1. education

PROGRAM
2011 Simulation Summit
November 3 - 5, 2011
Marriott Montréal Château Champlain
CONFERENCE SUPPORTERS
MARK YOUR CALENDAR
2012 Simulation Summit
November 17-18, 2012, Ottawa, ON, Canada
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
2011 Simulation Summit
THANK YOU TO ALL WHO SUPPORTED THE
2011 SIMULATION SUMMIT
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WELCOME
Welcome to Montreal and the 2011 Simulation Summit, jointly hosted by the Royal College of
Physicians and Surgeons of Canada, McGill University, and the Arnold and Blema Steinberg Medical
Simulation Centre.
This is the fourth Simulation Summit and under the leadership of Drs Susan Brien and Kevin
Lachapelle, the Planning Committee has put together a rigorous academic program highlighting some
of the best research and work in simulation-based medical education from Canada, the United States,
and outside North America.
As healthcare delivery is increasingly dependent on teams and teamwork, the 2011 Simulation
Summit has directed its focus on the training and evaluation of Interprofessional Teams. We all
realize the importance of good teamwork but often struggle to bring into practice true team-based
simulation training and evaluation. We believe this summit will provide the participants with the
necessary knowledge and skills to implement effective team training within their local environment
The meeting is anchored by three internationally recognized experts in team training and evaluation;
Drs Salas, Hunt, and Fried. Together with oral presentations, abstract presentations, video segments,
workshops, and social events, there are ample opportunities to interact and learn from colleagues.
Come and share what you know, we would love to hear it.
Don’t forget to stay for the post-conference activities on Saturday. There will be three educational
streams planned to meet the needs of simulation instructors, administrators and programmers. These
workshops are open to anyone with an interest in simulation-based learning and will be offered in both
English and French.
The opening Reception will take place in Le Caf Conc’ room of the Marriott Château Champlain
Thursday November 3, 17:00 hours. Everyone is invited and tickets are only $20 per person.
Thank you to McGill University, the Arnold and Blema Medical Simulation Centre and our sponsors for
their valuable support. We hope you enjoy the meeting!
Susan Brien, MD, MEd, CSPQ, FRCSC, CPE
Royal College of Physicians and Surgeons of Canada
Kevin Lachapelle, MD, FRCSC
McGill University/Arnold and Blema
Medical Simulation Centre
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
2011 Simulation Summit
Co-Chairs:
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2011 SIMULATION SUMMIT
TABLE OF CONTENTS
ACCREDITATION
This event is approved for up to 10.5 + 5.5 post conference credits by the Centre for Continuing
Health Professional Education (CCHPE). The Centre for CCHPE, Faculty of Medicine, McGill University is
fully accredited by the Committee on Accreditation of Canadian Medical Schools.
This event is an Accredited Group learning Activity as defined by the Maintenance of Certification
program of the Royal College of Physicians and Surgeons of Canada.
Through a reciprocal agreement between the American medical Association and the Royal College of
Physicians and Surgeons of Canada, The Centre for CCHPE, Faculty of Medicine, McGill University
designates this activity for AMA PRA Category 1 credit(s) up to the maximum number of credit hours
noted above.
Each physician should claim only those hours of credit that he/she actually spent at the educational
activity.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
2011 Simulation Summit
Planning Committee ...................................................5
Selection Committee...................................................5
Educational Goals .......................................................5
Who Should Attend .....................................................5
Registration ................................................................6
Cancellations ..............................................................6
Poster Sessions ..........................................................6
Accommodation ..........................................................6
Exhibits ......................................................................6
Keynote speakers .......................................................7
Program .....................................................................8
Post-Conference Program ...........................................13
Business Meetings ......................................................18
Workshops .................................................................19
Abstracts:
Oral Research Presentations ......................................29
Poster Presentations ..................................................39
Conflict of Interest .....................................................84
Floor Plan ...................................................................85
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2011 SIMULATION SUMMIT
INTERPROFESSIONAL TEAMS
PLANNING COMMITTEE
Co-Chair: Susan Brien, MD, MEd, CSPQ
FRCSC, CPE
Co-Chair: Kevin Lachapelle, MD, FRCSC
Linda Crelinsten, RN, MA
Mark Daly, RRT, MA (Ed.)
Ronald D. Gottesman, MDCM, FRCPC,
FAAP, FCCM
Leslie Graham, RN, BScN, MN, CNCC
Vincent Grant, MD, FRCPC
Susanne Lajoie, PhD
François Marquis, MD, FRCSC
Viren N. Naik, MD, MEd, FRCPC
Francesco Ramadori, MDCM, ABA (CCM),
FCCP
Melina Vassiliou, MD, M.Ed., FRCSC
SELECTION COMMITTEE (Abstracts, Workshops, Videos)
Co-Chairs: Viren N. Naik, MD, MEd, FRCPC / Ronald D. Gottesman, MDCM, FRCPC, FAAP,
FCCM
Farhan Bhanji, MD, FRCPC
Kevin Lachapelle, MD, FRCSC
Susanne Lajoie, PhD
Leslie Graham, RN, BScN, MN, CNCC
Vicki LeBlanc, PhD
Vincent Grant, MD, FRCPC
Stanley J. Hamstra, PhD
François Marquis, MD, FRCSC
EDUCATIONAL GOALS
The Simulation Summit 2011 invites health professionals to live and share the latest
innovations with regard to learning opportunities focused on the simulation. Under the
theme "The interprofessional teams," the summit this year is the educational objectives
include:
To advance the utilization of simulation for the assessment and evaluation of teams
To promote the use of simulation to define learning gaps in teams
To identify the opportunities to use simulation creatively to develop teams
WHO SHOULD ATTEND
This 1-1/2 day conference is open to all individuals engaged in the field of simulation, from
all healthcare disciplines. This includes:
• Health professional educators with an interest in simulation
• Simulation educators
• Health profession education researchers
• Simulation centre/program directors
• CPD educators
• CME planners
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
2011 Simulation Summit
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REGISTRATION
Category
Fee
Physician
Student*
Non-physician
Reception
$450
$75
$150
$20
$150
Post conference (Saturday, November 5)
*you will be contacted for confirmation of status
Registration will be located on the lower level of the Marriott Château Champlain
Registration Hours:
Thursday, November 3
Friday, November 4
08:00-17:00
07:00-17:00
CANCELLATIONS
A $25 administration fee will be charged for all cancellations. No refunds after September
28th.
POSTER SESSIONS
Poster sessions will take place in Salle de Bal room on Thursday and Friday (November 3rd
and 4th). Authors will be at their poster during breaks.
ACCOMMODATION
Discounted rooms have been reserved at the Marriott Château Champlain.
Online reservations: https://resweb.passkey.com/go/rcss
Tel: (800) 200-5909 for reservations
Rate: $179 Single/Double (taxes not included)
EXHIBITS
Please take time to visit the exhibits located in the Viger room and lower level
Foyer.
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CAE Healthcare
Canadian Network for Simulation in Healthcare
Covidien
DiscoveryCampus
Laerdal Medical Canada Ltd.
Limbs & Things, Inc.
Practice Performance Innovation Unit (Royal College)
Royal College of Physicians and Surgeons of Canada
Simulab Corporation
Exhibit Hours:
Thursday, November 3
Friday, November 4
13:00-17:00
08:00-17:00
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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KEYNOTE SPEAKERS
Eduardo Salas, PhD
• Pegasus Professor & University Trustee Chair Department
of Psychology Institute for Simulation & Training
University of Central Florida
Elizabeth (Betsy) Hunt, MD, MPH, PhD
• Assistant Professor of Anesthesiology and Critical Care
Medicine
• Assistant Professor of Pediatrics Johns Hopkins School of
Medicine
• Director of the Johns Hopkins Medicine Simulation Center
Gerald M. Fried, MD, FRCSC
• Chairman, Department of Surgery McGill University
• Surgeon-in-Chief McGill University Health Centre
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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PROGRAM
DAY 1
08:00 - 17:00
13:00 – 13:15
THURSDAY, NOVEMBER 3
SALLE DE BAL
REGISTRATION
Lower Level Foyer
Susan Brien, MD
Kevin Lachapelle,
MD
Moderator: Kevin
Lachapelle
Welcome
Opening Plenary
13:15 – 14:15
Simulation based team training and evaluation
Learning objectives:
Following this presentation the learner will be able to:
•
Define the components and process of teamwork
•
Identify metrics of simulation-based teamwork
•
Discuss the tools available to assess teams
13:55 – 14:15
Teamwork has become an obsession in many industries. But, what do we
know about teamwork, team training and team performance measurement
after several decades of research? This presentation will highlight what we
know about the science and practice of teamwork so far. It will provide
insights to those in those in practice as to what contributes to team
effectiveness in organizations and how to assess it.
Q&A
14:15 – 15:00
15:00 – 16:00
Eduardo Salas,
PhD
POSTER SESSION/ EXHIBIT VIEWING / BREAK
Oral Research Presentations: Training and Evaluation
Moderator: Viren
Naik
15:00 – 15:11

Within-team debriefing versus instructor-debriefing for
interprofessional simulation-based education: A prospective
randomized trial
15:11 – 15:22

Emotions, cognitive load, and learning outcomes during simulation
training
Kristin Fraser
15:22 – 15:33

A new attitude questionnaire designed to evaluate undergraduate
health professional students attitude toward the relevance of
simulation, IPE, and the precepts of teamwork
Elaine Sigalet
15:33 – 15:44

Standardized actors as performance evaluators in simulation-based
multiple mini-interviews for selection for entry into medical school:
would the same candidates get in?
15:44 – 15:55

16:00 – 16:40
Team training in trauma (3T): A model for evidence-based
interdisciplinary crisis management training curricula
Video Presentations
Sylvain Boet
Laura Easty
Itay Keshet
Moderator:
Francesco
Ramadori
16:00 – 16:10
•
Multidisciplinary Simulation at the University of Ottawa - A Meeting of
the Minds in the ER
David Glenn
Posner
16:10 – 16:20
•
Development of a Low Cost Simulator
16:20 – 16:30
•
Teaching Acute Communication and Teamwork using web-based
Video Clips of a dramatized obstetrical emergency
David Berger
Richardson
•
Trauma Team Training in Distributed Simulation (DS) - A low-cost,
portable and immersive environment
16:30 – 16:40
Neil Cowie
Alexandra Cope
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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PROGRAM
DAY 1
16:40 – 17:00
16:52-17:00
17:00-1830
THURSDAY, NOVEMBER 3
Poster Flash Points
SALLE DE BAL
Moderated by:
François Marquis

Simulation in the Canadian context: Perceptions of program
directors and university administrators
Vicki LeBlanc

Simulation for family centered care : improving caregiver skills,
self-efficacy and quality of life using a practice-until-perfect
simulation intervention for seizure management in the home
environment
Elaine Sigalet

The role of leadership in establishing mutual trust and team
coordination
Q&A
OPENING RECEPTION
Featuring the McGill residents jazz trio
Ilian CruzPanesso
LE CAF CONC’
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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PROGRAM
DAY 2
FRIDAY, NOVEMBER 4
08:00 – 08:30
POSTER SESSION / EXHIBIT VIEWING / BREAKFAST
08:30 – 09:30
Work-based simulation training: Overview of a
multidisciplinary professional curriculum
Learning objectives:
Following this presentation the learner will be able to :
•
Define in-situ simulation
•
Discuss methods of integrating in-situ and lab based simulation
into curricula
•
Describe the utilization of simulation to advance the safety and
quality agenda
09:11 – 09:30
09:30 – 10:30
In-situ simulation is an effective form of team-based training but it is not
a magic bullet. There are inherent risks, benefits and advantages to insitu training and these issues must be understood prior to embarking on
point of care training. The success of such a program is truly a team
effort involving design, delivery, logistics and evaluation
Q&A
Oral Research Presentations: Simulation-based metrics
Moderated by:
Vincent Grant
Elizabeth Hunt, MD
Moderated by:
Ronald Gottesman
09:30 – 09:41

Gender differences in spatial abilities in medical students
entering their residency programs – a five-year experience
09:41 – 09:52

A comparison of the Ottawa GRS and the ANTS scale for
evaluating performance in Crisis Resource Management
simulation scenarios
Rachel Fisher
09:52 – 10:03

Mastery versus standard proficiency targets for basic
laparoscopic skill training: effect on skill transfer and retention
Nicoleta Kolozsvari
10:03 – 10:14

Psychometrics of a behavioral marking system for obstetrical
teams
Deborah Tregunno
10:14 – 10:25

