Simulation-based medical education (SBME) is often delivered as one-size-fits-all, with no clear guidelines for personalization to achieve optimal performance. This essay is intended to introduce a novel approach, facilitated by a home-grown learning management system (LMS), designed to streamline simulation program evaluation and curricular improvement by aligning learning objectives, scenarios, assessment metrics and data collection, as well as integrate standardized sets of multimodal data (self-report, observational and neurophysiological). Results from a pilot feasibility study are presented. Standardization is important to future LMS applications and could promote development of machine learning-based approaches to predict knowledge and skill acquisition, maintenance and decay, for personalizing SBME across healthcare professionals.
The busy and distraction-rich environment in which anaesthetic practice occurs is fertile ground for error. Frequently, ad hoc teams with variable experience assemble to deliver high-stakes care. During this time, multiple medications are prepared and administered, patient physiology is altered by pharmacology and surgical insult, and an increasing number of monitors and other technological devices compete for clinicians' attention. It should be unsurprising, therefore, that errors do occur.Numerous groups have recognised the value of error reporting and have implemented mechanisms to capture and analyse data. Incident reporting systems are now routine at an institutional level and larger patient safety databases exist to cover specific circumstances across multiple institutions. Published case reports allow colleagues from across the world to learn from the experiences of others by providing nuanced and varied accounts of error or failure which clinicians deem impactful enough to share in a public forum. They also provide an opportunity for the clinicians involved to share and reflect on the learning points from the case and a basis for debate and discussion among peers. The impact of reporting an error on the clinicians involved may, however, influence whether something is reported in a public forum. The second victim effect, whereby healthcare providers involved in an unanticipated adverse patient event, medical error or patient-related injury experience event-related trauma, may also discourage the reporting of at least some cases. Conversely, other errors may not be reported because they are deemed to be 'low level' or of a lesser importance or significance; however, the educational value of these lower-level errors should not be underestimated. The invisibility of these near misses or 'low level' errors may not reflect the potential impact they have on patient care and safety.
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