Clinical Simulation (eBook)

Richard Kyle, W. Bosseau Murray (Autoren)

eBook Download: PDF

2010 | 1. Auflage
848 Seiten
Elsevier Science (Verlag)
978-0-08-055697-0 (ISBN)

Infos

Simulation facilities are invaluable for training in medicine and clinical education, biomedical engineering and life sciences. They allow the practice of prevention, containment, treatment, and procedure in a risk-free setting.

This book is a practical guide and reference to the latest technology, operations and opportunities presented by clinical simulation. It shows how to develop and make efficient use of resources, and provides hands-on information to those tasked with setting up and delivering simulation facilities for medical, clinical and related purposes, and the development and delivery of simulation-based education programs.

. A step-by-step manual to developing successful simulation programs
. Shows how to design, construct, outfit and run simulation facilities for clinical education and research.
. The Residency Review Committee of the US Accreditation Council on Graduate Medical Education has begun requiring residency programs to have simulation as an integral part of their training programs.

Inhalt

Front Cover 1
Clinical Simulation: Operations, Engineering and Management 4
Copyright Page 5
Table of Contents 8
Dedication 6
Epigraph 7
Biographies 12
Foreword 23
How to use this book 24
Introduction 25
Topic I Why Simulate? 28
Chapter 1 From Primitive Cultures to Modern Day: Has Clinical Education Really Changed? 30
1.1 Chance-based Hunter-Gatherer Culture 30
1.2 Intended/Predictable/Deliberate Agriculture Model 31
1.2.1 Where Do We Go From Here? 32
1.2.2 How Do We Get There? 32
1.3 Conclusion 33
1.4 Favorite Problem Solvers 34
References 34
Chapter 2 Undergraduate Medical Education is NOT Rocket Science: But that Does NOT Mean it’s Easy! 36
2.1 The Big Picture 36
2.2 Successful Applicants Becoming Successful Graduates: Modifying Attitudes 37
2.3 Words Matter 39
2.4 Make the Verbal-Visual Link 39
2.5 The Four Questions Algorithm 39
2.6 Analysis and Diagnosis 40
2.7 Probability and Uncertainty 40
2.8 Short-term and Long-term Views 41
2.9 Test-taking Strategies and Educational Value of Tests 41
2.10 Studying Hard Versus Studying Smart 42
2.11 Broader Perspective 43
2.12 Conclusion 43
Reference 43
Chapter 3 Guidance for the Leader-Manager 46
3.1 You as the Reader 46
3.2 You as the Leader 46
3.3 The Clash of the Titans 47
3.4 The Aviation Analogy: Is it Valid? 48
3.5 The Systems Approach to Training 49
3.6 Defining the Performance Requirement 49
3.7 Cost Versus Value Added 51
3.8 Operations Cost 51
3.9 Standardization: What is it, and who Wants it? 52
3.10 Patients as Training Conditions 52
3.11 Equipment as Training Conditions 53
3.12 Increase in Training System Cost 53
3.13 You as the Leader-Manager 54
3.14 Conclusion 54
Endnotes 54
Topic II What’s In It For Me 56
Chapter 4 Basing a Clinician’s Career on Simulation: Development of a Critical Care Expert into a Clinical Simulation Expert 58
4.1 New Path to Perennial Goal 58
4.2 Health Sciences Center Demographics 59
4.3 Simulation Capabilities 59
4.4 Topics of Study 64
4.4.1 Magnet Recognition® 64
4.4.2 The Reality 64
4.5 An Overview of Benner’s Novice to Expert 64
4.6 Development of a Tiered Critical Care Education Program 65
4.7 Tier One: Advanced Beginner to Competent 65
4.7.1 Cardiac Simulation Laboratory 66
4.7.2 Pulmonary Simulation Laboratory 68
4.7.3 Neuroscience Simulation Laboratory 71
4.7.4 Multisystem Simulation Laboratory 71
4.7.5 Incorporating the Family 73
4.7.6 Lessons Learned 73
4.7.7 Lessons Learned by the Clinical Educators 73
4.7.8 Evolving Uses for the Essentials of Critical Care Orientation Simulation Labs 74
4.8 Tier Two: Competent to Proficient 74
4.8.1 Lessons Learned 75
4.9 Tier Three: Proficient to Expert 76
4.9.1 Lessons Learned 77
4.10 Conclusion 77
References 77
Chapter 5 Basing a Nonclinician’s Career upon Simulation: The Personal Experience of a Physicist 80
5.1 From Nonclinician to Clinical Simulation Professional 80
5.2 Working in a Versatile Environment 80
5.3 The Personal Experience of a Physicist Working in a Simulation Center 81
5.4 Advice to Engineers and Scientists Aspiring to Work in Health Care Simulation 82
5.5 Conclusion 83
5.6 Favorite Problem Solvers 83
References 84
Chapter 6 Overcoming Operational Challenges: An Administrator’s Perspective 86
6.1 Start-up Management 86
6.2 Challenge 1: Convincing Others within the Organization, including the People Holding the Purse-strings, that Simulation Is Here to Stay, and Is Worth 90
6.2.1 Limited Validation Studies 90
6.2.2 Some Forms of Simulation can be Expensive 90
6.2.3 All Forms of Ineffective Clinical Education and Clinical Care are Even More Expensive 90
6.2.4 Simulation Is more than just the Mannequin 90
6.2.5 How do you Prove that Simulation Is not a Passing Trend, Like Total Quality Management, Quality Circles, or Pet Rocks? 91
6.2.6 How do you Encourage Learners and Faculty to Come to your Center? 91
6.2.7 Once People Know about your Simulation Center, How do you make your Facility Inviting? 91
6.2.8 How do you Demonstrate your Excellence? 91
6.3 Challenge 2: Getting The Key Players Together to make Strategic and Operational Decisions 92
6.3.1 How do you Make Strategic Decisions? 92
6.3.2 How do you Communicate to your Team Regularly? How do they Communicate with you? 92
6.3.3 How do you Communicate with Executive Staff? 92
6.4 Challenge 3: Doing What Needs to be Done with Limited Resources 93
6.4.1 How do I Get Electronic and Print Design and Production Support? 93
6.5 The Cliché Conclusion 93
References 94
Topic III How to Fit in while Standing Out 96
Chapter 7 When Simulation should and should not be in the Curriculum 98
7.1 What is Simulation? 98
7.2 What is a Curriculum? 98
7.3 Which Components are in a Curriculum? 99
7.4 Dimensions of Clinical Practice 99
7.5 Which of these Curriculum Components are Best Suited to Simulation? 100
7.6 Linking Simulation to the Curriculum 101
7.7 Example: Emergencies in a General Dental Practice 101
7.8 Conclusions 102
References 102
Chapter 8 To Simulate or not to Simulate: That is the Question 104
8.1 Our World 104
8.2 High-fidelity Simulation 104
8.3 Low- and Mid-fidelity Simulation 106
8.4 Standardized Patients 107
8.5 Preparing Students for Standardized Patients 108
8.6 Suspending Disbelief 108
8.7 Summary of Standardized Patients 109
8.8 Attrition in Health Sciences Education 109
8.9 Conclusion 110
References 111
Chapter 9 Simulated Realism: Essential, Desired, Overkill 112
9.1 Realism: What Is it Good for? 112
9.2 Dexterity Skills 112
9.3 Human with Human Skills 112
9.4 Purpose of Realism 112
9.5 Learner-centric Realism 113
9.6 Conclusion 114
Chapter 10 Realism and the Art of Simulation 116
10.1 Simulated Realities 116