From bench to bedside: effective knowledge translation with
incorporation of a novel debriefing tool into the new 2011 PALS
instructor manual and course
Q&A
10:25 – 10:30
10:30 – 10:45
POSTER SESSION/ EXHIBIT VIEWING / BREAK
10:45 – 12:15
Concurrent Workshops (repeated in the afternoon)
W-1 Scripted debriefing for teams: optimizing the impact of postsimulation debriefing using a standardized debriefing script
W-2 Interprofessional team training: using simulation to teach
professionalism
W-3 Valid, reliable, and fair simulation-based assessment: what you
need to know and think about
Jean Langlois
Adam Cheng
Adam Cheng,
Elizabeth Hunt,
Vincent Grant,
Farhan Bhanji,
Jonathan Duff
Michelle Chiu,
Simone Crooks, Amy
Fraser, Daniel Power
Saleem Razack,
Farhan Bhanji,
Yvonne Steinert,
Meredith Young
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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W-4 Creative scenario design: taking interprofessional simulation to the
next level
M. Dylan Bould,
Sylvain Boet, Glen
Posner, Scott Reeves
W-5 Innovative simulation; strategies for developing interprofessional
competencies
Eleanor Riesen,
Debra Clendinneng,
Michelle Morley,
Susan Ogilvy, Mary
Ann Murray
W-6 Watch one, do (a simulated) one, teach one: integrating video
and other tools into procedural skills curricula
Melina Vassiliou, Yo
Kurashima
W-7 All for one and one for all: The challenges of simulation for
interprofessional teams (French)
François Marquis,
Pierre Cardinal
W-8 Debriefing hi-fidelity simulations
Viren Naik, Megan
Hayter, Zeev
Friedman, Jordan
Tarshis
W-9 Nursing simulation: taking it to the next level and beyond
12:15 – 13:30
POSTER SESSION/ EXHIBIT VIEWING / LUNCH
13:30 – 15:00
Concurrent Workshops
W-1 Scripted debriefing for teams: optimizing the impact of postsimulation debriefing using a standardized debriefing script
W-2 Interprofessional team training: using simulation to teach
professionalism
W-3 Valid, reliable, and fair simulation-based assessment: what you
need to know and think about
W-4 Creative scenario design: taking interprofessional simulation to the
next level
Leslie Graham,
Sandra Goldsworthy,
B. Nicole Harder
Adam Cheng,
Elizabeth Hunt,
Vincent Grant,
Farhan Bhanji,
Jonathan Duff
Michelle Chiu,
Simone Crooks, Amy
Fraser, Daniel Power
Saleem Razack,
Farhan Bhanji,
Yvonne Steinert,
Meredith Young
M. Dylan Bould,
Sylvain Boet, Glen
Posner, Scott Reeves
W-5 Innovative simulation; strategies for developing interprofessional
competencies
Eleanor Riesen,
Debra Clendinneng,
Michelle Morley,
Susan Ogilvy, Mary
Ann Murray
W-6 Watch one, do (a simulated) one, teach one: integrating video
and other tools into procedural skills curricula
Melina Vassiliou, Yo
Kurashima
W-7 All for one and one for all: The challenges of simulation for
interprofessional teams (French)
W-8 Debriefing hi-fidelity simulations
François Marquis,
Pierre Cardinal
Viren Naik, Megan
Hayter, Zeev
Friedman, Jordan
Tarshis
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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W-9 Nursing simulation: taking it to the next level and beyond
Leslie Graham,
Sandra Goldsworthy,
B. Nicole Harder
W-10 Human interruptus: Tech + talk (integrating human and medical
simulation)
Nancy McNaughton,
Diana Tabak, Kerry
Knickle
15:00 – 15:15
POSTER SESSION/ EXHIBIT VIEWING / BREAK
15:15 – 16:15
How individual task oriented skills drive team performance
Learning objectives:
By the end of the session, the learner will be able to:
•
Define three levels of performance as it relates to skills
acquisition
•
Understand the importance of evaluating and validating metrics
of performance in the simulated and clinical environment
•
Discuss methods and tools to evaluate performance in the
simulated and clinical environment.
15:56 – 16:15
16:15 -16:35
16:27 – 16:35
16:35 – 17:00
This presentation will illustrate an experience teaching technical skills to
individuals, incorporating the concepts of simulation and objective metrics
of performance. These principals led to the development of metrics of
performance in the clinical setting so that transfer of training from the
simulated setting to the clinical environment could be evaluated. These
learning programs have extended from specific skills to entire procedures.
The logical segue is to extend these principals of teaching and objective
measurements to situations where the completion of a procedure requires
the choreographed performance of the team to achieve an effective
outcome.
Q&A
Poster Flash Points

Effects of the level of clinical supervision on team resuscitation
and resident learning during simulated ICU scenarios

The effects of operating room team dynamics on trainee’s ability
to challenge authority: Measuring health advocacy with patient
simulation
Q&A
Closing Remarks and Awards


Moderated by: Melina
Vassiliou
Gerald Fried, MD
Moderated by: Leslie
Graham
Dominique Piquette
Devin Sydor
Susan Brien, MD
Kevin Lachapelle, MD
Best Presentation Award
Arnold Steinberg
PLEASE REMEMBER TO COMPLETE YOUR EVALUATION
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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POST CONFERENCE PROGRAM OUTLINE
Participants should meet at the Arnold and Blema Steinberg Medical Simulation Centre to
pick up registration materials. A guide will bring you to the New Residence Hall at McGill.
DAY 3
SATURDAY, NOVEMBER 5
08:00-09:00
Workshops: McGill University New Residence
08:30–09:00
09:00–15:30
Steinberg Simulation
Centre
REGISTRATION
BREAKFAST
Instructor Workshop (Bilingual):
Debriefing strategies following team training simulation: This is a
full day workshop designed for the non-beginner (beginners are welcome).
The workshop will review:

