社会保健事业中做出有意义和持久的选择。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
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引用次数: 0
A58 Mastery Based Simulation approach enabling social care teams to rapidly order small pieces of equipment to a person in their home A58精通模拟方法使社会护理团队能够快速地为家中的人订购小型设备
Julie Mardon, Amrita Brara, April Beattie, Lisa Wilson, Julie McKinven
Traditionally small pieces of equipment (e.g. Zimmer frame, commode, toilet frame and raise and walking sticks) required for frail older people in their home environment are ordered by Allied Health Professionals who are highly skilled in ensuring safety and functionality of the chosen item. However, the problem is that this process can sometimes take up to six months due to backlogs in the system. This means the person is living with unacceptable risk within their own home and losing the ability to perform activities of daily living (ADLs). This could also potentially result in falls and hospital admissions with the subsequent increase in morbidity and mortality. The team working within social care are often the referrers into this service and we wondered if the use of simulation-based mastery learning which has been shown to allow safe successful dissemination of skills in other areas of health and social care could be used to enable home care teams to safely, timeously and appropriately order small pieces of equipment autonomously [1]? Using the 7-stage approach to SBML, Checklists allowing the safe acquisition of small pieces of equipment aiding ADLs were developed by our trained mastery learning facilitators (senior AHPs). Sessions were delivered to a wide range home care team members. The training was delivered using mastery-based learning approach. We believe that this is the only example of the use of SBML in the social care environment and are really excited about the safety benefits and the way SBML enables a person-centred approach to social care [2]. The SBML training and the train the trainers will be continued to be disseminated and we will continue to evaluate the impact both on practitioners, the time it takes to get a piece of equipment and also rates of falls and admissions to hospital. The feedback from the sessions reflects the massive benefit perceived from the participants in the way their new ability will transform the way they can support people in their homes: We can’t believe this is happening it will make such a difference to our practice and the care we can deliver to our clients in their own home I never thought the day would come We will continue to assess impact on home care teams especially whether this added enhanced role aids joy at work. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
传统上,家庭环境中体弱的老年人所需的小部件设备(例如齐默架、马桶架、马桶架和手杖)由联合健康专业人员订购,他们在确保所选物品的安全性和功能性方面非常熟练。然而,问题是,由于系统中的积压,此过程有时可能需要长达六个月的时间。这意味着这个人在自己的家中生活在不可接受的风险中,失去了进行日常生活活动的能力。这也可能导致跌倒和住院,从而增加发病率和死亡率。在社会护理领域工作的团队通常是这项服务的转诊者,我们想知道,基于模拟的掌握学习是否可以使其他健康和社会护理领域的技能安全成功地传播,从而使家庭护理团队能够安全、及时、适当地自主订购小型设备[1]?使用SBML的7阶段方法,我们训练有素的熟练学习促进者(高级ahp)开发了允许安全获取辅助adl的小设备的清单。课程提供给广泛的家庭护理团队成员。培训采用以掌握为基础的学习方法。我们相信这是在社会护理环境中使用SBML的唯一例子,我们对SBML的安全效益和以人为本的社会护理方法感到非常兴奋[2]。将继续传播SBML培训和对培训人员的培训,我们将继续评估对从业人员的影响、获得设备所需的时间以及摔倒和住院率。会议的反馈反映了参与者的巨大利益感知他们的新能力的方式将改变他们的方式可以支持人们在家里:我们不能相信这是发生会使这种差异我们实践和照顾我们可以提供我们的客户在自己的家里,我从来没有想过这一天会来我们将继续评估影响家庭护理团队特别是艾滋病快乐在工作中是否添加增强作用。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
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引用次数: 0
A79 PA-rticipating in Simulation: Developing a novel teaching programme mapped to the physician associate curriculum, using simulation and interactive workshops to cover core conditions and non-technical skills A79 pa -参与模拟:开发一种新的教学方案映射到医师助理课程,使用模拟和互动研讨会来涵盖核心条件和非技术技能
Emma Higgie, Hannah Parker, Natalia Zucca