10.2 The Orientation 117
10.3 The Medium of Simulation 117
10.4 Clinical Scenarios: Who are the Scenarios for? 118
10.5 Simulation Theater: Design for Effective Story Telling 118
10.6 Props: Place and Purpose 119
10.7 The Human Elements 120
10.8 Conclusion 121
Chapter 11 Integrating Simulation with Existing Clinical Educational Programs: Dream and Develop while Keeping the Focus on your Vision 122
11.1 Background 122
11.2 Have the Dream 123
11.3 Realize the Dream 123
11.4 Teaching with Simulation 125
11.5 Pediatric Intensive Care Medicine 125
11.6 Pediatric Emergency Medicine 126
11.7 Paramedics 127
11.8 Third Year Medical Students and Problem-based Learning Discussion 128
11.9 Medical Students and Anesthesiology 128
11.10 First Year Medical Students and Doctoring 1 128
11.11 Second Year Medical Students and Doctoring 2 129
11.12 Other Medical Student Rotations 129
11.13 Other Simulation Users 130
11.14 Our Approach to Simulation in Education 130
11.15 Focus on your Vision 131
11.16 Conclusion 132
Topic IV Curriculum: Planning for Success 134
Chapter 12 Integration of Simulation with Existing Clinical Educational Programs 136
12.1 Setting the Context: Experiential Learning 136
12.2 Applied to Multilevel and Multidisciplinary Learning Groups 139
12.3 Using Mid-fidelity Simulation for Critical Care and Subacute Care Competency Evaluation 149
12.4 Using High-fidelity Simulation for Critical Care Competency Evaluation 150
12.4.1 Arrhythmia Recognition Competency Evaluation 152
12.4.2 Intermediate Life Support 152
12.4.3 Other Initiatives 152
12.5 Conclusion 152
References 153
Chapter 13 Incorporating Simulation into Graduate (Resident) Medical Education: With Special Reference to the Emergency Department 154
13.1 Role of Simulation in Teaching Emergency Medicine 154
13.2 Procedure Training 155
13.3 Emergency/Resuscitation Skill Integration 155
13.4 ACGME Core Competencies 158
13.5 Crisis Resource Management 158
13.6 Complex Scenarios 160
13.7 Conclusion 160
References 160
Chapter 14 Theory and Practice of Developing an Effective Simulation-based Clinical Curriculum 162
14.1 Setting the Plan 162
14.2 Methods of Teaching 163
14.3 Place and Role of Didactic Teaching 164
14.3.1 Didactic Teaching Before the Simulation Session 165
14.3.2 Didactic Teaching During Simulation Session 165
14.3.3 Didactic Teaching After the Simulation Session 165
14.4 Learning Objectives 165
14.5 Two Designs: Learning and Engagement 167
14.6 Realism of Simulation 168
14.7 Simulation Scenario as an Instance of Disease 169
14.8 Internal Logic 171
14.9 Stages of Curriculum Implementation 172
14.9.1 Assessment Methods 173
14.10 Multiple Experiences 175
14.11 Setting the Appropriate Psychological Environment 176
14.12 Conclusion 177
Endnotes 177
References 178
Chapter 15 Creating Effective Learning Environments – Key Educational Concepts Applied to Simulation Training 180
15.1 Competent Trainers 181
15.2 The Learning Environment 181
15.3 The Trainees and their Physical Environment 181
15.4 The Trainer’s Role in the Learning Environment 181
15.5 Illuminating Ignorance or Unconscious Incompetence (What the Educator Is Supposed to Do) 182
15.6 Conscious Incompetence to Unconscious Competence 183
15.7 A Learning Journey 183
15.8 Training Faculty – Nature or Nurture? 183
15.9 Trainers – True Value added? 183
15.10 Learning Through Teaching – The Value Proposition! 184
15.11 Learner-centered not Trainer-centered 184
15.12 For the Learner and the Trainer 184
15.13 Developing the Training Faculty 184
15.14 Identifying Facilitator Trainers 185
15.15 Creating Effective Health Care Professional Learning 186
15.15.1 The Physical Environment 186
15.15.2 The Human Component 186
15.15.3 The Intellectual or Cognitive Element 186
15.16 Professional Training – An Apprenticeship? 186
15.17 Standardized Clinical Learning Opportunities 187
15.18 Teaching Professional Behaviors 187
15.19 Blended Learning – Using Simulation Techniques 187
15.20 Simulation – An Educational and Clinical Catalyst? 188
15.21 A Recipe for Success with Simulation Techniques? 188
15.22 The Reward of Creating Effective Learning Environments 188
Reference 188
Topic V The Best Form Follows the Essential Functions 190
Chapter 16 Thought Thinking Itself Out: Anticipatory Design in Simulation Centers 194
16.1 Users Defined and Counted 194
16.2 Facility Designers 195
16.3 Integrating Infrastructures 195
16.4 Adaptations to Curriculum Constraints 197
16.5 Early Users 197
16.6 “Lessons Learned” Cover each of the Domains Involved in the Design Process 199
16.6.1 Design Team 199
16.6.2 Program Definition 200
16.6.3 Space Allocation and Utilization 200
16.7 Conclusion 201
Endnotes 202
References 202
Chapter 17 Simulation Facility Design 101: The Basics 204
17.1 The Virtual Hospital – A Virtual Fantasy? 204
17.2 Design and Build for the Actual Use 205
17.3 The Center Design Team 206
17.4 Simulation Center Design Considerations 206
17.5 Function and Utilization 208
17.6 Space by Design 208
17.6.1 Virtual Reality Area 208
17.6.2 Skills Training Area 208
17.6.3 Computer-based Learning Area 209
17.6.4 Full-sized High-fidelity Mannequin-based Area 209
17.7 Utilities 209
17.7.1 Gases and Suction 209
17.7.2 Sound 209
17.7.3 Lighting 210
17.7.4 Electrical and Information Technologies 210
17.7.5 Security 210
17.7.6 Storage 210
17.8 A Walk-through 210
17.9 Conclusion 211
Chapter 18 Creation of Structure-Function Relationships in the Design of a Simulation Center 212
18.1 More Than the Position of the Walls, Doors, and Windows 212
18.2 Preliminary Considerations to Designing a Simulation Space 213
18.3 Developing a Conducive and Inviting Educational Environment 213
18.4 Separation of Learners and the Actors/Evaluators 216
18.5 Promoting an Educationally Intense Environment 216
18.6 Information Flow Within Your Center 221
18.7 Communication, Tracking and Recording Within Your Center 221
18.8 Serving the Learners and Educators 222
18.9 Storage Rooms and Storage Space 223
18.10 Last But Not Least 224
18.11 Conclusions 225
18.12 Example Sequence for Defining Structure-Function Relationships for Simulation Centers 225
Chapter 19 Evaluating, Prioritizing, and Selecting Simulators 228
19.1 Now that You are Responsible for Equipping a Simulation Center, What Do You Do? 228
19.2 Membership of the Simulation Operations/Equipment Committee 229
19.3 Request from a Proponent or Department for New Simulation Equipment 229
19.4 Review of the Simulation Device Manufacturer 230
19.5 Evaluation and Prioritization of Equipment Requests by the Committee 230
19.6 Alternate Sources of Equipment and Props 231
19.7 Conclusion 231
Acknowledgments 231
Chapter 20 Choosing Full-function Patient Simulators, Creating and Using the Simulation Suite 232
20.1 Selecting Simulators, Creating and Using Simulation Environments 232