principles of good debriefing

various methods and approaches to debriefing, and allow for a
large component of hands on practice among participants.
McGill University New
Residence
McGill University New
Residence, Prince
Arthur B, Level C
Facilitated by: Kevin
Lachapelle, François
Marquis, Farhan Bhanji,
Ronald Gottesman,
Francesco Ramadori
The initial plenary will be in English while the hands on component will be
in separate into French and English. We will be using live but scripted
scenarios using standardized actors.
Breakouts French: Capacités d’observation
Breakouts English: Observational Skills
09:00–15:45
Simulation Program Administrators Workshop (English): One day
workshop for simulation program administrators and mangers covering
various topics of interest
McGill University New
Residence, Prince
Arthur A, Level C
Facilitated by: Linda
Crelinsten, Michelle
Morley, Lisa
Satterthwaite, Kim
Tardioli, Jordan Tarshis
Kevin Thomas
08:30 – 09:00
09:00 – 15:45
Workshop – Arnold and Blema Steinberg Medical Simulation Centre
Steinberg Simulation
Centre
BREAKFAST
Programmers Workshop – (Français)
Comment bâtir un scénario efficace et réaliste de simulation haute
fidélité : outils et astuces de la technologie
Facilitated by: Guylaine
Neveu
La programmation sera fondée sur la technologie Leardal, mais les
principles peuvent être appliqués à tous les types de technologie. Les
cours seront fondés sur les scenarios, les methods et l’experiénce de
l’Université McGill.
09:00 – 15:45
Programmers Workshop – (English)
Facilitated by: Kevin King
How to Construct an Effective and Realistic High-Fidelity
Simulation Scenario: Technology tools and Tricks
Programming will be based on Laerdal technology but the principles can
be applied to all types of technology. Course will be based on McGill’s
scenarios, methods, and experience.
16:00 – 16:30
Tour
Arnold and Blema Steinberg Medical Simulation Centre
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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POST CONFERENCE PROGRAM
Saturday, November 5, 2011
Instructor Workshop
Debriefing Strategies Following Team Training Simulation
Facilitated by: Kevin Lachapelle, MD, François Marquis, MD, Farhan Bhanji, MD,
Ronald Gottesman, MD, Francesco Ramadori, MD
McGill University Residence – Prince Arthur B, Level C
09:00 - 15:30
Particpants should meet at the Arnold and Blema Steinberg Medical Simulation Centre to
pick up registration materials. A guide will bring you to the New Residence Hall at McGill
University.
Language:
The initial plenary will be in English while the hands-on component will be
divided into French and English. We will be using live but scripted scenarios
using standardized actors.
CanMED Roles: Medical Expert, Communicator, Collaborator, Manager, Health Advocate
Debriefing is an important tool to optimize experiential learning. It is a process which allows
for learner self-reflection and growth. Debriefing utilizes techniques which can be learned
and refined with practice. Although sparingly used following clinical activities, debriefing is
the cornerstone of simulation-based teaching, especially following team training using high
fidelity simulation.
For simulation instructors, the “debrief” is frequently the most difficult aspect of simulationbased activities. This workshop will allow participants to gain insight into the debriefing
process and share their debriefing knowledge and experience through interactive simulation
scenarios. This workshop will allow participants to practice debriefing skills and allow
participants to receive feedback from faculty, peers, and standardized healthcare
professionals.
Goal: The goal of this workshop is to have participants implement effective debriefing
strategies following high–fidelity simulation team-training scenarios.
At the
1.
2.
3.
4.
5.
6.
end of this workshop, the participant will be able to:
List unique characteristics of an interprofessional team
Define and contrast the process of debriefing and feedback.
List characteristics of a good ‘debrief’
List 4 components of a structured debriefing
Improve observational skills for effective debriefing
Appropriately use rating scales and video for effective debriefing
• Relating back to scenario objectives
7. Apply effective strategies for a good ‘debrief’
8. Apply effective strategies for problems encountered during debriefing. For instance:
• Scenario breakdown
• Emotions
• Talkative individual
• Non-receptive individual/group (it’s not real/not like my environment)
• Silent individual/group
• Conflict among group members
• Debriefer “stuck”
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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Debriefing Strategies Following Team Training Simulation
SATURDAY, NOVEMBER 5, 2011
09:00 – 09:15
09:15 – 10:00
Introductions and Goals
Plenary
•
•
•
•
•
Debriefing; why, what, who, and when
Structured vs. non-structured debriefing
Debriefing techniques
Observational skills, rating scales and forms; defining performance gaps
The difficult debrief
10:00 – 10:15
10:15 – 11:00
Break
English
Observational skills
This will be short and snappy video examples
of actual scenarios and debriefing situations
highlighting various techniques and
approaches to debriefing
11:00 – 11:15
11:15 – 12:00
Break
English
Debriefing
View and practice debriefing scenarios (easy to
medium difficulty) practice with standardized
healthcare professionals
12:00 – 13:00
13:00 – 15:00
15:00 – 15:30
French
Capacités d’observation
Des exemples vidéo très brefs et percutants de
scénarios et de situations de débreffage réels feront
ressortir diverses techniques et démarches de
débreffage
French
Débreffage
Voyez des scénarios de débreffage (niveau de
difficulté allant de facile à moyen) et exercez-vous
à les utiliser avec des professionnels de la santé
standardisés
Lunch
English
Debriefing
Debriefing highlighted with standardized
healthcare professionals
French
Débreffage
Séance de débreffage avec des professionnels de la
santé standardisés
Group feedback and Wrap up
Optional:
Following the workshops, there will be a tour of the Arnold and Blema Steinberg Medical Simulation Centre at 3575
Parc Avenue, Suite 5640 from 16:00-16:30
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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POST CONFERENCE PROGRAM
Saturday, November 5, 2011
Workshop for Simulation Program Administrators
Facilitated by: Linda Crelinsten, RN, MA, Michelle Murray, Lisa Satterthwaite,
Jordan Tarshis
McGill University Residence – Prince Arthur A, Level C
09:00 - 15:45
Particpants should meet at the Arnold and Blema Steinberg Medical Simulation Centre to
pick up registration materials. A guide will bring you to the New Residence Hall at McGill
University.
Target Audience:
Language:
CanMED Roles:
Directors, managers and coordinators of simulation programs
English
Manager, Communicator
Learning Objectives:
Upon completion of this workshop simulation staff will have a better understanding of the
infrastructure required for a successful program or centre.
Participants will:
• Gain a better understanding about how to build a team with diverse skill sets and
improve staff training.
• Discuss opportunities for revenue generation and the relationship that is required
with their institution, hospital or university.
• Review health and safety issues in simulation centres and identify the different
policies and procedures required to work with the human patient simulators, versus
cadavers and animal tissue.
• Compare and contrast the different accreditation processes and evaluate what is the
best fit for their simulation program.
Each session will begin with a short presentation by a panel followed by participant
discussion and Q & A.
SATURDAY, NOVEMBER 5
09:00 – 09:30
09:30 – 10:30
Welcome and Introductions
McGill University
Residence
Linda Crelinsten
Staffing: How do we find the right help?
10:30 – 10:45
Break
10:45 – 11:45
11:45 – 12:45
Revenue Generation: What we charge for, what should we charge
for?
Lunch
12:45 – 13:45
Surgical Skills Labs: What are the health and safety issues
13:45 – 14:45
Accreditation: by whom, when, how to?
14:45 – 15:30
Should we have a support network?
15:30 – 15:45
Wrap-up and follow-up
Optional:
Following the workshops, there will be a tour of the Arnold and Blema Steinberg Medical Simulation Centre at 3575
Parc Avenue, Suite 5640 from 16:00-16:30
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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POST CONFERENCE PROGRAM
Saturday, November 5, 2011
Programmers Workshop
How to Construct an Effective and Realistic High-Fidelity Simulation
Scenario: Technology Tools and Tricks
Facilitated by: Guylaine Neveu, RRT (Français), Kevin King, CCP(F), MBA(CAN)
(English)
Arnold & Blema Steinberg Medical Simulation Centre
Target Audience:
Language:
CanMED Roles:
09:00 - 15:45
Simulation programmers, technicians and instructors
Concurrent workshops English and French
Medical Expert, Collaborator, Communicator
Abstract: Educators work hard to develop learner centered-objectives, scenarios and
curricula. They focus on identifying learning gaps, giving feedback, and providing an
environment for good debriefing. Central to the success of this educational activity is a
simulation scenario which provides clinically relevant situations that seamlessly create a
realistic living environment into which learners are immersed. This does not happen by
chance. It occurs through careful and realistic programming based on learner objectives,
understanding the functionality of your mannequin, applying special effects to improve
realism, and being able to troubleshoot common technical problems which occur during a
scenario. This workshop will focus on how to bring to life a simulation scenario so that it is
effective, realistic, and provides the necessary platform for learning. This will be done via
hands-on work with programming scenarios, learning the tricks of creating special effects,
and actual trouble shooting technical problems.
Goal: The overall goal of the workshop is to provide participants with the necessary
knowledge and skill to program and create a simulation scenario
Objectives:
The workshop is divided into three parts:
• How to program an educational scenario
• Understand what your mannequin can and cannot do
• Understand how your mannequin program functions
• List principles of scenario building
• Link learning objectives to your high-fidelity
• Using advanced features
• Realism. Tricks of the trade
• Environmental Realism
• Moulage
• Special Effects
• Incorporating Standardised Actors
• Scenario Trouble Shooting
• List ten typical problems and how to fix them
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
17
BUSINESS MEETINGS
By invitation only
08:00-17:00
WEDNESDAY, NOVEMBER 2, 2011
Canadian Pediatric Simulation Network
For information, contact: Dr. Ronald Gottesman at:
[email protected] or Dr. Vincent Grant
at: [email protected]
13:00-17:00
08:00-12:00
Industry Roundtable
For information, contact John Parker at:
[email protected] or Linda Crelinsten
[email protected]
Montreal Marriott Château
Champlain
Maisonneuve A
THURSDAY, NOVEMBER 3, 2011
Canadian Network for Simulation in Healthcare
For information, contact, Linda Crelinsten at:
Montreal Marriott Château
Champlain
[email protected]
07:30-12:00
Arnold & Blema Steinberg Medical
Simulation Centre
Huronie A&B (Plaza level)
Royal College Simulator Instructor Training Committee
Montreal Marriott Château
Champlain
Terrace (Plaza level)
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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WORKSHOPS
Thursday, November 3, 2011
Deliberate Practice: simulated families help meet communication outcomes
Facilitated by: James Downar, MD, Patti O’Brien, Assistant Director Professional Affairs, Royal College
Friday, November 4, 2011
W-1 Scripted Debriefing for Teams: Optimizing the impact of post-simulation
debriefing using a standardized debriefing script
Facilitated by: Adam Cheng, MD, Elizabeth Hunt, MD, Vincent Grant, MD, Farhan Bhanji, MD, Jonathan
Duff, MD
W–2 Interprofessional Team Training: Using simulation to teach professionalism
Facilitated by: Michelle Chiu, MD, Simone Crooks, MD, Amy Fraser, MD, MSc, MHPE, Daniel Power,
MD, CCFP (EM)
W–3 Valid, Reliable and Fair Simulation-based Assessment: What you need to
know and think about
Facilitated by: Saleem Razack, MD, Farhan Bhanji, MD, Yvonne Steinert, PhD, Meredith Young, PhD
W–4 Creative Scenario Design: Taking interprofessional simulation to the next
level
Facilitated by: M. Dylan Bould, MB, ChB, FRCA, MEd, Sylvain Boet, MD, MEd, Glenn Posner, MD, Scott
Reeves, PhD
W–5 Innovative Simulation Strategies for Developing Interprofessional
Competencies
Facilitated by: Eleanor Riesen, RN, PhD, CPsych, Debra Clendinneng, Michelle Morley, Susan Ogilvy,
Mary Ann Murray
W–6 Watch One, Do (A Simulated) One, Teach One: Integrating Video and Other
Tools into Procedural Skills Curricula
Facilitated by: Melina Vassiliou, MD, M.Ed., Yo Kurashima, MD, PhD
W–7 All for One, and One for All: The Challenges of Simulation for
Interprofessional Teams
Facilitated by: François Marquis, MD, Pierre Cardinal, MD
W–8 Debriefing the High-Fidelity Simulations
Facilitated by: Viren Naik, MD, Megan Hayter, MD, MEd, Zeev Friedman, MD, Jordan Tarshis, MD
W–9 Nursing Simulation: Taking it to the next level and beyond
Facilitated by: Leslie Graham RN, BScN, MN, CNCC, Sandra Goldsworthy, RN, BScN, MSc, CMSN, B.
Nicole Harder, RN, BN, MPA
W–10 Human Interruptus: Tech + Talk (Integrating human and medical
simulation)
Facilitated by: Nancy McNaughton, MEd, PhD, Diana Tabak, MEd (S), Kerry Knickle, LLM (ADR)
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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WORKSHOPS
Thursday, November 3, 2011
Deliberate Practice: simulated families help meet communication outcomes
Facilitated by: James Downar, MD, Patti O’Brien, Assistant Director Professional Affairs,
Royal College
Neufchatel
Target Audience:
Level:
Language:
10:00 o 12:00
All allied health professionals involved in simulation-based education
Beginner / Intermediate
English
CanMED Roles: Communicator, Collaborator, Health Advocate
Learning Objectives:
Upon the completion of this session, participants will be able to:
1. Describe the practical advantages of using standardized patients in simulation based
education
2. Discuss the relevance of this simulation format in acquiring knowledge, enhancing
comfort when dealing with conflict, and improving communication skills.
3. Identify important considerations and success factors for implementation of standardized
patient simulations as an educational strategy.
Supporting patients and family members in end-of-life decision making requires a certain
degree of proficiency in communication and conflict management skills. These skills can be
difficult to acquire and even more difficult to apply. Teaching these skills to health care
providers is a challenging task, one that has been undertaken using a variety of teaching
strategies. Adding standardized patient simulation as an experiential learning activity to the
teacher’s tool kit can provide a realistic opportunity for learners to apply knowledge,
enhance their comfort level and engage in reflective practice. This workshop is geared
toward simulation instructors and medical educators who are interested in using this type of
simulation to enhance and reinforce CanMEDS roles outside the medical expert role.
Attendees will have the opportunity to participate in/or observe a simulated conversation
about end-of-life decisions and will participate in a hands-on session where they will begin
identifying practical considerations for imbedding this type of simulation into their own
curriculum.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
20
WORKSHOPS
Friday, November 4, 2011
W-1 Scripted Debriefing for Teams: Optimizing the impact of postsimulation debriefing using a standardized debriefing script
Facilitated by: Adam Cheng, MD, Elizabeth Hunt, MD, Vincent Grant, MD, Farhan Bhanji,
MD, Jonathan Duff, MD
Target Audience:
Level:
Language:
CanMED Roles:
All allied health professionals involved in simulation-based education
Beginner / Intermediate
English
Medical Expert, Communicator, Collaborator, Health Advocate,
Scholar, Professional
Learning Objectives:
Upon the completion of this session, participants will be able to:
1. Describe the theory behind existing debriefing scripts;
2. Discuss the importance of debriefing scripts;
3. Apply a debriefing script to enhance learning from post-simulation debriefing.
Effective post-simulation debriefing helps teams understand the basis of their actions and
