interprofessional simulation-based team training
TRANSCRIPT
P R A E L A D A W O N G S I R I M E T E E K U L , M D P R I N C E M A H I D O L A W A R D S C H O L A R 2 0 1 5
I N T E R P R O F E S S I O N A L S I M U L A T I O N - B A S E D T E A M T R A I N I N G : L E S S O N L E A R N E D T H E H A R D W A Y
Scholar Praelada Wongsirimeteekul, MD Resident of Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand Surgical Education and Simulation Research Fellow, The Massachusetts General Hospital, Harvard Medical School, USA
O U T L I N E :
• What is simulation?
• Why simulation is important?
• Interprofessional Operating Room (OR) Team Training
• My experiences
W H A T I S S I M U L A T I O N ?
"Simulation is a technique to replace or amplify real-patient experiences with guided educational experiences that evoke or replicate aspect of the real world."
Society for Simulation in Healthcare. What is simulation? 2009 May
• Patient Safety
• Safe zone to learn
• Well-matched with adult learning theories
• Repeatable and Controllable
• Fun
W H Y S I M ?
K O L B ’ S E X P E R I E N T I A L L E A R N I N G C Y C L E
I N T E R P R O F E S S I O N A L S I M U L A T I O N O R T E A M T R A I N I N G F O R R E S I D E N T S
I N T E R P R O F E S S I O N A L O R T E A M T R A I N I N G
• Six simulation scenarios were developed by a multidisciplinary team in order to promote inter-professional skills
• Intraoperative arrhythmia
• Intraoperative ST-elevated myocardial infarction (STEMI)
• Operating room fire
• Malignant hyperthermia
• Difficult airway
• Massive haemorrhage
I N T E R P R O F E S S I O N A L O R T E A M T R A I N I N G
• Weekly simulation sessions from 2013 to 2015.
• Conducted in the in-situ simulation operating room set up with general
surgery supplies, anesthesia equipment, and a SimMan® patient
simulator
Multidisciplinary OR Team
Surgical residents
Anesthesiology residents Nurses
Surgical Technologists
Debriefing (30 mins)
Orientation (10 mins)
Case scenario (20 mins)
Each session was approximately 60 minutes
Evaluation form was done after simulation session.
T O T A L N U M B E R O F 5 7 8 P A R T I C I P A N T S
Anesthesiology Residents
34%
Surgical Residents
29%
Nurses 25%
Surgical Technicians
13%
Question
Stro
ngly
agr
ee
(%)
Agr
ee (%
)
Som
ewha
t
agre
e (%
)
Neu
tral (
%)
Som
ewha
t
disa
gree
(%)
Dis
agre
e (%
)
Stro
ngly
Dis
agre
e (%
)
The simulation was realistic enough for
me to engage in learning? 44 42 9 2 1 0 2
The simulation exercise helped me
improve my teamwork skill? 36 47 12 4 0 0 1
The simulation exercise was clinically
applicable to my practice. 65 30 3 1 0 0 1
I will change my practice because of this
simulation exercise. 32 42 14 10 0 2 0
Working in mixed team was important to
my learning for this simulation exercise. 64 30 3 3 0 0 0
The instructors also learned by working as multidisciplinary team
to create case scenarios, troubleshoot the problems, and
improve teaching skills as simulation educators.
L I M I T A T I O N
• Hard to find the time to do the multidisciplinary team training.
• Clinical assessment has not been done in this study.
F U T U R E R E S E A R C H
• Formal assessment of
teamwork
• Effect on patient care
• Improved integration into
daily work.
I M P L E M E N T A T I O N I N T H A I L A N D
• Important to develop inter-professional skills and effective teamwork
• May ultimately improve patient care and outcomes
C O N C L U S I O N
• Simulation is an effective method to learn and improve intra-
operative teamwork.
• The implementation of inter-professional simulation-based team training
may improve overall patient care and outcomes.
• More research is required to determine how to streamline integration
into daily practice.
M O R E E X P E R I E N C E S
MGH Surgical Education Research Team
NEJM Educational Research Team
M O R E E X P E R I E N C E S
• Teaching Technical skills for Harvard medical students • Observing Surgery Clerkship OSCE and Intern Bootcamp
M E D I C A L E D U C A T I O N O P P O R T U N I T I E S
NEJM Group Educational Strategy Workshop: Learning at the Crossroads
M E D I C A L E D U C A T I O N O P P O R T U N I T I E S
Harvard Macy Institute: Health Care Education 2.0 Transforming your teaching for the digital age
M E D I C A L E D U C A T I O N O P P O R T U N I T I E S
OR Team Instructor Course at Centre of Medical Simulation
Lab resident as a teacher workshop
C O N F E R E N C E S
Surgical Education Week in San Diego, CA, USA
AMEE 2017 in Helsinki, Finland
ACS Clinical Congress
in San Diego, CA, USA
IMSH 2018 in LA, CA, USA
M E D I C A L E D U C A T I O N R E S E A R C H C E R T I F I C A T E ( M E R C )
F R O M A S S O C I A T I O N O F A M E R I C A N M E D I C A L C O L L E G E S ( A A M C )
International Mentor Associate Professor Roy Phitayakorn, MD, MHPE(Med), FACS General and endocrine surgery and Director of Medical Student Education and Surgery Education Research, Department of General Surgery, Massachusetts General Hospital, Harvard Medical School, Senior Education Research and Development Consultant, NEJM
Thai Mentor Manoch Chokjamsai, MD, MMed Assistant Dean for Clinical Academic, Department of Forensic, Faculty of Medicine, Chiang Mai University,
A C K N O W L E D G E M E N T The MGH Learning Laboratory and all of the staffs and simulation specialists:
• Dr. James Gordon
• Dr.Denise Gee
• Mrs. Andrea Paciello
• Mrs. Bethany Daily
• Mr. Kevin Synnott
• Ms. Sara Midwood
• Mrs. Christina Valle
• Mr. Jim Titus
• Mr. Wayne Stathapoulos
• Mr. Suresh Venkatan