20.2 Types of Simulators 232
20.3 General Selection Principles 233
20.3.1 Interface with Clinical Monitors 233
20.3.2 Ventilation 233
20.3.3 Airway 233
20.3.4 Portability 234
20.3.5 Specific Features 234
20.3.6 Costs 234
20.4 Examples of Current Devices: Operator-dependent and Model-assisted 235
20.4.1 Lessons Learned 236
20.5 Evolution of a Simulation Suite 237
20.5.1 The Closet-sized Room 237
20.5.2 Designing Within a Dedicated Space 237
20.5.3 Lessons Learned 239
20.6 A Crisis Resource Management Success Story 240
20.6.1 Lessons Learned 241
20.7 Conclusion 241
20.8 Favorite Problem Solvers 241
20.9 Example: Use of the Simulator in a Large Lecture Hall 242
References 242
Access to Information and Specific Products Listed 242
Chapter 21 Survival Guide to Successful Simulation When Located Far Away 244
21.1 Location, Location, Location 244
21.2 Good Fortune/Bad Luck 244
21.3 Words to the Wise 245
21.4 Conclusion 245
Endnotes 246
Chapter 22 Retrofitting Existing Space for Patient Simulation: From Student Lounge to Acute Care Patient Unit 248
22.1 Initial Conditions 248
22.2 Previous Experience with Simulated Patients 248
22.3 Deciding to Build 249
22.4 Deciding What to Build 249
22.5 Deciding Where to Build 249
22.6 Finding and Installing Infrastructure and Utilities 250
22.7 Buying and Using Simulators 254
22.8 Success and Growth 256
22.9 Lessons Learned 256
22.9.1 There Is No Such Thing as Enough Space 258
22.9.2 To Build and Operate a Hospital, You Need Personnel 259
22.10 Conclusion 259
22.11 Favorite Problem Solvers 259
Topic VI Functional Forms at the Institutional Size 260
Chapter 23 The One-Room Schoolhouse for Simulation: Adapting to the Learning 262
23.1 Novel Tools in Familiar Environments 262
23.2 Clinicians-in-training 263
23.3 Student Clinicians 263
23.4 Operations 264
23.5 Management 264
23.6 Conclusion 265
Chapter 24 All-in-one-room Schoolhouse: Clinical Simulation Stage, Control, Debrief, and Utilities All within a Single Room 266
24.1 Starting Conditions 266
24.2 A New Venture 266
24.3 A Newer Venture 267
24.4 Producing Scenarios 269
24.5 Staffing 269
24.6 Conclusion 269
Endnote 269
Reference 269
Chapter 25 The Clinical Simulation Service at NIH: Our Journey 270
25.1 Characterization of the Initial Program How We Got Started
25.2 Our First Goals 270
25.3 A Slow Start 271
25.4 Starting a Program from the Ground Up 271
25.5 Budgets: Large, Small, and In-between 271
25.5.1 Tips on Doing it Cheaply 272
25.6 Researching Your Simulator Options 272
25.7 Train the Trainer, Education for the Staff 272
25.8 Obtaining Space and Making it Work for You 273
25.9 Obtaining Equipment and Supplies (Begging, Borrowing, and Trading) 277
25.10 Getting a Program Up and Going 278
25.11 Writing Scenarios/Executing Scenarios 279
25.11.1 Fully Manually Controlled Scenarios 280
25.11.2 Preprogramed Scenarios 280
25.11.3 Hybrids 280
25.11.4 Lights, Sometimes Camera, Action 280
25.11.5 Lessons Learned 280
25.12 Measure the Impact 281
25.13 Conclusion 281
Acknowledgments 281
Chapter 26 The Single, Dedicated Clinical Simulation Suite 284
26.1 The Simulation Suite 284
26.2 Instruction in the Simulation Room 284
26.3 Instruction Transitioning Out of the Simulation Room 285
26.4 Instruction Outside the Simulation Room 286
26.5 Operations 286
26.6 Management 287
26.7 Conclusion 287
Chapter 27 The Patient Simulation Suite: A Single Dedicated Clinical Simulator Stage Surrounded by Dedicated Control, Observing/Debriefing, Utility, and 288
27.1 Definition 288
27.2 Purposes, Functional Components, and Prototypical Architectural Models 288
27.3 Example Configurations for Different Clinical Environments 290
27.4 In the Real World: From an All-in-one Facility to Separate Dedicated Spaces 291
27.5 Conclusion 292
Reference 292
Chapter 28 Multiservice, Single Institution Simulation Center with Multiple Simulation Suites 294
28.1 Capabilities 294
28.2 Operations for Independent Sessions 295
28.3 Operations for Virtual Hospital Sessions 295
28.4 Single Specialty Participants 295
28.5 Multiple Specialty Participants 296
28.6 Technical and Nontechnical Support Personnel 297
28.7 Management 297
28.8 Our Experience 297
28.9 Conclusion 298
Chapter 29 Operations and Management at the VA Palo Alto/Stanford Simulation Center 300
29.1 Students and their Courses 300
29.1.1 Simulator Training for Acute Resuscitation Skills (STARS) 301
29.1.2 Anesthesia Medical Student Clerkship 301
29.1.3 Introduction to the Management of Ill Patients (IMIP) 301
29.1.4 Stanford Course on Active Resuscitation, Evaluation, and Decision Making (SCARED) 301
29.1.5 Sort-of-SCARED (SOS) 301
29.1.6 Anesthesia Crisis Resource Management (ACRM) 301
29.1.7 Emergency Medicine Crisis Resource Management (EMCRM) 302
29.1.8 Improving the Management of Patient Emergency Situations (IMPES) 302
29.2 Preparation and Logistics 302
29.3 Layout and Equipment of the Simulation Center 302
29.4 Simulation Rooms and Equipment 302
29.5 Control Rooms 304
29.6 Debriefing Room 305
29.7 Audiovisual System 305
29.7.1 Observation 305
29.7.2 Annotation 306
29.7.3 Managing Video Recordings 306
29.8 Scheduling Courses 306
29.8.1 Number of Participants and Length Of Course 307
29.9 Scheduling Visitors 308
29.10 Scheduling Research 308
29.11 Conclusion 308
29.12 Example: Drug Recognition Exercise 308
References 309
Chapter 30 Health Care Simulation with Patient Simulators and Standardized Patients 310
30.1 The Community 310
30.2 Beginnings 310
30.3 Patient Simulator Program 311
30.4 Standardized Patient Program 311
30.5 Facilities 312
30.6 Patient Simulator Center 312
30.6.1 Simulation Laboratories 312
30.6.2 Classrooms 313
30.6.3 Control Rooms 313
30.6.4 Audiovisual System 314
30.6.5 Additional Spaces 316
30.7 Standardized Patient Clinic 317
30.7.1 Examination Rooms 317
30.7.2 Control Room 317
30.7.3 Conference Room 317
30.8 Functional Issues 319
30.8.1 Operational Models 319
30.8.2 Organizational Position 319
30.8.3 Personnel 320
30.8.4 Personnel for Robotic Simulation 320
30.8.5 Personnel for Standardized Patients 321
30.9 Lessons Learned 321
30.9.1 Engineering 321
30.9.2 Operations 324
30.9.3 Management 325
30.10 Conclusion 326
References 327
Chapter 31 Educational Needs Dictating Learning Space: Factors Considered in the Identification and Planning of Appropriate Space for a Simulation Learning 328
31.1 Introduction 328
31.2 The Need for More Space: Which Educational Needs are the Most Pressing? 329
31.3 Existing Space 330
31.4 Converting Educational Needs to Space Requirements 333
31.5 Ensuring Educational Needs will be Met by Dual Use of Rooms, i.e., Development of Options 336
31.6 Educational Requirements Dictating Options for Location of Learning Space 336
31.7 Refining Options 341
31.8 Cost and Schedule 342
31.9 Mechanism of Funding 342
31.10 Lessons Learned 342