ultimately, close performance gaps that were identified during the simulation. Our team of
investigators (EXPRESS collaborative) has developed and studied a debriefing script which
improves acquisition of knowledge and behavioural skills when used by novice debriefers.
This workshop is geared towards simulation instructors who are interested in improving the
quality of debriefing sessions by using a simple and generalizable debriefing script for
simulation-based education. We will briefly examine the theory behind scripted debriefing,
introduce the debriefing script, and then allow hands-on opportunity for participants to learn
how to use the debriefing script.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
21
WORKSHOPS
Friday, November 4, 2011
W–2 Interprofessional Team Training: Using simulation to teach
professionalism
Facilitated by: Michelle Chiu, MD, Simone Crooks, MD, Amy Fraser, MD, MSc, MHPE, Daniel
Power, MD, CCFP (EM)
Target Audience:
Level:
Language:
CanMED Roles:
This interprofessional, intermediate level workshop would be of
interest to faculty looking to gain skills and practical knowledge on
how to use simulation to teach professionalism
Intermediate
English
Professional, Communicator, Collaborator
Learning Objectives:
By the end of this workshop participants will be able to:
1. Define professionalism;
2. Identify the strengths/limitations of how simulation can be used to teach this
competency;
3. Develop a relevant “professionalism” scenario including learning objectives.
Professionalism is a competency required of all health professionals, yet it is one that is
challenging to teach and evaluate. Many national and provincial regulators have demanded
that this needs to be addressed at all educational levels and in all medical and allied-health
specialties. Simulation provides the ideal setting to teach, observe and assess this specific
competency in a safe and controlled environment.
How can simulation be used to teach professionalism for teams? In this interactive
workshop, a trigger video will be shown which highlights specific aspects of professionalism
within a team. The video will serve to promote group discussion on the definition of
professionalism. Workshop participants will be divided into four facilitated breakout groups,
with each group designing and developing a simulation scenario that addresses a
professional learning need. A tailored scenario template will be used that documents:
learning objectives, scenario setup, scenario implementation and debriefing points. Each
group will present their approach to a different professionalism problem and by the end of
the workshop, participants will bring home four fully developed scenarios to trial at their
own centre.
Participants must consent to share their work with other participants of this workshop.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
22
WORKSHOPS
Friday, November 4, 2011
W–3 Valid, Reliable and Fair Simulation-based Assessment: What you need
to know and think about
Facilitated by: Saleem Razack, MD, Farhan Bhanji, MD, Yvonne Steinert, PhD, Meredith
Young, PhD
Target Audience:
Level:
Language:
CanMED Roles:
Health professions educators who currently use or are interested in
using simulation-based evaluation tools
Beginner / Intermediate
Plenary in English. Discussion and small group work is bilingual
Medical expert, Communicator, Collaborator, Manager, Health
Advocate, Scholar, Professional
Learning Objectives:
By the end of this workshop participants will be able to:
1. Develop simulation-based evaluation strategies to assess performance;
2. Describe the common psychometric indicators used in interpreting results of simulationbased assessments.
Ideal assessment strategies should be systematically aligned to curricular outcomes, thereby not only
measuring student achievement, but also playing an integral role in learning and teaching. Increasing
curricular focus in the health professions on authentic practice-based assessment contexts makes
simulation-based assessment particularly attractive as a tool for performance assessment.
Simulation offers a unique learning environment that challenges learners to perform in an authentic
clinical encounter with no risk to patient care. Well-designed simulation based assessment also offers
the opportunity to evaluate students’ performance in realistic contexts, with the potential for rational
linkage between what students are taught (curriculum) to curricular outcomes, and ultimately,
through attention to the authenticity of the design, to their practice as professionals.
In designing effective and valid simulation-based assessment tools educators must bring together two
discrete bodies of knowledge –that of simulation-based educational interventions (considering
contextual factors such as authenticity and fidelity), and that of the interpretive sciences of the
psychometrics of performance-based evaluation (considering factors such as reliability, validity,
generalizability, equity and bias).
The authors have designed an interactive case-based workshop in which participants will explicitly
consider the design of simulation-based assessment tools through these two lenses, understanding the
importance of both and the relationship between them. Simulation-based assessment is being used in
a wide variety of settings, from primary health professions education to the assessment of practicereadiness for international medical graduates and, as such, carries with it many important equity and
bias concerns that must also be considered in the design of fair and valid tools.
We will present a framework for educational assessment tools evaluation, and participants will have
the opportunity to enhance their understanding of the design of authentic, fair and valid simulation
based assessment tools by applying this framework to the cases of simulation-based assessment
presented and from their own contexts.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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WORKSHOPS
Friday, November 4, 2011
W–4 Creative Scenario Design: Taking interprofessional simulation to the
next level
Facilitated by: M. Dylan Bould, MB, ChB, FRCA, MEd, Sylvain Boet, MD, MEd, Glenn Posner,
MD, Scott Reeves, PhD
Target Audience:
Level:
Language:
Anyone involved in or interested in becoming involved in
interprofessional simulation
Intermediate
Plenary in English. Small groups bilingual
Learning Objectives:
At the end of the session, participants will be able to:
1. Design scenarios that highlight interprofessional elements of care;
2. Consider hybrid simulation to optimize learning objectives;
3. Recognize and implement the concept of ‘sociological fidelity’.
Interprofessional collaboration in healthcare involves the development of a shared mental
model between team members. Simulation-based education with an interprofessional group
allows learning within the same team structure that the learners will experience in the
clinical realm giving the opportunity to accurately reproduce team interactions. The learning
objectives and scenarios are the foundation of simulation and it is essential that these
elements focus on aspects that are missing from sessions that are limited to professional
silos. However, to effectively focus on these interprofessional elements, educators must do
more than just getting learners from different healthcare professions in the simulator
together. This workshop will focus on how to design learning objectives and simulation
scenarios that will maximize the learning opportunities of interprofessional simulation, with
the ultimate goal of improving team performance and therefore patient safety. We will
discuss (1) the importance of involving an interprofessional team of educators in scenario
design, (2) how to target the shared mental model, (3) how hybrid simulations can be an
effective way of reproducing a full range of tasks for a team, (4) how to recognize when
simulation is unintentionally reproducing existing power relationships and hierarchies in
healthcare and how to optimally implement the concept of sociological fidelity. Participants
will have the opportunity to practice creating learning objectives and scenarios in small
groups with subsequent discussion with the whole group.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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WORKSHOPS
Friday, November 4, 2011
W–5 Innovative Simulation Strategies for Developing Interprofessional
Competencies
Facilitated by: Eleanor Riesen, RN, PhD, CPsych, Debra Clendinneng, Michelle Morley,
Susan Ogilvy, Mary Ann Murray
Target Audience:
Level:
Language:
CanMED Roles:
All
Intermediate
English
Communicator, Collaborator, Professional
Learning Objectives:
At the end of the session, participants will be able:
1. Identify the benefits and challenges of using virtual reality simulation;
2. Describe strategies for incorporating virtual reality simulation in healthcare curricula;
3. Practice evaluating team performance in a virtual reality simulation.
Simulation experiences in online immersive worlds enhance learners' abilities to develop
teamwork and communication skills. We will describe the process of creating, implementing
and evaluating an innovative educational program in a virtual world where learners interact
as avatars. Participants in this session will practice evaluating a team simulation in virtual
reality, discuss the results and future implications.
W–6 Watch One, Do (A Simulated) One, Teach One: Integrating Video and
Other Tools into Procedural Skills Curricula
Facilitated by: Melina Vassiliou, MD, M.Ed., Yo Kurashima, MD, PhD
Target Audience:
Level:
Language:
CanMED Roles:
All
Beginner / Intermediate
Bilingual
Medical Expert, Communicator, Collaborator
Learning Objectives:
At the end of the session, participants will be able:
1. Recognize the importance of learner motivation in the acquisition and retention of
procedural skills;
2. Effectively integrate video into procedural skills training Create simulation-based curricula
that combine different genres of simulation (hybrid);
3. Observe and evaluate student performance and provide feedback during and after a
simulated procedure or skill.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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WORKSHOPS
Friday, November 4, 2011
W–7 All for One, and One for All: The Challenges of Simulation for
Interprofessional Teams
Facilitated by: François Marquis, MD, Pierre Cardinal, MD
Target Audience:
Level:
Language:
CanMED Roles:
Multidisciplinary Teams
Intermediate
French
Communicator, Collaborator, Manager
Learning Objectives:
Upon completion of this session participants will be able to:
1. Understand the unique challenges in creating high-fidelity simulations for
multidisciplinary teams;
2. Adapt the content of both simulations and debriefings to the multidisciplinary paradigm.
W–8 Debriefing the High-Fidelity Simulations
Facilitated by: Viren Naik, MD, Megan Hayter, MD, MEd, Zeev Friedman, MD, Jordan
Tarshis, MD
Level:
Language:
CanMED Roles:
Intermediate
English
Communicator, Collaborator, Manager
Learning Objectives:
Upon completion of this session participants will be able to:
1. Use different strategies to get through difficult debriefings;
2. Adapt debriefing strategies to different simulation situation;
3. Adapt debriefings for ‘debriefers’.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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WORKSHOPS
Friday, November 4, 2011
W–9 Nursing Simulation: Taking it to the next level and beyond
Facilitated by: Leslie Graham RN, BScN, MN, CNCC, Sandra Goldsworthy, RN, BScN, MSc,
CMSN, B. Nicole Harder, RN, BN, MPA
Target Audience:
Level:
Language:
All members of the interprofessional team
Intermediate
English
Learning Objectives:
At the end of the session, participants will be able to:
1. Identify barriers and opportunities to interprofessional simulation;
2. Discuss the appropriateness of interprofessional simulation within a variety of contexts;
3. Create a variety of sample outlines of a interprofessional simulation.
Interprofessional education has become the new buzz word in healthcare. Adopting a team
approach to optimize patient safety, hospitals and academic institutions hone their skills
using simulation. In designing team based simulations, important questions such who are
members of the inter-professional (IP) team need to be addressed. When designing IP
simulation balancing role recognition with role confusion needs to be considered. In this
workshop, the controversies of IP simulation are illuminated. Engaging in group discussion
barriers and opportunities will be explored. The participants will create a sample of an IP
simulation unique to their work environment.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
27
WORKSHOPS
Friday, November 4, 2011
W–10 Human Interruptus: Tech + Talk (Integrating human and medical
simulation)
Facilitated by: Nancy McNaughton, MEd, PhD, Diana Tabak, MEd (S), Kerry Knickle, LLM
(ADR)
Target Audience:
Language:
CanMED Roles:
Professional
All
English
Medical Expert, Communicator, Collaborator, Health Advocate,
Learning Objectives:
Upon the completion of this session, participants will be able to:
1. Describe a conceptual model illustrating the continuum and intersections of human and
medical simulation;
2. List the relevant and practical applications of different simulation modalities along the
continuum;
3. Engage in or observe a hybrid simulation applying the conceptual model.
Technical procedural and communication skills are seldom taught together but are required
to be integrated in clinical practice. Engaging living and medical simulation modalities in
teaching and assessment practices can contribute to the depth of clinical learning across a
spectrum of skills, knowledge and behaviour. This workshop will provide a conceptual
model for thinking about where and how to integrate human simulation with other
simulation modalities along a continuum of learning. Participants will be invited to reflect on
factors influencing effective implementation of different simulation modalities and
opportunities for enhancing existing simulation curricula at their institutions. Technical
expertise and communication skills for interacting with the patient, family and health care
team will be explored via participation in or observation of a hybrid simulation.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
28
ABSTRACTS
ORAL RESEARCH PRESENTATIONS – SALLE DE BAL
Thursday, November 3
15:00 - 16:00
Within-Team Debriefing versus Instructor-Debriefing for Interprofessional
Simulation-based Education: A Prospective Randomized Trial
Boet, Sylvain (The Ottawa Hospital, Ottawa, ON, CAN); Bould, M Dylan (Children’s Hospital of Eastern Ontario,
Ottawa, ON, CAN); Sharma, Bharat (Allan Waters Family Patient Simulation Centre, Toronto, ON, CAN); Reeves,
Scott (Li Ka Shing International Healthcare Education Centre & Li Ka Shing Knowledge Institute of St Michael’s
Hospital, Toronto, ON, CAN); Naik, Viren (The University of Ottawa Skills and Simulation Centre, Ottawa, ON,
CAN); Triby, Emmanuel (Faculté de Sciences de l’Education, Strasbourg, FRA); Grantcharov, Teodor (Allan Waters
Family Patient Simulation Centre, Toronto, ON, CAN)
Objective: This study compared the effectiveness of within-team debriefing (led by the
individuals of the team itself without external instructor) to that of instructor debriefing on
interprofessional team performance during a simulated operating room (OR) crisis.
Methods: After IRB approval, 120 participants were grouped into 40 teams consisting of
one anesthesia resident, one surgical resident and one staff circulating OR nurse. An actor
played the scripted role of an OR scrub nurse. All teams managed a simulated crisis
scenario (pre-test). Teams were then randomized to either a within-team debriefing or an
instructor debriefing. In the within-team debriefing group, the teams reviewed the video of
their scenario by themselves with a debriefing guide based on the Ottawa Global Rating
Scale. The teams in the instructor debriefing group reviewed their scenario, guided by a
trained instructor. Immediately following debriefing, all teams were recorded managing a
different intraoperative crisis scenario (post test). After data collection, three blinded expert
examiners rated all performances in a random order using the validated TEAM scale.
Results: A two-way, mixed ANOVA detected a significant improvement in team
performance from pre-test to post-test (p=.008) with no significant effect of the debriefing
type received (p=.91). The effect of debriefing modality showed no interaction with respect
