Simulation in medical education

So, H.; Chen, Phoon Ping; Wong, George Kwok Chu; Chan, Tony Tung Ning

doi:10.4997/jrcpe.2019.112

Cited by 200 publications

(193 citation statements)

References 27 publications

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“…Indeed, some have raised concerns that simulation may hinder development if it fails to encapsulate the complexities of authentic clinical experiences. 2,7,8 Our study adds weight to this argument, highlighting a need for increased nuance within undergraduate simulation.…”

Section: Discussionmentioning

confidence: 68%

“…7 Situating complex 'authentic' tasks within simulation may address this issue. 8 To further explore this, we delivered simulations that ran contrary to 'typical' presentations in an effort to provoke clinical uncertainty. We theorised that students would expect the simulation to follow a predictable 'typical' course, with uncertainty provoking cognitive dissonance -a rich potential source for learning.…”

Section: Introductionmentioning

confidence: 99%

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Medical education, simulation and uncertainty

Scott

Sudlow

Shaw

et al. 2020

The Clinical Teacher

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Background: Foundation doctors often feel underprepared to cope with uncertainty, particularly in an acute setting. Simulation is an established method for teaching about the management of acutely unwell patients, yet simulated cases are often simplified to ensure that a given learning outcome is reached. This approach may present learners with challenges in clinical practice when more complex nuanced cases are encountered. We explored final-year medical students' perceptions of clinical uncertainty when facing an 'authentically' complex simulated patient. Methods: We adapted a simulation scenario in an attempt to replicate clinical uncertainty. The simulated patient had a confused history, only mildly deranged physiology, no current clear diagnosis and no diagnostic investigations yet available. Students engaged in debriefs facilitated by the researchers, which employed advocacy and enquiry to help students to reflect on their simulations (the 'Diamond Approach'). These were transcribed, coded and analysed thematically. Results: Students found the 'uncertainty' simulation more challenging than a 'typical' simulation. Students found it disheartening when the patient had no clear diagnosis and We delivered simulations that ran contrary to 'typical' presentations in an effort to provoke clinical uncertainty

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Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Medical education, simulation and uncertainty

Scott

Sudlow

Shaw

et al. 2020

The Clinical Teacher

View full text Add to dashboard Cite

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“…Anonymised feedback forms completed by 100% of participants suggest that they are more confident to handle real-life scenarios and have a better understanding of their own role 6 26. It is well recognised that in order for experiential learning to be effective, learners need to have time to receive feedback and reflect on their performance 27.…”

Section: Discussionmentioning

confidence: 99%

Multiprofessional in situ simulation is an effective method of identifying latent patient safety threats on the gastroenterology ward

Uttley

Suggitt

Baxter

et al. 2020

Frontline Gastroenterol

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ObjectiveIn situ simulation (ISS) is an effective training method for multiprofessional teams dealing with emergencies in high pressured environments. A regular ISS programme was organised for the multiprofessional gastroenterology team with a primary objective of identifying, classifying and addressing latent patient safety threats and secondary objectives of improving team confidence and individual role recognition.Method22 unannounced ISS sessions (averaging approximately one session every 6 weeks and four participants per session) were conducted between February 2017 and August 2019 involving multiprofessional team members. The sessions centred around the following four common gastrointestinal emergency scenarios: massive upper gastrointestinal haemorrhage; biliary sepsis (cholangitis) and shock; postendoscopic retrograde cholangiopancreatography complications including perforation and cardiac arrest. Following the simulation, the faculty, which included nurses and doctors, facilitated a structured debrief session and action plan to identify and address latent errors.Results96 participants from nursing, medical, physician associate and pharmacy backgrounds took part in the simulation programme. Analysis of collected latent safety threats identified the following four themes: education and training; equipment; medication and team working. Analysis of anonymously completed questionnaires identified that 95% of participants had a perceived better understanding of their role and 86% felt more confident in assessing an unwell patient. 96% of participants felt comfortable during the debrief.ConclusionISS provides a unique opportunity to train the multiprofessional gastroenterology team in their own high-pressured environment, helping identify and address latent patient safety threats and improve perceived participant confidence and role recognition.

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“…While computer simulations are widely used in medical education [17][18][19][20], we are unaware of computer simulation having been previously used to model careers in the way shown in this report. We imagine our approach will be of interest to others seeking to motivate students towards increased commitment to study both rare and moderately uncommon diseases.…”

Section: Discussionmentioning

confidence: 99%

Career-computer simulation increases perceived importance of learning about rare diseases

Sarrafpour

Hegde

Delamare

et al. 2020

Preprint

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Background Rare diseases may be defined as occurring in less than 1 in 2,000 patients. Such conditions are, however, so numerous that up to 5.9% of the population is afflicted by a rare disease. The gambling industry attests that few people have native skill evaluating probabilities. We believe that both students and academics, under-estimate the likelihood of encountering rare diseases. This combines with pressure on curriculum time, to reduce both student interest in studying rare diseases, and academic content preparing students for clinical practice. Underestimation of rare diseases, may also contribute to unhelpful blindness to considering such conditions in the clinic. Methods We first developed a computer simulation, modelling the number of cases of increasingly rare conditions encountered by a cohort of clinicians. The simulation captured results for each year of practice, for each clinician throughout the entirety of their careers. 462 theoretical conditions were considered, with prevalence ranging from 1 per million people through to 64.1% of the population. We then delivered a class with two in-class on-line surveys evaluating student perception of the importance of learning about rare diseases, one before and the other after, an in-class real-time computer simulation. Key simulation variables were drawn from the student group, so students could see a projection of their own careers. Results The in-class computer simulation revealed that all graduating clinicians from that class would frequently encounter rare conditions. Comparison of results of the in-class survey conducted before and after the computer simulation, revealed a significant increase in the perceived importance of learning about rare diseases (p < 0.005). Conclusions The computer career simulation appeared to affect student perception. Because the computer simulation demonstrated clinicians frequently encounter patients with rare diseases, we further suggest this should be considered by academics during curriculum review and design.

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Simulation in medical education

Abstract: What is simulation?

Cited by 200 publications

References 27 publications

Medical education, simulation and uncertainty

Medical education, simulation and uncertainty

Multiprofessional in situ simulation is an effective method of identifying latent patient safety threats on the gastroenterology ward

Career-computer simulation increases perceived importance of learning about rare diseases

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