Endnotes 344
Topic VII Functional Forms at the State and Nation Size 346
Chapter 32 Designing and Developing a Multi-institutional, Multidisciplinary Regional Clinical Simulation Center 348
32.1 Benefits and Challenges 348
32.2 Our College, City, and State 348
32.3 Joint Decision on a Joint Venture 350
32.4 Simulation Center Design 351
32.5 Success Leads to Growth 358
32.6 Lessons Learned 359
32.6.1 Staffing 359
32.6.2 Planning 359
32.6.3 Information Technology and Audio/Visual Infrastructure 359
32.6.4 Logistics and Supplies 360
32.6.5 Scheduling 360
32.6.6 Storage 360
32.6.7 Miscellaneous 360
Chapter 33 Partners in Simulation: Public Academic–Private Health Care Collaboration 362
33.1 Purpose and Players 362
33.2 The Partnered Approach 363
33.3 Space 364
33.4 Funding 364
33.5 Equipment 365
33.6 Staffing Model 367
33.7 Supportive Infrastructure 367
33.8 Focus 368
33.9 Example Scenario 369
33.10 Conclusion 371
Chapter 34 A National Simulation Program: Germany 372
34.1 Early Adopters 372
34.2 Planning Phase 372
34.3 Definition and Planning Process 373
34.4 Installation Phase 374
34.5 Application Training 375
34.6 Regional Meetings 376
34.6.1 Training 376
34.6.2 Experience 377
34.6.3 Community Shaping 377
34.7 Application Phase 377
34.8 After the Revolution: The Current State of the Project (Spring 2006) 379
34.8.1 Ownership Aspects 379
34.8.2 The Willingness to Accept a Present 379
34.8.3 Achievements 380
34.9 Failures 380
34.10 Conclusion 380
References 380
Chapter 35 Statewide and Large-scale Simulation Implementation: The Work of Many 382
35.1 Scale and Goals 382
35.2 A Nongoverning Model and Structure: The Statewide Oregon Simulation Alliance 383
35.3 The Alliance 383
35.4 Site Assessments 383
35.5 Funding Distribution 384
35.6 Funding with Purpose 384
35.7 The Glue 385
35.8 Conclusion 385
Acknowledgments 385
Chapter 36 Implementing Military Health Simulation Operations: The Australian Defence Force 386
36.1 Strategic Implementation 386
36.1.1 Background – Program Initiation 386
36.1.2 Sequence of Events 387
36.2 Operational Implementation 387
36.2.1 Value Added by Simulation 387
36.2.2 Simulation Topics and Students 387
36.2.3 Simulator Evaluation 388
36.2.4 Curriculum Integration 389
36.3 Tactical Implementation – Lessons Learned 389
36.4 Conclusion 390
References 390
Disclaimer and approval 391
Chapter 37 A National Simulation Center Influences Teaching at a National Level: Scotland 392
37.1 Outcomes Measures for Whom? 392
37.2 Designing the Course Based upon a Needs Assessment 393
37.3 Producing the Course 393
37.4 First Phase of Feedback 395
37.5 Next Set of Information 395
37.6 There can be too Many Ways to Skin a Cat 395
37.7 Designing Teaching Material 396
37.8 Studying the Impact of Teaching Material 396
37.9 Conclusion 396
37.10 About Our Center 397
Endnotes 397
References 397
Chapter 38 Clinical Simulation on a National Level: Israel 398
38.1 The Nation and its Health Care System 398
38.2 The Israel Center for Clinical Simulation 398
38.3 Cultural Change 399
38.4 Educational Approach 399
38.5 Simulation Instructors 399
38.6 Simulation Resources 400
38.7 Bringing the Center to Life Through Collaboration 400
38.8 Performance Assessment/Accreditation 400
38.9 Readiness to Meet Emergencies 401
38.10 Money, Money, Money. . . 401
38.11 Is It All Worth It? 402
38.12 Conclusion 402
References 402
Topic VIII The Big Picture: Sum of Many Smaller Views 404
Chapter 39 The Invisible Standardized Patient 406
39.1 Definition 406
39.2 Motivation 407
39.3 Method 407
39.3.1 Identify a Patient Encounter Environment 407
39.3.2 Determine Whether a Standardized Patient can be Integrated into This Encounter 407
39.3.3 Chose a Scoring System 408
39.3.4 Train the Actor 408
39.3.5 Feedback 408
39.4 Problems 408
39.5 Results 409
39.6 Conclusion 409
39.7 Examples 409
1. Simulated Patient Case Scenario 409
2. Patient Checklist 410
3. Anesthesia Record Assessment Checklist 410
Chapter 40 Prehospital and Tactical Simulation: More than Just a Mannequin 412
40.1 Tasks, Conditions, and Standards 412
40.2 Equipment 413
40.3 Environment 413
40.4 Real Learning, Real Risks 414
40.5 Patient Selection 415
40.6 Conclusion 416
40.7 Teaching Resource 416
Chapter 41 Value Added by Partial-task Trainers and Simulation 418
41.1 Value Added 418
41.2 Intravenous Access 418
41.3 Airway Access 419
41.4 Pelvic Examination 420
41.5 Lumbar Puncture 421
41.6 Conclusion 421
Chapter 42 Implementing Partial-task Trainers in Simulation 422
42.1 Right Tools for the Job 422
42.2 Plan for Success 422
42.3 Successfully Execute the Plan 423
42.4 Make What You can’t Buy 424
42.5 Adapt Tools to Your Teachings 424
42.6 Make Tangible the Ethereal 426
42.7 Conclusion 426
Chapter 43 The Role of Patient Simulators in Pediatric Education 428
43.1 History of Patient Simulators in Clinical Education 428
43.2 Clinical Skills Needed to Provide Care for the Pediatric Patient – Are They Adequate? 428
43.3 Application of Patient Simulators in Pediatric Training 429
43.4 Conclusion 430
Endnote 430
References 430
Chapter 44 Simulation Training for Pediatric Emergencies 432
44.1 Big Challenges Learning to Care for Small Patients 432
44.2 Simulation Course Goals 433
44.2.1 Course Location and Staffing 433
44.2.2 Course Design 434
44.2.3 Scenarios 434
44.2.4 Faculty 435
44.2.5 Candidates 435
44.2.6 Course Impact 435
44.3 Conclusion 435
References 436
Information Resources 436
Chapter 45 Considerations of Pediatric Simulation 438
45.1 Differences of Approach to Pediatric Simulation 438
45.2 Scenarios 441
45.3 Debriefing Methods 441
45.4 Lessons Learned 442
45.4.1 Pediatric Resident Mock Codes 442
45.4.2 Chemical Agent Workshop 443
45.4.3 Advanced Life Support (Pediatric and Neonatal) 444
45.5 Conclusion 446
45.6 Favorite Problem Solvers 446
References 447
Chapter 46 Critical Care Simulation: A Nursing Perspective 450
46.1 Increase Learning, Decrease Risks 450
46.2 Historical Clinical Education 450
46.3 Learning Theory 450
46.4 Preparation for Instruction 451
46.5 Practical Application Examples 451
46.6 Evaluation of Performance 452
46.7 Conclusion 452
Endnote 452
Chapter 47 Transporting a Patient: Interdisciplinary Simulation Exercises 454
47.1 Who We Are 454
47.2 Total Application Scenario 455
47.3 Creating a Team-building Opportunity: The Transportation Scenario 455
47.4 Setting the Stage 456
47.5 Getting People on Board 460
47.6 Developing the Scenario 460
47.7 Selection and Presentation of the Patient 461
47.8 Presentation of the Patient: Version 2 462
47.9 Effective Team-based Learning 463
47.10 Conclusion 464
Topic IX Make Your Own 466
Chapter 48 Development and Implementation of a Low-budget Simulation Center for Clinical Emergencies (Ambulance in a Box) 468
48.1 Purpose and Means to its Fulfillment 468
48.2 Inventing a Trauma Patient Vital Signs Simulator 469