to pre or post test performance (p=.52).
Conclusion: Within-team debriefing results in measurable improvements in team
performance in simulated crisis scenarios, and may be as effective as instructor team
debriefing for interprofessional team-based simulation, which could improve costeffectiveness and flexibility of scheduling.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
29
ABSTRACTS
ORAL RESEARCH PRESENTATIONS – SALLE DE BAL
Thursday, November 3
15:00 - 16:00
Emotions, Cognitive Load, and Learning Outcomes During Simulation Training
Fraser, Kristin (University of Calgary, Calgary, AB, CAN); Ma, Irene (University of Calgary, Calgary, AB, CAN);
Wright, Bruce (University of Calgary, Calgary, AB, CAN); McLaughlin, Kevin (University of Calgary, Calgary, AB,
CAN)
Our objective was to assess the emotional reaction and cognitive load of learners during
simulation training, and the association between these and learning outcomes.
Participants were 84 first year medical students at the University of Calgary training on a
cardiorespiratory simulator (Harvey). We used an eight item rating scale to assess students’
emotional reaction to training, and a nine-point Likert-type rating scale to assess cognitive
load. We evaluated diagnostic performance on the same simulated clinical findings one hour
after training. We used factor analysis to identify the principal components of emotion, and
multiple linear regression to study the association between emotion and cognitive load, and
cognitive load and diagnostic performance.
We identified two principal components of emotion, representing “enjoyment” and “anxiety”.
We found a significant positive association between both enjoyment and anxiety and
cognitive load (regression coefficient [95%CI] 0.66 [0.31, 0.01], p < 0.001 and 0.47 [0.13,
0.82], p = 0.007, respectively). There was a non-linear (inverted U) relationship between
cognitive load and diagnostic performance, with significantly lower diagnostic performance
for students in the highest cognitive load tertile (p < 0.001).
Emotions experienced during simulator training are associated with perceived cognitive
load, which is, in turn, related to learning outcomes. Specifically, learning outcomes decline
with high levels of cognitive load. Further studies are needed to evaluate aspects of
simulation that contribute to emotions and cognitive load so that we can maximize learning
outcomes.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
30
ABSTRACTS
ORAL RESEARCH PRESENTATIONS – SALLE DE BAL
Thursday, November 3
15:00 - 16:00
A New Attitude Questionnaire Designed to Evaluate Undergraduate Health
Professional Student Attitudes Toward the Relevance of Simulation, IPE, and the
Precepts of Teamwork
Sigalet, Elaine (University of Calgary, Community Health Science, Division of Medical Education and KidSIM ASPIRE
Research Team, Calgary, AB, CAN); Grant, Vince (University of Calgary, Faculty of Medicine, and KidSIM ASPIRE
Research Team, Calgary, AB, CAN); Robinson, Traci (KidSIM-ASPIRE Pediatric Simulation Research Program,
Alberta Children's Hospital, University of Calgary KIDSIM Program Alberta Children's Hospital, Calgary, AB, CAN);
Donnon, Tyrone (University of Calgary, Community Health Science, Division of Medical Education and KidSIM
ASPIRE Research Team, Calgary, AB, CAN)
There is no standardized measure in health professional education to evaluate attitudes of
participants to the learning modality used to deliver interprofessional education (IPE). The
KidSIM Attitude Toward Teamwork in Training Utilizing Designed Educational Simulation
(ATTITUDES) Questionnaire was developed to assess learners’ attitudes towards relevance
of simulation in teaching IP teamwork, the IPE, and the concepts of teamwork. A quasiexperimental pre-test/post-test research design was used. Consenting undergraduate
students (n=196) from nursing, medicine and respiratory therapy completed the
questionnaire prior to and immediately after engaging in two scenarios of pediatric critical
illness (sepsis, seizure, anaphylaxis or asthma). All learning was conducted as an
interprofessional team. There were highly significant increases in the value placed on an IPE
curriculum, utility of simulation in teaching IPE, and the role of teamwork in delivering
patient care (each p < 0.001) in all student groups. The internal reliability coefficient
(Cronbach’s alpha) of the KidSIM ATTITUDES questionnaire was α = .95. An exploratory
factor analysis resulted in a five-factor solution accounting for 61.6% of the variance.
Factors suggest we measured relevance of simulation (α = 0.83), relevance of IPE (α =
0.90), communication (α = 0.84), roles and responsibilities (α = 0.86) and situation
awareness (α = 0.77). The reliability of the IPE and teamwork subscales are higher than
reported on other questionnaires, particularly the roles and responsibility factor previously
reported to be < .50. These results support the value of high-fidelity simulation as a
learning modality for IPE, and the reliability and construct validity of the newly developed
KidSIM ATTITUDES questionnaire.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
ORAL RESEARCH PRESENTATIONS – SALLE DE BAL
Thursday, November 3
15:00 - 16:00
Standardized Actors as Performance Evaluators in Simulation-Based Multiple MiniInterviews for Selection for Entry into Medical School: Would the Same Candidates
Get In?
Easty, Laura (McGill University, Montreal, QC, CAN); Moreau, Louis-Charles (McGill University, Montreal, QC, CAN);
Young, Meredith (McGill University, Montreal, QC, CAN); Kagan, Lisa (Arnold and Blema Steinberg Medical
Simulation Centre, Montreal, QC, CAN); Razack, Saleem (McGill University, Montreal, QC, CAN)
Objective: Applicant performance evaluation by standardized actors (SA’s) has not been
previously reported on in the setting of multiple mini-interviews (MMI’s) for medical student
selection. We compared the reliability of evaluations made by SA’s vs. expert evaluators
(admissions board members) in this context.
Methods: Expert Evaluators and SA’s rated student performance on a 5-item, 7-point
modified Likert scale (5th item always being a ‘global suitability for medicine’ rating).
Reliability was examined using generalizability theory, and consistency across SA’s’ and
Experts’ ratings was examined using Spearman rank (ρ).
Results: Total station scores correlated positively between the two evaluator groups
(r=.71, p<0.0001). The two evaluator groups ranked applicants similarly (ρ = 5.4, p<0.01).
Experts were more reliable than SA’s in both station specific questions (reliability (4 station
specific) questions: Expert: 0.17, SA: 0.11) and global ratings (reliability 5th item: Expert:
0.17, SA: 0.10). SA’s agreed with Experts for upper quartile ranking for 44 applicants (vs.
67 for the Experts). As for how this would translate into decision making (i.e. offer of
position or not), for top-ranked candidates SA’s would not have admitted a total of 54
applicants (out of 160 offers) that the faculty evaluators would have (a 33% discrepancy).
Conclusion: In multiple mini-interviews, scenario standardized actors show significant
agreement with expert evaluators on applicants’ performance and rank. There are, however,
differences in final applicant rankings between the SA’s and the evaluators, and further
study to elucidate these differences is warranted.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
32
ABSTRACTS
ORAL RESEARCH PRESENTATIONS – SALLE DE BAL
Thursday, November 3
15:00 - 16:00
Team Training in Trauma (3T): A Model for Evidence-Based Interdisciplinary Crisis
Management Training Curricula.
Keshet, Itay (St. Michael's Hospital, Toronto, ON, CAN); Doumaras, Ari (St. Michael's Hospital, Toronto, ON, CAN);
Ahmed, Najma (St. Michael's Hospital, Toronto, ON, CAN); Hicks, Christopher (St. Michael's Hospital, Toronto, ON,
CAN)
Introduction: Effective management of complex crises calls on a spectrum of non-technical
skills, yet surgical training has traditionally focused on technical skills and medical
knowledge. Crisis management skills have been under represented in many surgical
curricula despite evidence for significant patient safety benefits. The nature of crises as
rare, episodic events necessitates the use of high-fidelity simulation for deliberate practice,
yet increasingly elaborate technologies and an evolving body of literature create a confusing
landscape.
Methods: A meta-analysis of team-based crisis management training was conducted to
establish best-practice guidelines. A novel half-day interdisciplinary curriculum was then
developed (n=18). Face validity was assessed using the Participant Evaluation of Training
Quality (PETQ). Shifts in learner attitudes were assessed pre and post intervention using the
Human Factors Assessment Scale (HFAS), and behaviour changes were determined in real
time using the Mayo High Performance Team Scale (MHPTS).
Results: Participants valued the exercise (mean PETQ score=.81, sd=0.1). There was a
mean 7.2% change in HFAS score from pre to post intervention (paired t-statistic = 4.85,
df=17, p < 0.0001). Raters’ assessment of team performance on MHPTS demonstrated a
significant improvement at midpoint (p=0.017) and endpoint (p=0.033) relative to
baseline.
Conclusion: Crisis management training benefits patient safety in the trauma setting.
Given the significant resource commitments required to deliver crisis management training,
there is a need for a best practice set of guidelines. To this end, current research was
distilled into methods that demonstrated strong face validity, significant positive changes in
attitudes, and real performance benefits.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
ORAL RESEARCH PRESENTATIONS – SALLE DE BAL
Friday, November 4
09:30 - 10:30
Gender Differences in Spatial Abilities in Medical Students Entering Their
Residency Programs: A Five-Year Experience.
Langlois, Jean (Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, CAN); Wells, George A (University
of Ottawa, Ottawa, ON, CAN); Lecourtois, Marc (Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC,
CAN); Bergeron, Germain (Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, CAN); Yetisir, Elizabeth
(University of Ottawa, Ottawa, ON, CAN); Martin, Marcel (University of Sherbrooke, Sherbrooke, QC, CAN)
Objective: Spatial abilities consist of visualization, orientation and manipulation of
structures in space. Spatial abilities have been related to 3-D anatomy knowledge and the
performance in technical skills. The objective was to assess gender differences in spatial
abilities in the medical field. The a priori hypothesis was to test for gender differences in
spatial abilities in medical students entering their residency programs in a five-year
experiment.
Methods: A cohort of 214 medical students entering their residency programs was enrolled
in a prospective study from 2005 to 2010. Data was not collected in 2009. Spatial abilities
were measured with a redrawn Vandenberg and Kuse Mental Rotations Tests in two (MRTA)
and three (MRTC) dimensions. The maximum scores were 24 for MRTA and MRTC.
Descriptive statistics included frequency and percent and mean ± standard deviation. The
MRTA and MRTC scores were evaluated using a two-way analysis of variance with two
between factors (year of study and gender). The Student’s t-test was used to compare
gender to MRTA and MRTC scores.
Results: No gender by time interaction or main effect of year was found. For the main
effect of gender, differences favouring males were identified in 131 (61.2%) female and 83
(38.8%) male medical students with the MRTA score (11.7 ± 4.2 vs. 15.0 ± 4.2,
respectively; p < 0.0001) and MRTC score (6.9 ± 3.1 vs. 9.9 ± 4.6, respectively; p <
0.0001).
Conclusion: Gender differences in spatial abilities favouring males were demonstrated in
the medical field in medical students entering their residency programs in a five-year
experiment. Future research will need to assess the implication of this knowledge for
simulation-based learning.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
34
ABSTRACTS
ORAL RESEARCH PRESENTATIONS – SALLE DE BAL
Friday, November 4
09:30 - 10:30
A Comparison of the Ottawa GRS and the ANTS Scale for Evaluating Performance
in Crisis Resource Management Simulation Scenarios
Fisher, Rachel (McGill University, Montreal, QC, CAN); Young, Meredith (McGill University, Montreal, QC, CAN);
Jecen, Nikole (McGill University, Montreal, QC, CAN); Ramadori, Francesco (McGill University, Montreal, QC, CAN);
Snell, Linda (McGill University, Montréal, QC, CAN)
With increasing recognition, and importance of team leadership in crisis situations,
simulation has become a natural place for the teaching, practice, and assessment of such
skills. With no current gold standard, several tools have been proposed for the evaluation of
non-technical Crisis Resource Management (CRM) skills, and here we compare two tools the
University of Ottawa Crisis Resource Management Global Rating Scale (Ottawa) and the
Anesthesia Non-Technical Skills Scale (ANTS).
22 anesthesia residents (R1 & R2) participated in at least two high-fidelity CRM scenarios.
Scenarios were recorded and evaluated later by a single rater using both scales, blinded to
training level of participants. Scale validity was examined comparing scores from R1s and
R2s, and internal structure was examined using a Factor Analysis. Reliability and Internal
Consistency was examined using G-Theory.
Ratings on both the ANTS and the Ottawa Scale distinguished between training levels
(ANTS: R1 mean (SE)=10.5(3.9), R2=13.54 (2.9), t (21)=4.49, p<0.001; Ottawa:
R1=19.21(4.62), R2=24.39(4.75), t(21)=5.17, p<0.001). Total scores on the ANTS and
Ottawa correlated (r=0.87, p<0.001), and when all items on both tools were entered in a
Factor Analysis, a single factor emerged that explained 79.9% of the variance in scores. For
both scales, internal consistency was high (ANTS=0.95, Ottawa=0.96), however, the
Ottawa scale was more reliable overall (Ottawa=.74, ANTS=0.53). Anecdotal evidence
suggests that the Ottawa scale is better suited for training novice raters.
The Ottawa and ANTS scales appear to measure the same underlying constructs, and
performance correlates well across the scales, the Ottawa scale appears to be more reliable,
and easier to use.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
ORAL RESEARCH PRESENTATIONS – SALLE DE BAL
Friday, November 4
09:30 - 10:30
Mastery versus Standard Proficiency Targets for Basic Laparoscopic Skill Training:
Effect on Skill Transfer and Retention
Kolozsvari, Nicoleta (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University,
Montreal, QC, CAN); Kaneva, Pepa (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation,
McGill University, Montreal, QC, CAN); Brace, Chantalle (Steinberg-Bernstein Centre for Minimally Invasive Surgery
and Innovation, McGill University, Montreal, QC, CAN); Vaillancourt, Marilou (Steinberg-Bernstein Centre for
Minimally Invasive Surgery and Innovation, McGill University, Montreal, QC, CAN); Banaszek, Daniel (SteinbergBernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, Montreal, QC, CAN); Cao, Jiguo
(Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, BC, CAN); Demyttenaere,
Sebastian (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, Montreal,
QC, CAN); Vassiliou, Melina (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill
University, Montreal, QC, CAN); Feldman, Liane (Steinberg-Bernstein Centre for Minimally Invasive Surgery and
Innovation, McGill University, Montreal, QC, CAN); Fried, Gerald (Steinberg-Bernstein Centre for Minimally Invasive
Surgery and Innovation, McGill University, Montreal, QC, CAN)
We investigated whether part-task training with a basic simulator task (peg transfer, PT)
facilitates learning a more complex skill (intracorporeal suture, ICS) and compared the
effect of PT overtraining with standard PT training on learning the ICS task.
Ninety-eight participants were randomized to one of three PT training groups: controls (no
practice), standard training (practice to the passing score), and overtraining (practice to
mastery level). Participants were then trained by a blinded educator in ICS. The ICS
learning curves were analyzed by estimating the learning plateau and learning rate using
nonlinear regression. Skill retention was assessed by retesting participants one month after
completing ICS training. The groups were compared using ANOVA. Skill transfer was
assessed using the Transfer Effectiveness Ratio (TER), relating time needed to learn ICS to
time invested in PT practice. Data are mean (SD).