Physician Associates (PAs) are an increasingly prevalent member of the medical team, with approximately 3000 working within UK health organizations [1]. The role offers continuity and stability to the multi-disciplinary team, addressing the issue of foundation doctors rotating 4-monthly and the impact of this on day-to-day ward work, speciality specific skills and knowledge. Due to their disparate, and sometimes non-medical, backgrounds, qualified PAs have varied exposure to the recognition and management of specific medical emergencies. They also have limited opportunity for simulation experience during their training. At present, there is no national PA teaching programme once qualified (as a Foundation doctor would have), yet PAs are still expected to continue their personal and professional development, in addition to completing a re-certification exam to remain registered. We developed an innovative PA teaching programme, combining simulation scenarios with interactive workshops, with all sessions linked to the PA Competence and Curriculum Framework [2], mirroring the set-up of the Foundation doctor teaching programme. Each session aimed to develop knowledge and confidence, whilst also offering opportunities to develop non-technical skills such as teamwork, communication, handover and breaking bad news. Simulation sessions focused on assessment and management of a simulated patient with an acute medical problem whereas workshops allowed case discussion of topics such as endocrine emergencies, resuscitation decisions and dementia & delirium. Written feedback and Likert scales were used to evaluate the sessions. To date, 7 sessions have been run, with average attendance of 8.5 PAs of the 12 PAs working within the Trust. 100% of attendees agreed the scenarios have been useful and provided more confidence to deal with conditions covered. Written feedback praised the ‘transferable nature’ of topics discussed, relevant to PAs working across multiple secondary care specialties. Introducing this educational programme has been beneficial for the PAs. PAs within our trust have noted the benefits to their practice, allowing them to develop improved clinical assessment skills alongside widening their knowledge base outside of their current specialty. This supports personal and professional development, as well as providing exposure to multiple secondary care settings. We aim to repeat the same simulation scenarios after 4 months to evaluate if knowledge has been retained by adding an extra level of complexity when the scenarios are repeated. We will also look to share our learning and scenarios with other local trusts, with the potential to create a regional PA teaching programme within the South West. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
医师助理(PAs)是医疗团队中越来越普遍的成员,在英国卫生组织中约有3000人[1]。该职位为多学科团队提供了连续性和稳定性,解决了基础医生每4个月轮换一次的问题,以及这对日常病房工作、专业特定技能和知识的影响。由于他们不同的背景,有时是非医学背景,合格的私人助理在识别和管理特定医疗紧急情况方面有不同的接触。在培训期间,他们的模拟体验机会也很有限。目前,一旦获得资格,就没有国家私人助理教学计划(就像基础医生一样),但私人助理仍然需要继续他们的个人和专业发展,除了完成重新认证考试以保持注册。我们开发了一个创新的PA教学计划,将模拟场景与互动研讨会相结合,所有课程都与PA能力和课程框架[2]相关联,反映了基础博士教学计划的设置。每节课都旨在培养知识和信心,同时也提供机会培养非技术技能,如团队合作、沟通、交接和披露坏消息。模拟会议侧重于评估和管理患有急性医疗问题的模拟患者,而讲习班则允许对诸如内分泌紧急情况、复苏决定和痴呆症等主题进行案例讨论;精神错乱。使用书面反馈和李克特量表对会话进行评估。到目前为止,已经进行了7次会议,在信托基金内工作的12名pa中,平均有8.5名pa出席。100%的与会者认为这些场景是有用的,并为处理所涵盖的条件提供了更大的信心。书面反馈赞扬了讨论主题的“可转移性”,与跨多个二级护理专业的PAs工作相关。引进这个教育方案对考察团是有益的。我们信托的PAs已经注意到他们的实践带来的好处,使他们能够发展改进的临床评估技能,同时扩大他们在当前专业之外的知识基础。这有助于个人和专业发展,并提供接触多个二级护理机构的机会。我们的目标是在4个月后重复相同的模拟场景,通过在场景重复时增加额外的复杂性来评估是否保留了知识。我们还将寻求与其他当地信托机构分享我们的学习和场景,有可能在西南地区创建区域PA教学计划。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
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International journal of healthcare simulation : advances in theory and practice
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