48.2.1 EKG 470
48.2.2 Pulse Oximetry 472
48.2.3 Noninvasive Arterial Pressure 472
48.2.4 Body Temperature 472
48.2.5 Alarms 472
48.3 Our Simulation Center 472
48.3.1 Interconnectivity 472
48.3.2 Ambulance Simulator 472
48.4 Ambulance Sights, Sounds, and Vibrations 475
48.5 Scenarios and Spaces 477
48.5.1 Urban Rescue and Stabilization Area 477
48.5.2 Stabilization and Life Support Area “Shock Room” 477
48.5.3 Debriefing Room 477
48.5.4 Control Room 477
48.5.5 Mannequin 480
48.6 Scenario Execution 483
48.7 Conclusion 483
48.8 Simulator Vendor Contact Information 484
48.9 “Hot Key” Keyboard Commands for our Trauma Patient Vital Signs Simulator 484
Chapter 49 Physiologic Modeling for Simulators: Get Real 486
49.1 Models: Of You, With You, In You 486
49.2 Glossary 486
49.3 Modeling Versus Simulation 487
49.4 Why Does a Simulator Need a Good Physiologic Model? 489
49.5 Modeling as an Hypothesis 489
49.6 Modeling as a Compromise 489
49.7 Modeling as a Tool for Simulation: How Does a Physiological Model Work in Simulation? 490
49.7.1 A Liver and Kidney 490
49.7.2 A Portal Circulation 491
49.7.3 Intramuscular or Subcutaneous Injections 491
49.7.4 Cardiopulmonary Resuscitation (CPR) 491
49.7.5 Quantitative Brain and Heart Damage 492
49.8 What Do You Want Out of a Model – Whether You Know it or Not? 492
49.8.1 Learning as an Example 492
49.8.2 Do we Stop at Physiologic Models? 493
49.9 Conclusion: Simulation without a Model 493
49.10 Information Resources 494
Endnotes 494
References 494
Topic X Buy from Others 496
Chapter 50 Success with Clinical Simulation = Assessment + Planning + Implementation 498
50.1 Successfully Select, Implement, and Integrate Simulation into Your Clinical Teachings 498
50.2 So, You Think You Need a Clinical Simulator? 499
50.3 Selecting the Right Simulator and Simulation Vendor 500
50.4 Purchasing and Fielding a Clinical Simulator 502
50.4.1 Creating a Plan 502
50.4.2 Executing the Plan 503
50.5 Conclusion 504
Acknowledgement 504
References 504
Chapter 51 Successful Simulation Center Operations: An Industry Perspective 506
51.1 The Industry 506
51.2 Facilities Preparation: Key Questions 507
51.2.1 What is the Mission of the Simulation Center? 507
51.2.2 Who are the Learners? 507
51.2.3 What is to be Taught? 508
51.2.4 What is to be Measured? 508
51.2.5 What are the Clinical Environments to be Created? 508
51.2.6 What Clinical Equipment is Needed? 508
51.2.7 What is the Budget? 509
51.2.8 What Space is Needed and/or Available? 509
51.2.9 What Simulation Technologies will be Used? 509
51.3 Faculty, Leadership, and Staff Preparation 510
51.3.1 Obtaining Buy-in and Engagement of Faculty, Leadership, and the Community: What are the Fundamental Questions to Address and Why is this Necessary? 510
51.3.2 Establishing an Executive Committee for Simulation Integration: Why is this Necessary, What are the Responsibilities, and What are the Reporting 511
51.3.3 Simulation Center Staffing: Important Considerations in Determining Staffing 512
51.4 Considerations for Implementation and Initial Operations 513
51.4.1 Preopening Preparation 513
51.4.2 Center Grand Opening 514
51.5 Considerations for the First Year of Operation and Beyond 514
51.6 Conclusion 515
Endnote 515
References 515
Topic XI Funding, Funding is What Makes Simulation Go On 516
Chapter 52 Prosperous Simulation Under an Institution’s Threadbare Financial Blanket 518
52.1 Follow the Money 518
52.2 Networking, Negotiation, and Collaboration 518
52.3 Using Existing Resources 519
52.4 Keeping Things Simple 520
52.5 Building a Good Profile 520
52.6 Staffing 520
52.7 Minimizing Costs, Maximizing Returns 520
52.8 Conclusion 520
Endnote 520
References 520
Chapter 53 Creative Procurement for Your Simulation Program 522
53.1 Key Components to Simulation 522
53.2 Reality of Simulation Procurement 523
53.3 How are You Going to Use Simulation? 523
53.4 Suspension of Disbelief 523
53.5 Environmental Safety Issues 524
53.6 When Does the Scenario Begin? 524
53.7 Timing 524
53.8 Curriculum-driven Buy-in 525
53.9 Learning must be Objective Driven 525
53.10 What are You Going to Need? 525
53.10.1 Space 525
53.10.2 Creativity 526
53.10.3 Environmental Fidelity 526
53.10.4 Real Items, Devices, and Machines 526
53.11 Prioritize Your Fund Types and Sources 526
53.11.1 Coordinate With the Corporate/Foundation and Development Personnel at Your Institution 527
53.11.2 The Fine Art of Begging: SELL, SELL, SELL 527
53.11.3 Show Your Need 527
53.11.4 Recognize Your Competition 528
53.11.5 If Your Competition is Formidable, Partner With Them 528
53.11.6 Only Make Promises That You can Keep 528
53.11.7 Resources Available to You 528
53.12 Rearranging Your Environments 530
53.12.1 Flexibility 530
53.12.2 Size Does Matter 530
53.12.3 Packing the Laboratory 530
53.13 Conclusion 530
Reference 531
Topic XII Hybrid Vigor: The Simulation Professional 532
Chapter 54 The Simulation Professional: Gets Things Done and Attracts Opportunities 534
54.1 Tasks, Backgrounds, Characteristics, and Compensation 534
54.2 Desirable Qualities in the Simulation Professional 534
54.3 Tasks Performed 535
54.3.1 Educator 535
54.3.2 Master of Simulator Devices 535
54.3.3 Designer of Simulation Center 535
54.3.4 Researcher 535
54.4 Formal Education 535
54.4.1 Physiology 535
54.4.2 Engineering 536
54.4.3 Communication Skills 536
54.4.4 Languages 536
54.4.5 Teaching Skills 536
54.4.6 Biomedical Equipment Knowledge 536
54.4.7 Audio/Video 536
54.4.8 Computer Skills 536
54.5 Occupational Experience 536
54.5.1 Clinical 536
54.5.2 Audio and/or Video 536
54.5.3 Computers 536
54.6 Other Special Features 536
54.6.1 Interpersonal Skills 536
54.6.2 Resourceful and Quick Thinker 537
54.6.3 Commitment and Dedication 537
54.6.4 Creative Jack or Jill of All Trades 537
54.7 Compensation for the Simulation Professional 537
54.7.1 Bread on the Family Table 537
54.7.2 Satisfaction 538
54.7.3 Career Prospects 538
54.7.4 Job Security 538
54.7.5 Opportunities for Collaboration and Research 538
54.8 Conclusion 538
Endnote 538
Topic XIII Good Answers Start from Good Questions 540
Chapter 55 Pitfalls to Avoid in Designing and Executing Research with Clinical Simulation 542
55.1 Why Investigate? 542
55.2 Advantages 542
55.3 Participants’ Briefing and Data Collection 542
55.4 Significant and Contributing Factors: Are We on the Same Wavelength? 543
55.5 Comparing Like With Like 543
55.6 Conclusion 543
Reference 543
Chapter 56 Fundamentals of Educational Research Using Clinical Simulation 544
56.1 Components of Simulation-based Research 544
56.2 Background and History 545
56.2.1 Eight Unanswered Questions on Simulation in Clinical Education 545
56.2.2 Ten Features of Simulation Leading to Effective Learning 545
56.3 Sound Educational Research 546
56.4 Cumulative Research Program: The “Hothouse Effect” 548