Seventy-seven participants completed the study: 28 controls, 26 standard and 23
overtrained. ICS learning plateau rose with increasing PT training (452(10) vs. 459(10) vs.
467(10), p<0.01). There was a trend toward higher initial ICS scores (128(107) vs.
127(110) vs. 183(106), p=0.13) and faster learning rates (15(4) vs. 14(4) vs. 13(4) trials,
p=0.10) with increasing PT training. Overtrained participants saved 11(5) minutes in ICS
training compared to controls (p=0.04), but the overtraining TER was 0.165, suggesting
that PT overtraining took longer than the time saved on ICS training.
In surgically naïve subjects, part-task training with PT alone was associated with slight
improvements in the learning curve for ICS. However, overtraining with PT did not improve
skill retention and PT training alone was not an efficient strategy for learning ICS.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
ORAL RESEARCH PRESENTATIONS – SALLE DE BAL
Friday, November 4
09:30 - 10:30
Psychometrics of a Behavioral Marking System for Obstetrical Teams
Morgan, Pam (Sunnybrook Health Sciences Center, Toronto, ON, CAN); Tregunno, Deborah (York University,
Toronto, ON, CAN); Pittini, Richard (Sunnybrook Health Sciences Centre, Toronto, ON, CAN); Tarshis, Jordan
(Sunnybrook Health Sciences Centre, Toronto, ON, CAN); Regehr, Glenn (Centre for Health Education Scholarship,
Vancouver, BC, CAN); Haley, Michele (University of Toronto, Toronto, ON, CAN); DeSousa, Susan (Sunnybrook
Health Sciences Centre, Toronto, ON, CAN); Kurrek, Matt (Anaesthesia, Toronto, ON, CAN); Ryzynski, Agnes
(Sunnybrook Health Sciences Centre, Toronto, ON, CAN); Milne, Ken (Salus Global Corporation, London, ON, CAN)
This study investigated the internal consistency and reliability of two newly developed tools
to assess obstetrical team performance. Obstetricians, anesthesiologists, family doctors and
labour nurses from 6 hospitals were invited to participate. Each team participated in three
sessions separated by 5-9 months where they managed four high-fidelity obstetric
simulation scenarios involving critical events. Two tools, developed in a previous study, the
Assessment of Obstetric Team Performance (AOTP) and a Global Assessment of Obstetric
Team Performance (GAOTP) were used (1). Eight trained reviewers watched the DVDs of all
teams' performances and rated them using the AOTP and GAOTP. Across the 1088
completed evaluations the Cronbach's alpha for the 16 item AOTP was .96, and .91 for the
6-item GAOTP. Correlation between the two scales was 0.97; when treated as a single 22item rating scale, the alpha was 0.97 suggesting the measurement of a single dimension
(overall performance). The 8-rater alpha for the GAOTP was .81 (single-rater intra-class
correlation coefficient, 0.34) indicating acceptable inter-rater reliability with 8 raters. The 4station alpha for the 12 teams was .79 for session one, .88 for session two, and .86 for
session three, suggesting that performance is not strongly affected by scenario specificity.
Pearson's correlation of team performance scores from session one to session two for the
four scenarios were: .59, .35, .40, and .33 and for the total score across scenarios .47
indicating moderate test-retest reliability. We conclude that the GAOTP, used by at least
eight raters, would be a sufficient assessment tool for obstetrical team performance using
simulation.
References: (1) Tregunno D et al. Qual Saf Health Care 2009; 18: 393-6
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
ORAL RESEARCH PRESENTATIONS – SALLE DE BAL
Friday, November 4
09:30 - 10:30
From Bench to Bedside: Effective Knowledge Translation with Incorporation of a
Novel Debriefing Tool into the New 2011 PALS Instructor Manual and Course
Cheng, Adam (Alberta Children's Hospital, KidSIM-ASPIRE Simulation Program, Calgary, AB, CAN); Eppich, Walter
(Division of Emergency Medicine, Children's Memorial Hospital, Chicago, USA); Nelson, Kristen (Division of Critical
Care Medicine, Johns Hopkins Children's Hospital, Baltimore, USA); Hunt, Elizabeth (Division of Critical Care
Medicine, Johns Hopkins Children's Hospital, Baltimore, USA)
The objective of our project was to develop the new debriefing tool for the American Heart
Association (AHA) Pediatric Advanced Life Support (PALS) Instructor Manual. This new tool
is designed to standardize debriefing methodology amongst PALS instructors. Recent work
done by the EXPRESS (Examining Pediatric Resuscitation Education using Simulation and
Scripting) Collaborative demonstrated that scripted debriefing was effective at increasing
acquisition of knowledge and team leader behavioural skills compared with non-scripted
debriefing in novice instructors. However, EXPRESS debriefing script was long,
cumbersome, and had limited generalizability. After conducting a review of the EXPRESS
script and discussing its pros and cons, the AHA Pediatric Subcommittee gathered to
develop a debriefing tool for the new 2011 PALS course. This new tool incorporated the
AHA’s Gather-Analyze-Summarize (GAS) model of debriefing. After development, the
debriefing tool was pilot tested at BC Children’s Hospital (Vancouver, Canada) during
regularly scheduled simulation sessions, with a final set of revisions from members of the
AHA Pediatric Subcommittee. The final product incorporates the best elements of the
EXPRESS debriefing script: the framework, layout, pattern of questioning, and color
scheme. In order to shorten the script down to one page, we eliminated the pre-set
learning objectives, and questions were modified to be question stems only, providing the
instructor with freedom to add in content based on his own observations and judgments.
This approach will enhance the fluidity and relevance of discussion during debriefing. After
review and pilot testing, the new AHA debriefing tool has been included in the new 2011
AHA PALS instructor manual and course.
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November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
Learning objectives for posters: Simulation professionals have submitted educational posters on a variety of topics
relating to medical simulation and simulation-based education. This Poster Session will provide a means of stimulating
interest in simulation and communicating useful information to the profession, including best practices, new program
initiatives, etc.
Viewing Hours:
Thursday, November 3
Friday, November4
13:00 – 17:00
08:00 – 17:00
P-2
The Development and Implementation of an Inter-professional Resuscitation Competition:
The Simulation Olympics
Dagnone, J Damon (Queen's University, Kingston, ON, CAN); Takhar, Amandeep (Queen's University, Kingston,
ON, CAN); Howes, Dan (Queen's University, Kingston, ON, CAN)
We developed, implemented, and evaluated an inter-professional resuscitation competition
with the purpose of stimulating health care providers to practice resuscitation skills and
foster strong team-based attitudes.
An inter-professional high fidelity simulation-based resuscitation competition was developed
at Queen’s University in January 2010. 4-member teams were composed of a mix of nurses,
respiratory therapists, undergraduate and postgraduate medical trainees. Teams completed
three standardized resuscitation scenarios in a high-fidelity simulation lab. Judges used
standardized assessment tools with measures of clinical decision-making, team
communication, leadership, and a global assessment. The three highest scoring teams
advanced to the ‘Championship’ round which was held in front of an audience and offered a
significant cash prize. Participant attitudes towards the competitive event were evaluated
using short-answer questions and Likert rating scales.
Ten 4-member teams (n=40) participated in the competition in June 2010. The teams were
comprised of: 24 postgraduate trainees from the specialties of Emergency Medicine,
Internal Medicine, Family Medicine, and Psychiatry; 7 undergraduate medical students; 6
nurses; and 3 respiratory therapists. Completed questionnaires were received for 36 (90%)
participants. Evaluations were uniformly positive in short-answer feedback and attitudinal
scoring measures.
The first year of the Simulation Olympics was successful at motivating participants to
practice and perform in multidisciplinary teams. The project will be expanded to develop a
more comprehensive team training program at our center with increased multidisciplinary
involvement.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-3
The Link between Shared Mental Models and Team Effectiveness in a Simulated Team-Based
Course
Cruz-Panesso, Ilian (McGill University, MONTREAL, QC, CAN); Lajoie, Susanne (McGill University, Montreal, QC,
CAN); Lachapelle, Kevin (McGill University - Simulation Centre, Montreal, QC, CAN)
The degree to which team members share common knowledge, about team members' roles
and responsibilities is critically related to team coordination and effective team performance
(Orasanu, 2005; Salas, Sims, & Burke, 2005). However, few medical simulations target
cognitive skills such as team knowledge, otherwise known as Shared Mental Models (SMMs).
A questionnaire was developed to address issues pertaining to SMMs in a team-based
simulated training. The degree of agreement or overlap between team members’
interpretations about the simulation and team members’ roles was assessed among 8
multidisciplinary teams using a 5-point Likert scale (5 = strongly agree, 1 = strongly
disagree). 4 instructors assessed team performance based on Crisis Resources Management
Criteria and categorized team performance using a Likert scale, from very good
performance to very poor performance. The team rated by the instructors as having very
good performance consistently had higher levels of agreement or overlapping answers
(94.4%). Whereas, the team rated with poor performance had considerably less agreement
among team member’s answers (66.7%). Qualitative analysis of the simulation of the team
with very good performance showed that, assignation and re-affirmation of roles before and
during the simulation were essential for developing common knowledge about each team
member’s role and responsibilities. The leader's actions helped members recognize the
interdependency of roles, thus leading to better team performance and avoidance of
overlapping actions. We argue that SMMs lead to effective team performance and enhanced
leadership. Future team simulation research and instruction should consider interventions
for fostering SMMs as a method of improving team effectiveness.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-5
Learn to be Safe: A Simulation Learning Experience
Thompson, Laurie (Manitoba Institute for Patient Safety, Winnipeg, MB, CAN); Doggett, Murray (Canadian Patient
Safety Institute, Edmonton, AB, CAN); Lessard-Friesen, Susan (Manitoba Pharmaceutical Association, Winnipeg,
MB, CAN)
The Manitoba Institute for Patient Safety (MIPS) has developed a resource for simulation
learning experiences focused on enhancing collaborative patient/family centered care and
improving patient safety. Ineffective communication and teamwork among interprofessional
groups of healthcare providers have been identified as significant patient safety issues.
Including patients and families with caregivers as part of the healthcare team greatly
increases patient satisfaction, improves care and reduces the potential for patient harm.
Transitions in care and disclosure of harm represent two areas where significant opportunity
exists to improve patient safety through effective communication and teamwork. Evidence
supports that the best way for multidisciplinary groups of healthcare professionals to learn
to communicate and work together better as a team is through interprofessional education
(IPE). Providing IPE within a simulated learning experience may comprise the ideal learning
environment to enhance collaborative patient/family centered care and improve patient
safety.
In response, MIPS developed Learn to be Safe: A Simulation Learning Experience. Case
simulations have been packaged within a kit to facilitate a learning experience for
multidisciplinary groups (students and practitioners) that is highly customizable and fun.
This innovative learning tool includes a Primer on Patient Safety, Leader’s Guide, Scenario
Guides including character briefings and a Learner’s Workbook. Learning objectives are
mapped to the Canadian Patient Safety Institute’s Safety Competencies, the Canadian
Interprofessional Health Collaborative National Competency Framework and Accreditation
Canada’s Required Organizational Practices.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-6
Use of On-Site High-Fidelity Simulation to Improve Pediatric Resuscitation Teams – A
National Environmental Scan (a work in progress)
Bhanji, Farhan (Montréal Children's Hospital, Montréal, QC, CAN); Shuster, Michael (Mineral Springs Hospital,
Banff, CAN); Travers, Andrew (Dalhousie University, Halifax, CAN); de Caen, Allan (Stollery Children’s Hospital and
University of Alberta, Edmonton, CAN)
Pediatric cardiac arrests occur infrequently (even in tertiary-care centres), are most
commonly asphyxial in origin (i.e. secondary to untreated respiratory failure or shock) and
are often ‘preventable’. Education of healthcare providers on early recognition and the initial
management of pediatric patients with potentially life-threatening diseases should be a
fundamental requirement for hospitals caring for pediatric in-patients, as should Continuous
Quality Improvement measures to ensure appropriate systems and delivery of care.
Objective: Conduct a telephone survey of all tertiary-care pediatric hospital CPR committee
chairs to determine ‘current practice’ of resuscitation across Canada.
Methods: The pediatric CPR committee chair, their assigned delegate or the pediatric
representative to an ‘adult-based’, university-wide, CPR committee at each Canadian
tertiary-care centre (n=16) was approached to participate in a telephone survey.
Participants were asked if their centre used on-site high-fidelity simulation for team training
and if hospital-wide mock codes were used as part of Continuous Quality Improvement.
Results: To date we have interviewed representatives from 15/16 institutions. Ten out of
15 centres use mock-codes as part of their Continuous Quality Improvement and 10 centres
have on-site high-fidelity simulation. Two other centres have high-fidelity simulation
adjacent to the Children’s Hospital (as part of the medical school or health sciences
building) and 3 centres do not use on-site high-fidelity simulation.
Conclusion: This environmental scan suggests there is moderate uptake of in-situ mock
codes and high-fidelity simulation but that there may still be room to optimize training at
some centres.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-7
Team Training in Introduction to Clerkship Course using Simulation
Smith, Andrew (Memorial University of Newfoundland, St. John's, NL, CAN); Harris, Jennifer (Memorial University
of Newfoundland, St. John's, NL, CAN); Boone, Darrell (Memorial University of Newfoundland, St. John's, NL, CAN);
Hapgood, Joanne (Memorial University of Newfoundland, St. John's, NL, CAN); Drover, Anne (Memorial University
of Newfoundland, St. John's, NL, CAN)
The purpose of a Clerkship Preparation course is to ready the medical student for the
transition from pre-clinical to clinical practice. Clinical Clerks are often on the frontline in
critical situations. They must be adequately prepared both emotionally and intellectually for
their role in emergent patient care. It is felt that the earlier team training and patient safety
concepts are introduced into clinical education, the more effectively they are brought into
practice.
Most medical schools have clerkship transition courses which cover new information such as
order writing, charting and procedural skills. Canadian research has shown that clerkship
directors feel students are inadequately prepared for skills such as time management,
focused assessments, problem list and dealing with team conflict. Recommendations have
been to incorporate these concepts into active learning modes.
Simulation was introduced into Memorial University’s Introduction to Clerkship course for
concepts such as “first responder care”, focused information gathering, prioritizing care,
effective communication (SBAR) and crisis resource management. These innovative sessions
were: Introduction to Airway, Crash Cart -101, First Five Minutes, Trauma Simulation,
Approach to Critical Clinical Situations, and Professionalism.
Upon evaluation of the course, student satisfaction ratings increased from 3.4 / 5 to 4.2 / 5
