ProblemPhysical distancing restrictions during the COVID-19 pandemic led to the transition from in-person to online teaching for many medical educators. This report describes the Virtual Resus Room (VRR)-a free, novel, open-access resource for running collaborative online simulations. ApproachThe lead author created the VRR in May 2020 to give learners the opportunity to rehearse their crisis resource management skills by working as a team to complete virtual tasks. The VRR uses Google Slides to link participants to the virtual environment and Zoom to link participants to each other. Students and facilitators in the emergency medicine clerkship at McMaster University used the VRR to run 2 cases between June and August 2020. Students and facilitators completed a postsession survey to assess usability and acceptability, applicability for learning or teaching, and fidelity. In addition, students took a knowledge test pre-and postsession.
Background: Virtual interprofessional education (IPE) has emerged as a promising alternative to traditional in-person IPE. However, theoretical frameworks to support virtual interprofessional learning are not well established. Two theoretical frameworks emerged as relevant to virtual IPE: (1) the Canadian Interprofessional Health Collaborative (CIHC) interprofessional learning framework and (2) Dornan's Experience-Based Learning Model (ExBL) of workplace learning. In this study, we sought to explore virtual IPE using both frameworks to develop new theoretical understandings and identify assumptions, gaps and barriers.Methods: This was a qualitative study. Semi-structured interviews were conducted with medical and nursing student participants (n = 14) and facilitators (n = 3) from virtual IPE workshops. Transcripts were analysed using directed content analysis methodology, informed by the CIHC and ExBL frameworks. Themes were explored using mind-mapping transitional coding. Data collection and analysis were continued iteratively until themes with adequate conceptual depth, relevance and plausibility were identified.Results: Three themes were identified: (1) a shift in the balance of personal and professional, (2) blunted sociologic fidelity and (3) uncertainty and threats to interpersonal connections. Professional distinctions and hierarchies are blurred virtually. This contributed to an increased sense of psychological safety among most learners and lowered the threshold for participation. Separation from workplace sociologic complexity facilitated communication and role clarification objectives. However, loss of immersion may limit deeper engagement. Interprofessional objectives that rely on deeper sociological fidelity, such as conflict resolution, may be threatened. Informal interactions between learners are hindered, which may threaten organic development of interprofessional relationships.Conclusions: Role clarification and communication objectives are preserved in virtual IPE. Educators should pay close attention to psychological safety and sociologic fidelity-both to leverage advantages and guard against threats to connection and transferability. Virtual IPE may be well suited as a primer to in-person activities or as scaffolding towards interprofessional workplace practice.
Background Simulation provides consistent opportunities for residents to practice high‐stakes, low‐frequency events such as pediatric resuscitations. To increase standardization across North American residency programs, the Emergency Medicine Resident Simulation Curriculum for Pediatrics (EM ReSCu Peds) was developed. However, access to high‐quality simulation/pediatric expertise is not uniform. As the concurrent COVID‐19 pandemic necessitated new virtual simulation methods, we adapted the Virtual Resus Room (VRR) to teach EM ReSCu Peds. VRR is an award‐winning, low‐resource, open‐access distance telesimulation platform we hypothesize will be effective and scalable for teaching this curriculum. Methods EM residents completed six VRR EM ReSCu Peds simulation cases and received immediate facilitator‐led teledebriefing. Learners completed retrospective pre–post surveys after each case. Learners and facilitators completed end‐of‐day surveys. Primary outcomes were learning effectiveness measured by a composite of the Simulation Effectiveness in Teaching Modified (SET‐M) tool and self‐reported changes in learner comfort with case objectives. Secondary outcome was VRR scalability to teach EM ReSCu Peds using a composite outcome of net promoter scores (NPS), resource utilization, open‐text feedback, and technical issues. Results Learners reported significantly increased comfort with 95% (54/57) of EM ReSCu Peds–defined case objectives (91% cognitive, 9% psychomotor), with moderate (Cohen's d 0.71, 95% CI 0.67–0.76) overall effect size. SET‐M responses indicated simulation effectiveness, particularly with debriefing. Ninety EM residents from three North American residency programs were taught by 59 pediatric faculty from six programs over 4 days—more than possible if simulations were conducted in person. Learners (39) and faculty (68) NPS were above software industry benchmarks (13). Minor, quickly resolved, technical issues were reported by 18% and 29% of learners and facilitators, respectively. Conclusions Learners and facilitators report that the VRR is an effective and scalable platform to teach EM ReSCu Peds. This low‐cost, accessible distance simulation intervention could increase equitable, global access to high‐quality pediatric emergency education.
Pediatric Emergency and Critical Care-Kenya (PECC-Kenya) is an international collaboration between the University of Nairobi and the University of Washington (UW) supporting a combined fellowship program in pediatric emergency medicine (PEM) and pediatric critical care medicine (PCCM) in Kenya. Typically, PEM/PCCM faculty from UW travel to Kenya to support in-person simulation, which was cancelled due to COVID-19 travel restrictions. This presented a need for alternative modalities to continue simulation-based education. This technical report describes the use of virtual simulation for pediatric emergency and critical care fellow education on the management of hypovolemic and septic shock, utilizing international guidelines and being based on resource availability.
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