56.4.1 Formation and Planning 549
56.4.2 Developing Outcome Measures 549
56.4.3 Creating Algorithms and Checklists 549
56.4.4 Initiating a Randomized Clinical Trial 549
56.4.5 Consequences of Success 550
56.5 Practical Suggestions 550
56.5.1 Know the Literature 550
56.5.2 Write a Detailed Research Protocol 550
56.5.3 Obtain Methodological and Statistical Consultation Early 551
56.5.4 Discuss Authorship Openly and Early 551
56.5.5 Create a Research Team 551
56.5.6 Make Research a Routine Activity 552
References 552
Topic XIV Simulation Scenario: Telling the Story – Discussing the Story 554
Chapter 57 Scenario Design and Execution 556
57.1 Our Approach 556
57.2 A Favorite Scenario: The Postanesthesia Care Unit 556
57.2.1 Educational Goals and Objectives 556
57.2.2 Key Clinical Characteristics 557
57.2.3 Key Teamwork Challenges 557
57.2.4 Patient/Treatment Action/Reaction 557
57.2.5 Debriefing: Plus-Delta Method 558
57.3 Operations 558
57.3.1 The Paper Work 558
57.3.2 The Simulators 558
57.3.3 Audio/Video 558
57.4 Conclusion 559
Chapter 58 Simulation Scenario Building 562
58.1 The Scenario – Why Bother 562
58.2 “The Goal is . . . ?" 563
58.2.1 Acquiring New Skills 563
58.2.2 Practice Established Skills 563
58.2.3 Testing for Competency 563
58.2.4 Teamwork Development 563
58.3 Matching Simulation Capabilities to Learning Objectives 563
58.4 Patient, the Location, and the Environment 564
58.5 Ending the Scenario 565
58.6 Scenario Map 565
58.7 Debriefing 565
58.8 Conclusion 567
58.9 Examples 567
1. Framework for a Simulation Session 567
2. Framework for Planning a Scenario 567
Chapter 59 Designing a Scenario as a Simulated Clinical Experience: The TuPASS Scenario Script 568
59.1 Value in the Scenario Script 568
59.2 The TuPASS Scenario Script 569
59.3 Designing Scenarios 573
59.4 Preparing and Producing Scenarios 573
59.5 Experiences With the Script and Points to Consider During Scenario Design 574
59.5.1 The “too much” Scenarios 574
59.5.2 The “too fast” Scenarios 574
59.5.3 The “find the detail” Scenarios 575
59.5.4 The “props and whistles” Scenarios 575
59.6 Conclusion 575
Acknowledgments 575
Endnote 575
References 575
Topic XV Location, Location, Location 578
Chapter 60 Situated Simulation: Taking Simulation to the Clinicians 580
60.1 Defining “Situated Simulation” 580
60.2 Theoretical Underpinnings of Situated Simulation 580
60.3 Situated Approaches to Simulation – Pearls and Pitfalls 581
60.4 Simulation in the Intensive Care Unit and the Emergency Department 581
60.5 Examples 582
60.5.1 District Trauma Center Simulation 582
60.5.2 Paramedic Mega Code Recertification 583
60.6 Further Considerations 584
60.6.1 Cost/Benefit 584
60.6.2 Preparing to Hit the Road 584
60.6.3 Packaging and Transport Decisions 584
60.7 Conclusion 584
References 584
Chapter 61 On the Road with the Simulator 586
61.1 Road Trip 586
61.2 Planning 586
61.3 Our Experience 587
61.3.1 The Scenario 587
61.3.2 Staffing 587
61.3.3 Equipment 588
61.3.4 Schlepping 588
61.3.5 Setting Up 588
61.3.6 OK, So What Happened on the Big Day? 589
61.3.7 Evolution 590
61.3.8 Response 590
61.4 Conclusion 590
Endnote 590
Chapter 62 Mobile "In Situ" Simulation Crisis Resource Management Training 592
62.1 The Concept of Mobile In situ Simulation Training 592
62.2 Examples 593
62.3 What is Needed 603
62.3.1 The Technical Side 603
62.3.2 The Logistical Side 605
62.4 Advantages of In situ Training 605
62.4.1 For the Trainees 605
62.4.2 For the Simulator Instructor Team 606
62.5 Disadvantages and Problems of In situ Training 606
62.5.1 Problems for the Trainees/Local Facility 606
62.5.2 Problems for the Instructor Team 606
62.6 Mobile In situ Simulation Training Pearls 607
62.6.1 Organizational Pearls 607
62.6.2 Technical Pearls 607
62.6.3 Personnel Pearls 608
62.7 Potential Value of In situ Simulation Training 608
62.8 Conclusion 608
References 608
Topic XVI Move the Learning, Not the Learners 610
Chapter 63 Creation of a Combined Surgical Curriculum Using the Internet and Patient Simulation 612
63.1 Purpose and Goals 612
63.2 Planning the Project 613
63.2.1 The Status Before Implementation 613
63.2.2 Project Goals 613
63.2.3 Creating the Infrastructure 613
63.3 Implementation and Description of the Project 613
63.3.1 Online Curriculum 613
63.3.2 Patient Simulator Sessions 616
63.4 Current Status of the Project 616
63.5 Where are We Headed? 616
63.6 Lessons Learned 616
63.6.1 Accomplished 616
63.6.2 Future Directions 617
63.7 Conclusion 617
Acknowledgments 617
Endnote 617
References 617
Chapter 64 Distributed Simulation-based Clinical Training: Going Beyond the Obvious 618
64.1 Issues in Clinical Education and Training 618
64.2 Challenges in Training Prehospital Personnel 619
64.3 Existing Training Methods 619
64.4 Access to Remote Training: Equipment and Expertise 620
64.4.1 Concept of Telepresence and Visualization Devices 625
64.4.2 Telecommunication Infrastructure 631
64.5 The Goal for Simulation-based Distance Training 634
64.5.1 Preparedness and Readiness 634
64.5.2 Critical Thinking and the Observation, Orientation, Determination, Action Loop 636
64.6 Networkcentric Health Care Operations 638
64.7 Conclusion 639
64.8 Abbreviations and Definitions 639
Acknowledgments 641
References 642
Topic XVII We Teach in the Style that We Learn 650
Chapter 65 Staff Education for Simulation: Train-the-Trainer Concepts 652
65.1 Clinical Teachers to Simulation Facilitators 652
65.2 Functions and Staff in Simulation Centers 652
65.2.1 Education and the Educators 653
65.2.2 Operation and the Operators 653
65.2.3 Technical Support and the Technicians 654
65.2.4 Organization and the Managers 654
65.3 Who Does the Work? 655
65.4 Why Train-the-Trainer is Necessary – A Fundamental Decision 655
65.5 Which Skills are Needed? 656
65.6 Formal Requirements for Educational Staff 659
65.7 Topics for Staff Training Courses 659
65.7.1 Course Development 659
65.7.2 Human Factors/Crisis Resource Management/Root Cause Analysis/Human Error/Decision Making/Workload Management/Leadership 659
65.7.3 Debriefing 659
65.7.4 Operation of the Simulators 660
65.7.5 Deeper Insight into Technical Aspects: Modeling Details, Hardware Details, Programing Techniques 660
65.7.6 Presentation Techniques 660
65.7.7 Technical Troubleshooting 660
65.7.8 Clinical Topics 660
65.8 Detailed Description of the Train-the-Trainer Curriculum 660
65.9 Course Schedules 662
65.10 Discussion 668
65.11 Conclusion 668
Endnotes 669
References 669
Chapter 66 Experiential Training for New Simulation Coordinators 670
66.1 Balancing the Art with the Science 670
66.2 The Training 670
66.3 The Orientation 670
66.4 The Anatomy of a Simulation Session 671
66.4.1 Logistics of Delivery 671
66.4.2 Developing the Scenario 671
66.4.3 Simulation Software 672
66.4.4 The Theater Setup and a Props/To Do List 672