from the previous year with student comments suggesting that this form of simulated teambased learning was both highly preferred and highly effective.
We will present an overview of the course along with a summary of each simulation module.
Objectives and evaluations from the students will be provided so that educators can
introduce similar sessions into their own Clerkship Transition course.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-8
Expecting the Unexpected: Exposing Latent Threats During in situ Simulation.
Brisbin, Ken (Alberta Health Services, Edmonton, AB, CAN); Brooks, Sherry (Alberta Health Services, Edmonton,
AB, CAN)
Objective: During in situ scenarios a number of latent threats dealing with equipment and
processes have been uncovered which, if not discovered during simulation, may have
caused harm or significant delays in treatment.
Methods: Every two weeks, a Clinical Educator from the GSICU and an eSIM consultant set
up a clinical situation with a participating unit in the hospital that will require Code Team
activation. The Simulator is covertly set up and the unit staff is made aware of the clinical
situation. All actions are autonomous by the responders, with the expectation that they will
utilize their own equipment and adhere to local policies and procedures. The Educator and
Simulation Consultant then adjust the physiological trajectories and situation based on the
participants’ actions. When the scenario objectives are met, the simulation is halted and a
debriefing is conducted.
Results: Although minor issues come up during each scenario, three have resulted in major
changes in equipment procedures and system responses. Participants delivered energy
intended for the simulator into a pre-connected test load. Participants did not deliver
oxygen as a closed auxiliary source on a portable oxygen tank was inadvertently selected.
Also, priority elevators were not functional and alternate responses were not adhered to,
causing significant delay in code team response. All of these issues have since been
addressed through administrative actions and education.
Conclusion: Simulation has proven to be a valuable tool in exposing latent threats to
patient safety.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-9
Improving Care for Children in Rural and Regional Centres: The KidSIM Interprofessional
Outreach Program
Grant, Vincent (KidSIM - ASPIRE Pediatric Simulation Research Program, Calgary, AB, CAN); Lomas, Kate (KidSIM
Pediatric Simulation Program, Calgary, AB, CAN); Robinson, Traci (KidSIM Pediatric Simulation Program, Calgary,
AB, CAN)
The objectives of the KidSIM Interprofessional Outreach Program are: to provide pediatric
interprofessional simulation-based education to all rural and regional healthcare providers in
Southern Alberta and Southeastern British Columbia; to provide this education in situ in
their actual care environments, with their own teams and their own resources; to identify
areas of personal, team and system improvement for each of the care providers and their
sites. Development included: gauging learner and site interest, performing a needs
assessment, designing realistic objectives and scenarios, recruiting a positive team for
education delivery, performing evaluations and refreshing the needs assessment regularly.
The program focuses on three main components: 1) a didactic but interactive session
provided via telehealth while the outreach team travels and sets up; 2) a hands-on
workshop to cover specific identified learning needs (e.g. difficult airway management, rapid
sequence intubation, vascular access including difficult IV access and IO insertion); 3) a 4
year rotating simulation curriculum with 12 common and important pediatric scenarios.
Annually, the KidSIM Interprofessional Outreach Program visits 15-20 rural and regional
centres, teaching approximately 400 healthcare providers each year (73% nurses, 25%
physicians and 1% respiratory therapists and EMS providers respectively where they are
available). Review of learner evaluations reveals consistent positive feedback about the
importance of the interprofessional nature of these sessions, including a greater
understanding and appreciation for each team member’s role and abilities, as well as the
sharing of references and guidelines being used at the tertiary care centre.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-10
Welcome to the Real World! Or Almost… with the McSeal
Valois, Teresa (Montreal Children's Hospital, Montreal, QC, CAN)
Medical simulation includes a variety of methods, such as high-fidelity (Hi-Fi) simulation and
the use of standardized patients (SPs). In order to address locally identified gaps for nonanesthesiologists, we developed a sedation course that includes, modules on: getting
consent, providing sedation and breaking bad news. The use of SPs as a teaching tool for
communication skills has become widely adopted, however educational opportunities are
often isolated and not completely embedded in the “big picture” scenario. While allowing
practice, isolated SP experiences do not always mimic the complexity of a real clinical
situation. Furthermore, there is a scarcity of tools in health care professional education that
provide opportunities to develop the necessary coping skills in the face of bad outcomes.
From the SP’s point of view, the process of getting into character as well as sustaining the
character is fragmented, preventing them from experiencing the case scenario contextually.
We decided to merge both SPs and Hi-Fi into one coordinated scenario: “McSeal”
Concatenated Simulation EnhAnced Learning tool. The structure is as follows: Participants
conduct a pre-sedation assessment of a pediatric patient and family, and then will provide
sedation to a high-fidelity mannequin. Following an adverse event, they have to break bad
news to the parents. After the scenario, the SPs and instructors provided feedback to the
participant. Learners conveyed that the experience allowed them to reflect on their
performance under stress and develop coping skills for their future practice. From the
standardized patients point of view, sustaining the character allowed them to provide a
more credible and realistic feedback, therefore enriching the learning experience.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-13
Drama in Trauma
Rickeard, Debbie (University of Windsor, Windsor, ON, CAN); Bornais, Judy (University of Windsor, Windsor, ON,
CAN)
High-quality treatment of emergency patients requires optimal team function with respect to
leadership, communication, and cooperation. In the context of trauma management, there
is evidence to suggest that an effective team response improves patient care, reduces
clinical error, and improves patient outcome. A preferred educational method for this type of
training is simulation. However, this form of education to evaluate clinical decision making is
not routinely used in the hospital setting. The use of simulation allows students to
experience situations in a safe environment where they can develop and refine their skills
without compromising the safety of real patients.
This poster presentation, will describe three trauma scenarios that involved interprofessional
education. The scenarios were in the High Fidelity Simulation Center at the University of
Windsor. This was part of a Trauma Conference that took place in collaboration with a
Community Hospital. In the development of the scenarios EMS, medicine, and nursing were
involved.
Participants in the scenarios included physicians, residents, medical students, nurses,
nursing students, respiratory therapists and EMS. Following didactic presentations, they
were divided into teams and assigned roles for each scenario. Their roles in the scenario
were not their professional roles. The scenarios included a pediatric head injury, an
inhalation burn victim, and a traumatic partial amputation of a leg from a farm accident.
Evaluation of the simulation program showed an appreciation for the multidisciplinary
approaches to trauma care. Participants felt the simulation increased their confidence in
dealing with traumas and working with the multidisciplinary team.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
47
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-14
The Long and Winding Road to Effective Interprofessional Simulated Learning
Bornais, Judy (University of Windsor, Windsor, ON, CAN); Rickeard, Debbie (University of Windsor, Windsor, ON,
CAN)
Interprofessional education through simulation offers a promising approach to preparing
future healthcare professionals but like most educational tools it is not flawless. There exists
a significant body of literature on the benefits of interprofessional health care education
using simulation. Benefits such as: improving assessments and performance, patient
safety, communication and teamwork amongst health care professionals are evident. But
how exactly do you create effective interprofessional simulation scenarios? There are a
number of challenges to be addressed in order to assure the success of interdisciplinary
educational endeavours. These challenges may be philosophical and sociological (differences
in professional respect and commitment to an interdisciplinary approach), organizational
and structural (scheduling and timing difference amongst programs), academic or
professional (need for faculty development and finding and training appropriate mentors).
This presentation will begin with a brief overview of the numerous challenges cited in the
literature with tangible strategies to overcome them. Sometimes the best advice comes
from experience. Having journeyed down the long and winding road of interprofessional
simulated learning, we will share the key elements that were implemented to improve
simulated learning between pre-clerkship medical students and undergraduate nursing
students.
P-15
Hockey Lines to Enhance Group Participation in Team-Based Simulation
Topps, David (Northern Ontario School of Medicine, Calgary, ON, CAN); Ellaway, Rachel (Northern Ontario School
of Medicine, Sudbury, ON, CAN); Rose, Fran (Sault College, Sault Ste Marie, ON, CAN); Piper, Janet (Sault College,
Sault Ste Marie, ON, CAN)
Many simulation centres and activities face the challenge of time and resource optimization:
what to do when there are more learners per group than can be practically engaged in the
group activity. Using the metaphor of hockey lines and substitution on-the-fly, we have
developed an approach to team-based learning that greatly increases the engagement of
learners. The approach reinforces good crew resource management practices and closed
loop communications. Players are grouped into sub-teams or lines; as in hockey, lines
substitute with no stoppage in the flow of play. Substitutes are required to understand their
role and to engage in a smooth transition, with no interruption of key activities during the
scenario. Participants in an observing crowd of supporters can be further engaged by
heckling suggestions to the playing team, where appropriate. This novel approach has been
employed and iteratively refined by several participating organisations in the Northern
Ontario Simulation in Healthcare Network (NOSHN). Results from this mixed methodology
action research study will be presented, along with resources to help others to deploy this
technique.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
48
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-16
A Qualitative Study of Simulated Patient (SP) Based Simulation for Collaborative Learning
in the Context of Surgical Teams
Tabak, Diana (Standardized Patient Program, University of Toronto, Toronto, ON, CAN)
In 2007 Espin et al conducted a study, Using Simulation to Promote Team-Based Disclosure
of Errors, designed to pilot and implement a training program for team-based disclosure of
harmful errors. A secondary smaller study was undertaken to develop a deeper
understanding of collaborative team learning through simulated patient-based simulation by
identifying key issues that foster and constrain learning experientially.
After a preliminary analysis the dataset was narrowed down to three dyads, comprised of
surgeon and surgical RN, for a purposive sample reflecting varying degrees of surgical
experience, team relationships and simulation activity.
The simulation sessions took place in the participants’ own hospitals. Participants were
scheduled after their OR time to tackle two scenarios about error. They were expected to
plan and discuss their approach and then speak to the patient (SP). A feedback discussion
was held immediately after each scenario.
A qualitative, modified thematic, constant comparative analysis of audio transcripts of the
post-intervention individual interviews, video data and video transcripts of team preplanning, simulations and feedback was used. There were substantial differences in learning
foci and needs across teams. The teams showed a range of awareness regarding perceived
learnings. Similarities in identity construct and hierarchy were displayed.
Several key fostering influences were identified; particularly the value of pre-briefing
activities and constructive feedback. Constraining influences (e.g. lack of foundation in
communication skills, issues of hierarchy and crystallized team relationships) were
identified. Ideas to address the constraints and foster learning emerged from the analysis.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
49
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-17
Effect of Team Training on Management of Obstetrical Emergencies
Morgan, Pamela (Sunnybrook Health Sciences Centre, Toronto, ON, CAN); Tregunno, Deborah (York University,
Toronto, ON, CAN); Pittini, Richard (Sunnybrook Health Sciences Centre, Toronto, ON, CAN); LeBlanc, Vicki (Wilson
Centre- University of Toronto, Toronto, ON, CAN); Haley, Michele (Women's College Hospital, Toronto, ON, CAN);
DeSousa, Susan (Sunnybrook Health Sciences Centre, Toronto, ON, CAN); Tarshis, Jordan (Sunnybrook Health
Sciences Centre, Toronto, ON, CAN); Kurrek, Matt (University of Toronto Department of Anesthesia, Toronto, ON,
CAN); Nadiminti, Shivananda (Women's College Hospital, Toronto, ON, CAN); Milne, Ken (Salus Global Corporation,
London, ON, CAN)
Objective: Breakdowns in communication are considered a leading cause of maternal and
perinatal morbidity/mortality. High-fidelity simulation (HFS) may aid in improving patient
outcomes. The purpose of this study was to determine whether participation in HFS team
training improved clinical outcomes of simulated obstetrical emergencies.
Method: 4 scenarios were developed: 1) urgent Cesarean, general anesthesia, can't
intubate/ventilate, pulseless electrical activity; 2) severe pre-eclampsia, urgent Cesarean,
pulmonary edema; 3) prolapsed cord, amniotic fluid embolism, asystole and; 4) fetal
bradycardia, emergency Cesarean, postpartum hemorrhage. 18 clinical outcomes were
defined and validated via the Delphi technique. After REB approval, 12 multidisciplinary
teams managed the same 4 scenarios at 3 sessions, 5-9 months apart. A trained, blinded
observer, recorded the outcome resolution times. A repeated measures analysis of variance
was performed for each outcome measure with session time as the repeated measure.
Results: 34 teams had 136 recorded sessions. 6/18 outcomes demonstrated significant
differences over time, of which 3 were considered clinically relevant.
Scenario
1
1
2
Outcome
Arrest:Compressions PEA
Decision:Delivery
Decision:Delivery
Time 1
3m 56s
10m 57s
13m 10s
Time 3
2m 15s
6m 39s
6m 55s
This study demonstrated a significant training effect on decision to delivery time. PEA was
not easily recognized by teams nor was CPR promptly initiated. There was however, faster
onset of starting chest compressions between the 1st and 3rd sessions.
Conclusion: Multidisciplinary team training using HFS may help improve team functioning
including ACLS protocol education. A larger sample would help determine whether
debriefing influences performance.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
50
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-18
Distance Simulation Modality versus Face-to-Face Simulation Modality in Teamwork
Training
Koval, Valentyna (CESEI, UBC, Vancouver, BC, CAN); Popova, Kalina (Department of Anesthesiology, UBC,
Vancouver, BC, CAN); Ahmed, Sana (Department of Anesthesiology, UBC, Vancouver, BC, CAN); Kliffer, Paul
(Department of Anesthesiology, UBC, Vancouver, BC, CAN); Rupesinghe, Lalitha (Department of Anesthesiology,
UBC, Vancouver, BC, CAN); Roston, Christina (Department of Anesthesiology, UBC, Vancouver, BC, CAN); Turnbull,
