1

Simulation on a Budget - Building Low Cost Simulation into Your Training

Program

Tony Errichetti, PhD Chief of Virtual Medicine

Director, ICC NYIT – College of Osteopathic Medicine

2013 Osteopathic Medical Leadership Education Conference Scottsdale, AZ – January 4-6, 2013

What is Simulation?

A strategy – not a technology – to mirror, anticipate, or amplify real situations with

guided experiences in a fully interactive way.

Interactive and immersive

Agency for Healthcare Research & Quality

3

How realistic does it have to be?

4

How realistic does it have to be?

Low

Novice Expert e.g. MS 1-2 e.g. Trauma Team

Lower Higher Fidelity Fidelity

(lower cost) (higher cost)

5

Engineering (physical) Fidelity

The degree to which the training device or environment replicates the

physical characteristics of the real task.

Miller RB. Psychological considerations in the design of training equipment. Report no. WADC-TR-54-563, AD 71202. Wright Patterson Air Force Base, OH; Wright Air

Development Center; 1953.

6

Engineering (physical) Fidelity

“High Fidelity” (expensive) Sims

7

Engineering (physical) Fidelity

“High Fidelity” (expensive) Sims

8

High- vs. Low-Fidelity Simulations

Level of fidelity required depends on the type of task and stage of training

Druckman D, Bjork R, eds. Learning, Remembering, Believing, Enhancing Human Performance. Washington, DC: National Academic Press; 1994.

9

High- vs. Low-Fidelity Simulations

Level of fidelity required depends on the type of task and stage of training

Druckman D, Bjork R, eds. Learning, Remembering, Believing, Enhancing Human Performance. Washington, DC: National Academic Press; 1994.

10

High skills transfer with simple simulators (including paper exercises or simple plastic models) when training cognitive tasks and

procedures

Patrick J. Training: Research & Practice, London, UK: Academic Press; 1992.

11

Low-Fidelity Sims

12

Low-Fidelity Sims

13

Low-Fidelity Sims

12-lead part task trainer

14

Hybrid Injection Simulator

Low-Fidelity Sims

15

Breast Vest Hybrid Simulator

Low-Fidelity Sims

16

Low-Fidelity Sims / Games

Human Knot Focus: Teamwork

Everyone stands in a circle and puts their right hand

into the middle. They clasp hands with someone across the circle. Then, everyone

puts their left hand into the middle of the circle and clasps the hand of a *different* person. The group is

now in a “knot”. The object is for the group to untangle itself without releasing anyone’s hand.

17

Low-Fidelity Sims / Games

60 Second Speeches Focus: Speaking Skills

Have different topics pre-written on pieces of. One

by one, participants will pick a topic and must give a 60 second speech however they would like. The

only rule is that they must not stop talking or hesitate for the entire minute.

18

Low-Fidelity Sims / Games

“Malpractice”

19

Low-Fidelity Sims / Games www.mydoctorgames.com

20

Low-Tech / Low-High Fidelity

21

Low-Tech / Low-High Fidelity

22

Low-Tech / Low-High Fidelity

23

Focus on the learners, and psychologically significant aspects of the situation

Engaging the learner in the simulation

Psychological (functional) Fidelity

24

“Fiction Contracting”

Which Reality Matters? Questions on the Path to High Engagement in Healthcare Simulation. (Editorial) Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare. 2(3):161-163, Fall 2007.Rudolph, Jenny W. PhD; Simon, Robert EdD; Raemer, Daniel B. PhD

Brief the learners – “We know this is fake but act as if it’s real”

Stressful, challenging simulation (distraction) Reality cues

25

…The “5% rule”

Ultra concrete learners (5%)

They just don’t buy it

26

Ultra suggestible learners (5%)

…The “5% rule”

They’ll buy anything

Evaluative Space Model: Inviting Engagement in Learning

Activation

Pleasant

Deactivation

Unpleasant

•Alert •Excited •Elated •Happy

•Contented •Serene •Relaxed •Calm

•Sad •Depressed •Lethargic •Fatigued

•Tense •Nervous •Stressed •Upset

(From Cacioppo & Berntson, 1994, Psychological Bulletin, 115, p. 842)

Fear Anger

Disgust

Sadness

Happiness

CS

L

28

• Feedback / debriefing

• Repetitive practice

• Simulation & didactic learning integrated

• Learners practice tasks with increasing difficulty

Best Evidence Medical Education (BEME) collaboration

Conditions that facilitate simulation learning

Issenberg SB, McGahie WC, Petrusa ER, et al. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 2005; 27:10-28.

29

Thank you!