66.4.5 Rehearsing the Scenario 673
66.4.6 Presentation of the Session 673
66.5 Conclusion 673
Chapter 67 Becoming a Simulation Instructor and Learning to Facilitate: The Instructor and Facilitation Training (InFacT) Course 674
67.1 Why Instructor Courses are so Important 674
67.2 Tasks of Simulation Instructors During Simulation-based CRM Courses 675
67.3 Aim and Objectives 675
67.4 Basic InFacT Outline and Course Concept 676
67.5 Contents 676
67.5.1 Theory of Human Errors, Patient Safety, and CRM 676
67.5.2 Debriefing 676
67.5.3 Importance and Methods of Simulator Familiarization 676
67.5.4 Simulation Setting 677
67.5.5 Designing and Producing Scenarios 677
67.5.6 Instructor’s Role in the Different Phases of a Simulation Course 677
67.5.7 Blended Learning, Part-task Trainers and Computer Screen-based Simulators 677
67.6 Methods 677
67.7 Course Schedule 678
67.8 Experiences with Producing the InFacT Course 678
Further References 678
Acknowledgments 678
References 678
Topic XVIII Assessment: Why, What and How 680
Chapter 68 Simulation and High-stakes Testing 682
68.1 What is High-stakes Testing? 682
68.2 What is the History of High-stakes Testing in Health Professions? 682
68.3 The Pros and Cons of High-stakes Testing 684
68.4 What is it About High-fidelity Simulation that Makes it Attractive for High-stakes Testing? 684
68.5 What are the Potential Difficulties in Using Simulation for High-stakes Testing? 685
68.6 Examples 687
1. Standardized Patients 687
2. Pelvic Examination Simulator 687
3. Carotid Stenting Certification 689
68.7 Industry’s Role 692
68.8 Conclusion 692
Acknowledgment 692
Endnote 692
References 693
Chapter 69 Video-assisted Debriefing in Simulation-based Training of Crisis Resource Management 694
69.1 Debriefing: What is it Good for? 694
69.2 Debriefing Aims and Objectives 694
69.3 Instructor Versus Facilitator 695
69.4 Proposed Structure 695
69.5 Ways to Use the Structure 697
69.6 Additional Tools During the Observation Phase 697
69.7 Problems in Using the Structure 697
69.8 Conclusion 698
69.9 Words of Wisdom 698
Example Checklists 699
References 703
Chapter 70 Questionnaire Design and Use: How to Craft Tools to Determine How Well Your Simulation Program Objectives are Being Met 704
70.1 Why Should We be Collecting Feedback? 704
70.2 Questionnaire Design 704
70.3 Summary 706
70.4 Conclusion 706
Chapter 71 Planning and Assessing Clinical Simulation using Task Analysis: A Suggested Approach and Framework for Trainers, Researchers, and Developers 708
71.1 The Curriculum Procedures Frames Simulation Framework 708
71.1.1 Unfreeze! 709
71.2 About Task Analysis and Framework 710
71.3 C is for Curriculum 710
71.3.1 Selecting your Tasks 710
71.3.2 Complete the Task Inventory 711
71.4 P is for Procedures 714
71.4.1 Structuring Procedure 714
71.4.2 Five Ps of Procedures 714
71.5 F is for Frames 716
71.5.1 Concepts 719
71.5.2 Technical Skills 719
71.5.3 Human Skills 719
71.5.4 Processes 719
71.5.5 Tools 720
71.5.6 Actors 720
71.5.7 Environment 720
71.6 S is for Simulation 720
71.7 Conclusion 725
71.7.1 Re-freeze 725
References 725
Topic XIX Tricks of the Trade 726
Chapter 72 Professional Stage Craft: How to Create Simulated Clinical Environments Out of Smoke and Mirrors 728
72.1 Introduction and Disclaimer 728
72.2 Fundamentals of Fluids 728
72.3 Hemorrhage 730
72.4 Urinary Output 732
72.5 Fluid Administration 733
72.6 Makeup for Injuries and Bruising 733
72.7 Suctioning Vomit or Blood 734
72.8 Clinical Gas Ports 735
72.9 Arterial Blood Gas Analyzer Simulator 737
References 739
Chapter 73 Professional Audio/Video for Clinical Simulation 740
73.1 Good Answers come from Good Questions 740
73.1.1 Functionality Before Complexity 740
73.2 Matching the Tools to the Teachings: Three Examples 741
73.3 Simulation-specific A/V issues 742
73.4 Match the Tools to the Users 743
73.4.1 Simulator Controller 743
73.4.2 Clinical Instructor 743
73.4.3 Learners 743
73.4.4 Observers 743
73.4.5 Actors 744
73.4.6 Simulator 744
73.5 Using the A/V system 744
73.6 Matching the Tools to the Functions 745
73.6.1 Remote Access: Simulator Control/Simulation Direction 745
73.6.2 Debriefing: Recording and Playback 747
73.6.3 Presentation 750
73.6.4 Transmission for Remote Presentation: Live and Replay 750
73.6.5 After-the-fact Story Making 752
73.6.6 Unifying Control system 752
73.7 Educational Review/Feedback Using Audio/Video 752
73.7.1 Immediate 753
73.7.2 Postevent 753
73.7.3 Remote 753
73.8 Lessons Learned 753
73.9 Example Schematic of Audio/Video Signal Paths and Devices 754
Endnotes 755
Chapter 74 Simulation Audio/Video Requirements and Working with Audio/Video Installation Professionals 756
74.1 Deciding What Your A/V System Should Do for You 756
74.1.1 Bleeding Edge or Optimal Edge 757
74.1.2 Device Selection Criteria: Individual Component or Combination 757
74.1.3 Analog or Digital? 757
74.1.4 Wide Format High Definition, or Not 758
74.2 Sound Systems 758
74.2.1 Patient Speaking to the Students 758
74.2.2 Students Speaking to the Patient 758
74.3 Audio/Video Options for an Observation Room 759
74.3.1 Live Presentation from the Simulation Room 759
74.4 Clinical Monitor Image Capture 759
74.5 Video Observation and Presentation Options 760
74.6 Sound Options 761
74.7 Audio/Video Control Options 761
74.8 Control Room 762
74.9 Working with A/V System Design and Installation Professionals 762
References 763
Topic XX Rehearsing is the Basis of All Learning 764
Chapter 75 An Approach for Professional Development: Triad Gaming Techniques in Simulation 766
75.1 Play? 766
75.2 Gaming 766
75.3 Triads 767
75.4 The Approach and Grounds Rules 768
75.5 Some Observations and Analysis 769
75.6 Conclusion 769
References 769
Chapter 76 Learning Through Play: Simulation Scenario = Obstacle Course + Treasure Hunt 772
76.1 Playing as Learning 772
76.2 Creating the Right Atmosphere 772
76.3 The Simulation Teaching Philosophy 773
76.4 Reflection 773
76.5 Conclusion 776
References 776
Chapter 77 Adult Education Methods and Processes 778
77.1 Adult Learning 778
77.2 Andragogy – The Art and Science of Helping Adults Learn 778
77.3 Establish an Effective Learning Climate 779
77.4 Involve Adult Learners in Mutual Planning 780
77.5 Involve Adult Learners in Diagnosing Their Own Learning Needs 780
77.6 Encourage Adult Learners to Formulate Their Own Learning Objectives 780
77.7 Encourage Adult Learners to Identify Resources and to Devise Strategies for Using These Resources 780
77.8 Help Adult Learners to Carry Out Their Learning Plans 781
77.8.1 Dreyfus: Novice-Expert Continuum 781
77.8.2 Vygotsky: Zone of Proximal Development 782
77.8.3 Kolb: Experiential Learning Cycle 782
77.9 Implications for Simulation-based Clinical Teaching 782
77.10 Adult Learners Evaluating Their Own Learning 783
77.11 Conclusion 784
References 784
