Recent Advances in Simulation for Pediatric Critical Care Medicine

Harwayne‐Gidansky, Ilana; Panesar, Rahul; Maa, Tensing

doi:10.1007/s40124-020-00226-5

Cited by 7 publications

(3 citation statements)

References 99 publications

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“…Although there are a limited number of studies available on the topic and it is difficult to isolate the effects of simulation, Goldshtein found that the implementation of in situ simulation in training programs improves patient morbidity and/or mortality (Goldshtein et al, 2020). Therefore, simulation positively impacts standards of care by improving health professionals' performance (Harwayne-Gidansky et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Emergency Medicine Cases in Underwater and Hyperbaric Environments: The Use of in situ Simulation as a Learning Technique

et al. 2021

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IntroductionHyperbaric chambers and underwater environments are challenging and at risk of serious accidents. Personnel aiming to assist patients and subjects should be appropriately trained, and several courses have been established all over the world. In healthcare, simulation is an effective learning technique. However, there have been few peer-reviewed articles published in the medical literature describing its use in diving and hyperbaric medicine.MethodsWe implemented the curriculum of the Master’s degree in hyperbaric and diving medicine held at the University of Padova with emergency medicine seminars created by the faculty and validated by external experts. These seminars integrated traditional lectures and eight in situ simulation scenarios.ResultsFor the hyperbaric medicine seminar, simulations were carried out inside a real hyperbaric chamber at the ATIP Hyperbaric Treatment Centre, only using air and reproducing compression noise without pressurization to avoid damages to the manikins. The four scenarios consisted of hyperoxic seizures, pneumothorax, hypoglycemia, and sudden cardiac arrest. Furthermore, we added a hands-on session to instruct participants to prepare an intubated patient undergoing hyperbaric oxygen treatment with a checklist and simulating the patient transfer inside and outside the hyperbaric chamber. The diving medicine seminar was held at the Y-40 The Deep Joy pool in Montegrotto Terme (Italy), also involving SCUBA/breath-hold diving (BHD) instructors to rescue subjects from the water. These diving medicine scenarios consisted of neurologic syndrome (“taravana/samba”) in BHD, drowning of a breath-hold diver, pulmonary barotrauma in BHD, and decompression illness in a SCUBA diver.ConclusionWith this experience, we report the integration of simulation in the curriculum of a teaching course in diving and hyperbaric medicine. Future studies should be performed to investigate learning advantages, concept retention, and satisfaction of participants.

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Section: Discussionmentioning

confidence: 99%

Emergency Medicine Cases in Underwater and Hyperbaric Environments: The Use of in situ Simulation as a Learning Technique

et al. 2021

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“…These include translational simulation to prepare health services for the COVID-19 pandemic [ 18 – 30 ], for hospital relocation or physical space testing [ 31 ], for clinical pathway or process testing [ 32 – 39 ], and for shaping culture and teamwork in healthcare settings [ 35 , 40 – 46 ]. Other citing literature has included conceptual discussions and review articles [ 47 – 51 ], as well as efforts to develop methods and tools for ‘translational simulation in action’ [ 16 , 32 , 52 ]. We now consider and critique these examples and provide a summary in Table 1 .…”

Section: Exploring Translational Simulation In Practicementioning

confidence: 99%

Translational simulation revisited: an evolving conceptual model for the contribution of simulation to healthcare quality and safety

Brazil,

Reedy

2024

Adv Simul

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The simulation community has effectively responded to calls for a more direct contribution by simulation to healthcare quality and safety, and clearer alignment with health service priorities, but the conceptual framing of this contribution has been vague. The term ‘translational simulation’ was proposed in 2017 as a “functional term for how simulation may be connected directly with health service priorities and patient outcomes, through interventional and diagnostic functions” (Brazil V. Adv Simul. 2:20, 2017). Six years later, this conceptual framing is clearer. Translational simulation has been applied in diverse contexts, affording insights into its strengths and limitations. Three core concepts are identifiable in recently published translational simulation studies: a clear identification of simulation purpose, an articulation of the simulation process, and an engagement with the conceptual foundations of translational simulation practice. In this article, we reflect on current translational simulation practice and scholarship, especially with respect to these three core concepts, and offer a further elaborated conceptual model based on its use to date.

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“…Simulation education is commonplace within PICU and physiotherapy, where real patient encounters are substituted with artificial models, actors or virtual reality patients. Simulation enables the learner to engage in a safe environment, and provides hands-on learning in an immersive environment, with opportunities for repetition, practice and feedback (Harwayne-Gidansky et al, 2020). A video of a simulated patient assessment and treatment was used in this study as this was more readily available and offered fewer challenges related to patient confidentiality, when compared to a real patient video.…”

Section: Focus Group Structurementioning

confidence: 99%

Identifying and Understanding Risk Factors for Instability and Adverse Events Associated With Chest Physiotherapy in Ventilated Children

2019

CMR

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BackgroundChest physiotherapy is a treatment option for ventilated children. Evidence supporting treatment effectiveness is limited and the safety profile is unknown.This study aimed to identify and understand risk factors for physiological instability and adverse events associated with chest physiotherapy in ventilated children. MethodsThis was a convergent mixed methods study.Work package 1: Explanatory sequential study to describe current physiotherapy practice and explore decision making, utilising an anonymous questionnaire, semi-structured interviews, focus groups, and document analysis. Work package 2:Retrospective single-centre study, using high-resolution data and electronic patient records. Mechanically ventilated children, aged 0-4 years, receiving chest physiotherapy were included. The primary outcome was oxygen saturation index (OSI). Incidence of adverse events (change ≥0.3) in the 60 minutes post-physiotherapy was investigated. ResultsThe questionnaire was sent to 26/27 (96%) UK paediatric intensive care units, with a response rate of 61% (72/118). Sixteen physiotherapist interviews and two focus groups (n=7) were completed. Twenty-nine organisational documents were analysed. The most frequently used techniques were position changes, saline instillation, manual hyperinflations and chest wall vibrations. Variation in practice included the personnel involved in treatments. Clinical decision making was described as complex, iterative, and collaborative, with experience and expertise important factors. OSI data were available for 247 patients. OSI adverse event rates were between 7.4%-9.3%. The highest rate was recorded in the 5 minutes immediately post-ARDS Acute respiratory distress syndrome ASL Airway surface liquid BD Twice daily CAQDAS Computer assisted qualitative data analysis software CF Cystic Fibrosis CICU Cardiac intensive care unit CO2 Carbon dioxide COPD Chronic obstructive pulmonary disease COVID19 Severe acute respiratory syndrome coronavirus 2 2019 pandemic CPB Cardiopulmonary bypass CPT Chest physiotherapy CS Closed suction CVVH Continuous veno-venous haemofiltration CWV Chest wall vibrations CXR Chest x-ray

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Recent Advances in Simulation for Pediatric Critical Care Medicine

Cited by 7 publications

References 99 publications

Emergency Medicine Cases in Underwater and Hyperbaric Environments: The Use of in situ Simulation as a Learning Technique

Emergency Medicine Cases in Underwater and Hyperbaric Environments: The Use of in situ Simulation as a Learning Technique

Translational simulation revisited: an evolving conceptual model for the contribution of simulation to healthcare quality and safety

Identifying and Understanding Risk Factors for Instability and Adverse Events Associated With Chest Physiotherapy in Ventilated Children

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