Chapter 78 Creating Effective, Interesting, and Engaging Learning Environments 786
78.1 Education: It’s Not Just the Content 786
78.2 Educational Frameworks 786
78.3 Elements of Engaging Learning 787
78.3.1 Teacher Involvement 788
78.3.2 Autonomy Support 788
78.3.3 Collaboration 788
78.3.4 Real World Interaction 788
78.3.5 Strategy Instruction 788
78.3.6 Reward and Praise 788
78.3.7 Interesting Texts 788
78.4 The Adult Learner 788
78.4.1 The Learner’s Need to Know 789
78.4.2 Learner Self-concept 789
78.4.3 Previous Experience 789
78.4.4 Readiness to Learn 789
78.4.5 Orientation to Learning 789
78.4.6 Motivation 790
78.5 Kolb Decision-making Model 790
78.5.1 Active Experimentation 790
78.5.2 Concrete Experiences 790
78.5.3 Reflective Observation 790
78.5.4 Abstract Conceptualization 790
78.6 Putting It All Together 790
78.7 Conclusion 792
References 792
Chapter 79 Adult Learning: Practical Hands-on Methods for Teaching a Hands-on Subject 794
79.1 Self-directed 794
79.2 Types of Adult Learners 795
79.3 Content Delivery 795
79.3.1 Student Goals 795
79.3.2 Breaks 795
79.3.3 Story Telling or Sharing Experiences 795
79.3.4 Humor 795
79.3.5 Exercises/Games 795
79.3.6 Role-playing/Case Studies 796
79.3.7 Demonstration 796
79.3.8 Handouts 796
79.3.9 Sleepy Time 796
79.3.10 Class Champion 796
79.3.11 PowerPoint Presentation 796
79.3.12 Body Language 796
79.4 Program the Student to Succeed 796
79.5 Conclusion 797
Chapter 80 How to Build a Successful Simulation Strategy: The Simulation Learning Pyramid 798
80.1 Learning via Simulation 798
80.2 High-fidelity Environment Analog Training: A NASA Example 799
80.3 Simulation Learning Pyramid 800
80.3.1 Simulation Plan 800
80.3.2 Present the Simulation 801
80.3.3 Debriefing 801
80.3.4 Transference 801
80.4 Adult Learning Principles (Knowles) as Applied to the Learning Pyramid 801
80.4.1 Motivation 802
80.4.2 Reinforcement 802
80.4.3 Retention 803
80.4.4 Transference 803
80.5 Experiential Learning Theory as Applicable to the Learning Pyramid 803
80.5.1 Concrete Experience 803
80.5.2 Reflective Observation 803
80.5.3 Abstract Conceptualization 804
80.5.4 Active Experimentation 804
80.6 Applying Learning Principles to Simulator Session Design 804
80.6.1 “Fly as You Simulate – Simulate as You Fly” 805
80.6.2 No Torpedoes 805
80.6.3 Death of a Simulated Patient 806
80.6.4 How to Handle Negative Behaviors 807
80.6.5 How Much Stress 807
80.6.6 Never Discuss Performance Outside the Simulation (Confidentiality, Security) 807
80.6.7 Rules of Engagement 807
80.6.8 Privacy is Maintained 807
80.6.9 Have a Backup Plan and be Open to Changes in the Simulation 807
80.6.10 Simulation Planning 808
80.7 Debriefing – Rules of Engagement 808
80.7.1 Begin with Positive Reward 808
80.7.2 Constructive Criticism 808
80.7.3 Leave the Participant Ready to Learn 809
80.7.4 Roles of Debriefers and Types of Debriefing 809
80.7.5 Debriefing Techniques 809
80.7.6 Content-neutral or Content-specific Debriefings 810
80.8 Conclusion 810
Endnotes 810
References 811
Further Readings 811
Topic XXI Expect the Unexpected 814
Chapter 81 Managing a Simulation Session at a Congress, Away from Home Base 816
81.1 Management and Preparation 817
81.2 Educational Issues in General (Needed for Planning) 817
81.2.1 Who is the Target Audience/Learner/Customer? 817
81.2.2 What are the Target Audiences’ Learning Objectives? 817
81.2.3 Who are the Required Subject Matter Experts? 818
81.2.4 Who are the Required Administrative Leaders and Supporters? 818
81.2.5 What is the Time Line to Completing this Project? 818
81.2.6 Will There be any Media Coverage? 819
81.2.7 Agenda Planned? 819
81.2.8 Data Collection? 819
81.2.9 How Much Time is Available for Presenting this Session? 819
81.2.10 Sequence: Hands-on Session Before or After the CRM Lecture? 819
81.2.11 Is it Really Necessary to Have a Live Hands-on Scenario as Part of the Session? 819
81.2.12 Mini-scenarios 820
81.2.13 Role of Hot Seater 820
81.2.14 Real-life Events 820
81.3 Example: A Real Life Case 820
81.4 Issues Related to the Congress 820
81.4.1 Group Size of Hot Seat Participants 820
81.4.2 Avoid Embarrassing Participants 820
81.5 Issues Related to Venue/Environment 821
81.5.1 Where will the Project/Class be Held? 821
81.5.2 Observers in the Same Room 821
81.5.3 Audio/Video Equipment 821
81.5.4 Wireless Communication 822
81.5.5 Telephone/Intercom 822
81.5.6 Lack of Control Room and One-way Glass Partition 822
81.5.7 Waiting Area for Second Responder Needs to be Identified 822
81.5.8 Storage of Props and Equipment 822
81.5.9 Projection and Presentation Systems 822
81.5.10 Handouts Need to be Prepared in Appropriate Quantities 822
81.5.11 Pre- and Post-questionnaires Need to be Available 822
81.5.12 Confidentiality (Volunteers, Performance, Scenario, etc.) 823
81.5.13 Knowledge of Scenario 823
81.5.14 Familiarity with All Loaned Clinical Equipment 823
81.6 Standard CRM Issues in Need of Modification 823
81.6.1 Equipment Needs to be Available 823
81.6.2 Props Need to be Checked 823
81.6.3 Power Supplies and Batteries 823
81.6.4 Roles of “Actors” – Multiple Roles for a Given Actor Versus a Single Role for Each Actor 823
81.6.5 Changes “On the Fly” 823
81.6.6 Drug Recognition System 824
81.6.7 Fluids and their Messes 824
81.7 Developing the CRM Session 824
81.7.1 Time Requirements and Planning for a Single Hands-on Crisis Event 824
81.7.2 The Sequence of Sections of the Training Course 824
81.7.3 Pre-questionnaire/Data Collection/Confidentiality Form 824
81.7.4 Familiarization with the Simulator 825
81.7.5 Crisis Event 825
81.7.6 Lecture on CRM Principles 825
81.7.7 Practice Session Using CRM Terminology in a Non-medical Crisis 825
81.7.8 Debriefing 826
81.7.9 Post-questionnaire 826
81.8 Conclusion 826
References 826
Topic XXII Borrow Success 828
Chapter 82 An Innovative Way to Think about Simulation Laboratory Core Administrative Functions: Comparing Managing a Simulation Laboratory to a Restaurant 830
82.1 Academic Entrepreneurs 830
82.2 Successful Simulation Program from Successful Business Practices 830
82.3 What are the Questions You Ask? 831
82.4 Who are the People You Include? 831
82.5 What are the Services You Provide? 833
82.6 What Spaces Do You Need? 833
82.7 Conclusion 833
References 833
Index 834

Produkt-Details

• Erscheint lt. Verlag: 27.7.2010
• Sprache: englisch
• Themenwelt: Sachbuch/Ratgeber
• Themenwelt: Informatik ► Software Entwicklung ► User Interfaces (HCI)
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete
• Themenwelt: Medizin / Pharmazie ► Physiotherapie / Ergotherapie ► Orthopädie
• Themenwelt: Naturwissenschaften ► Chemie
• Themenwelt: Technik ► Bauwesen
• Themenwelt: Technik ► Medizintechnik
• Themenwelt: Technik ► Umwelttechnik / Biotechnologie
• ISBN-10: 0-08-055697-3 / 0080556973
• ISBN-13: 978-0-08-055697-0 / 9780080556970