Kenneth (Department of Anesthesiology, UBC, Vancouver, BC, CAN); Nazer, Marjan (CESEI, UBC, Vancouver,
CAN); Gladkikh, Rita (CESEI, UBC, Vancouver, BC, CAN); Pachev, George (CESEI, UBC, Vancouver, CAN); Qayumi,
Karim (CESEI, UBC, Vancouver, BC, CAN)
This research project was conducted to study the effect of simulation-based education on
knowledge and non-technical skills acquisition in distance modality versus face-to-face
modality.
One hundred and forty-four 3rd Year UBC medical students at the University of British
Columbia (UBC), during their core Anesthesia rotation, were randomly assigned into one of
two groups: distance modality or face-to-face modality. Forming eighteen teams of four
students each, both groups underwent simulation teamwork training at the Centre of
Excellence for Simulation Education and Innovation (CESEI). The training consisted of online
modules and simulation sessions. Each session includes two distinct scenarios, each
followed by a post simulation debrief. Students’ knowledge and acquisition of non-technical
skills were assessed based upon the Anesthetist Non Technical Skills (ANTS) categories and
elements. The acquisition of knowledge in each category was assessed by multiple-choice
question tests administered pre and post training and measured on an individual level. The
non-technical skills acquisition in each category was assessed using a checklist adapted
from the ANTS and completed by two blinded, independent observers.
The collected data was described using means, standard deviations and ranges for each
group. Results were analyzed with knowledge acquisition and non-technical skills outcomes
as the dependent variables for each analysis. The results will be presented and discussed at
the conference.
This study aims to be used as a recommendation to adapt new simulation modality for
team-based practice. Particularly to identify, plan and implement simulation-based distance
learning into the current medical curriculum.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
51
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-19
Interdisciplinary Team Members Value a Low-Fidelity, On-site Pediatric Mock Code Program
Zavalkoff, Samara (Montreal Children's Hospital, Montreal, QC, CAN); Bhanji, Farhan (Montreal Children's Hospital
and the Centre for Medical Education, McGill University, Montreal, QC, CAN)
Our ‘high-fidelity simulation centre’ remains off-site from our hospital, making it challenging
to gather interdisciplinary team members for training (due to logistical issues such as travel
and scheduling). We implemented an on-site, low-fidelity (i.e. static manikin) pediatric
mock code program and evaluated interdisciplinary team members’ impressions of the
program. To minimize barriers to participation the program is based at the Montreal
Children’s Hospital during team members’ regular working hours. The program spans 3
weeks and repeats every month. Week 1 focuses on respiratory problems, week 2 on shock
and week 3 on arrhythmias. During the codes (10 minutes), instructors provide real-time
information at the learners’ request. Participants are instructed to behave, as closely as
possible, to how they would in real life by assuming their usual role in patient care. Course
instructors facilitate debriefing sessions (30 minutes) following the codes. Both medical and
crisis resource management principles are debriefed with emphasis on the later. Learners
voluntarily and anonymously assessed the program based on a 5 point Likert Scale: 1 being
not useful, 3 being useful and 5 being very useful. From January 2008 until February 2009,
42 residents and 55 nurses and respiratory therapists participating in the program
completed course evaluations. The mean Likert score for the overall program was 4.97 and
4.7 from each respective group. The mean Likert scale for the debriefing sessions was 4.67
and 4.87 from each respective group. Residents, nurses and respiratory therapists valued
this on-site pediatric mock code program using low-fidelity simulation despite access and
exposure to ‘high-fidelity’ simulation training.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
52
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-20
Is “See One, Do One, Teach One” Really Enough?
Gamble, Paul (The Michener Institute, Toronto, ON, CAN); Bandali, Karim (The Michener Institute, Toronto, ON,
CAN)
As the importance of inter-professional education and collaboration (IPC) continue to grow,
the emphasis on non-cognitive skills as defined by the relational, affective, and moral
qualities of health providers are now also recognized as crucial elements of professionalism
and effective patient-centered care. Within any healthcare curriculum, the determination of
students’ readiness for their clinical practicum involves the measurement of these noncognitive abilities in addition to the profession-specific competencies. The purpose of this
study was to investigate the definition of non-cognitive competencies through a quantitative
survey methodology with focus groups that consisted of 24 faculty, 158 clinical educators
and 24 students across a number of the applied health programs. Outcomes were analyzed
for the expectations, perceptions, and beliefs towards a clinically ready student, while the
student participation was examined for critical support needs for clinical readiness. Themes
of profession-specific technical skills, communication, professionalism, self-reflection,
affective behaviour and other-centeredness were identified by faculty members and clinical
educators. Student participants recommended comprehensible performance expectations,
transferable skills, and diverse practice opportunities. Clinical readiness in applied health
students was characterized by the concurrent possession of the appropriate profession
specific skills, innate personal traits and attitudinal attributes. These findings were key to
revising the admissions processes to address the required balance of cognitive and noncognitive competencies and curriculum to clearly defined expectations and ample chances to
practice.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
53
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-22
Building Health Professionals’ Surge Capacity and Interprofessional Competency
Mazurik, Laurie (Sunnybrook Health Science Centre, Toronto, ON, CAN); Bull, Ellen (Centennial College,
Scarborough, ON, CAN); Atack, Lynda (Centennial College, Scarborough, ON, CAN); Dryden, Trish (Centennial
College, Scarborough, ON, CAN); Maher, Janet (Centennial College, Scarborough, ON, CAN); Rocchi, Marie
(University of Toronto, Toronto, ON, CAN)
Objective: To explore the impact of an online course, a tabletop activity and a multi-player
e-simulation activity on health professionals’ surge capacity and interprofessional
competency.
Methods: Clinical sites opted for the surge capacity training method that best met their
needs. All sites completed an online, workplace-based, interprofessional course in surge
capacity. Four sites added a tabletop component and one site added both the tabletop and
the e-simulation. A descriptive study was conducted with 72 clinicians at 5 hospitals from a
range of sectors and disciplines, using validated, reliable surveys. The surveys measured
change in interprofessional and disaster management competencies and learner satisfaction
with the different learning modalities.
Results: There was a statistically significant difference in the mean pre and post course
surge capacity and interprofessional competency scores (p = .000). Satisfaction scores for
all 3 modalities were greater than 75/100, however scores for the in -person tabletop
simulation were highest: 87/100. The tabletop and e-sim provided an intense,
interprofessional learning experience. The majority of table-top participants agreed that the
collaborative environment helped build individual and organizational surge capacity.
Conclusion: The e-Sim was an important innovation developed and tested in this study;
very little is known about online drills and disaster preparedness education. This study
demonstrates that blended learning approaches, using simulation, can be a convenient,
effective way to support both surge capacity and interprofessional competency.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
54
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-23
Simulation through the Lens of Learning Design
Ellaway, Rachel (NOSM, Sudbury, ON, CAN); Topps, David (University of Calgary, Calgary, AB, CAN); Lachapelle,
Kevin (McGill University, Montréal, QC, CAN); Joy, Aislinn (University College Cork, Cork, IRL)
Learning design (LD) is based on the idea that activities that are appropriately structured
can enable better learning outcomes for individuals or groups than unstructured or poorly
structured activities. LD is rooted in behaviourism and is concerned predominantly about
knowledge transfer. LD uses aspects of scaffolding, social learning and multimedia learning
to create predetermined sequences of activities.
A similar model exists in current simulation practice, where simulator devices are predefined
as scenarios with key events and triggers that move learners through the case while giving
them feedback. Similarly standardized patient briefings typically provide a series of
cues/triggers to move through the activity. The benefits of this approach are activities that
can balance predetermined learning points with emergence and variance in learner
performance within the scenario.
This presentation will discuss learning design as a philosophy and set of principles to work
creatively with the simulated learning environment and the resources within it along with
issues such as usability, accessibility and understandability. The presentation will be based
around a common activity framework: design within the simulator (encoded activities);
design around the simulator (constructed activities); non-educational design (distal
activities); and where activities are omitted from the design to allow for variance and
improvisation (emergent activities). A range of tools and techniques will also be discussed,
such as the semi-structured learning design template (SSLD) and the SAVOIR simulation
integration platforms.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
55
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-24
Cyberinfrastructure for Simulation Instruction
Ellaway, Rachel (NOSM, Sudbury, ON, CAN); Topps, David (University of Calgary, Calgary, AB, CAN); Lachapelle,
Kevin (McGill University, Montréal, QC, CAN); Joy, Aislinn (University College Cork, Cork, IRL)
Cyberinfrastructure is a relatively new concept that refers to something more specific than
the network but more general than a tool or a resource. The HSVO Project was funded by
CANARIE to develop a Network Enabled Platform as a form of cyberinfrastructure to explore
how networked training and simulation resources could be built. The resulting system
allowed different simulation devices to be connected, controlled and combined to make
better use of those simulators and to allow for new and innovative simulation scenario
designs.
This was achieved through a software integration platform called SAVOIR. Scenario design
within SAVOIR involves selecting the different simulators to be used and arranging them in
sequence along with the rules that connect them. Simulators are connected over a network
connection with an interpreter between the generic SAVOIR controls and the device-specific
capabilities of different simulators. The resulting cyberinfrastructural platform allows
simulators to be integrated and automated in multiple locations as well as in multiple
sequences of different devices. Not only can scenarios be loaded and devices started and
stopped but data such as vital signs can also be shared between devices.
Not only does this allow simulators to be used in more creative ways it also extends the
range and applicability of simulator-based training and assessment to teams that are not
collocated or have to work remotely. Integrated simulation for teams can therefore run in
ways that more accurately simulate the complexities of multi-site healthcare. This
presentation sets out the use of cyberinfrastructure in medical simulation using the HSVO
Project as an example.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
56
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-25
New Approaches to Simulation Activity Analysis
Ellaway, Rachel (NOSM, Sudbury, ON, CAN); Topps, David (University of Calgary, Calgary, AB, CAN); Lachapelle,
Kevin (McGill University, Montréal, QC, CAN); Joy, Aislinn (University College Cork, Cork, IRL)
The HSVO Project was funded by CANARIE to explore how networked training and
simulation resources could be built. A series of 11 multi-site simulation activities connecting
4 learning centres (NOSM, McGill, Ottawa and Cork in Ireland) were run using variations on
different network resources. All of the sessions were videoed and baseline data about the
participants, and their post session reflections on the system were recorded. A behaviour
checklist was developed by reviewing the videos and looking for common elements. Initially
a 25 item framework, this was whittled down through multiple revisions to a saturated list
of 19 learner and/or tutor behaviours (such as discussion, reflection and problem solving)
along with technical events such as interruptions.
Five raters from the project reviewed each video and noted all of the behaviours observed in
two-minute intervals. These were coded back to the constructs and compared for inter rater
reliability. A series of plots were made of the level of construct expression over the time of
the session and compared as including: comparing two groups involved in the same or
similar activities; comparing tutor actions for impact on learning behaviours; checking
impact of interruptions and disruptions; comparing planned and actual sequences; and
looking at densities and ordering of different activities.
The paper will demonstrate the breadth of activity designs possible using integrated
simulation as well as the variability in doing so, the preferred design patterns and the
interactions between the teachers, learners and simulation technologies used. It will also
demonstrate how some issues (such as technical interruptions) are more or less important
than others (such as tutor interactions).
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
57
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-26
NOSHN – Where Scale Fails and Networks are the Only Way Forward
Ellaway, Rachel (NOSM, Sudbury, ON, CAN); Bonin, Lise (Collège Boréal, Sudbury, ON, CAN); Carbonneau,
Johanne (Northern College of Applied Arts and Technology, Timmons, ON, CAN); Hildebrandt, Kathryn (Lakehead
University, Thunder Bay, ON, CAN); Knight, Jeremy (Ornge, Mississauga, ON, CAN); Kupsh, Christine (NOSM,
Sudbury, ON, CAN); Lortie Carlyle, Suzanne (NOSM, Sudbury, ON, CAN); Morrison, Barb (Confederation College,
Thunder Bay, ON, CAN); Peer, Judy (Sault Area Hospital, Sault St Marie, ON, CAN); Rose, Fran (Sault College,
Sault St Marie, ON, CAN)
Northern Ontario has many challenges arising from its geography, climate and its many
languages and cultures. Health professional educators in the region have developed
significant capabilities in using simulation for teaching, learning and assessment. However,
there are problems in sustaining a critical mass of skilled educators.
Following a number of discussions between different simulation providers the Northern
Ontario Simulation for Healthcare Network (NOSHN) was established in 2008. Developed as
a grassroots collaborative network with no external funding or other support, NOSHN
involved providers exploring ways of sharing resources and ideas and supporting each other
across Northern Ontario. The network developed to include all of the colleges and
universities involved in health professional education in Northern Ontario along with a
growing number of hospitals and other care providers.
Common policies were developed around sharing equipment, scenarios and skills to allow
personnel and equipment to be used in different contexts. This involved covering issues
such as liability and warranty for damage and how expenses such as transporting
equipment between sites would be covered. Benefits from participation in this network
include: regular peer communication and sharing of ideas; shared training around
simulation skills; the ability as a group to leverage greater influence over simulation
vendors and suppliers; and the ability to share scenarios, equipment and staff.
This paper will set out how the network was developed and how it has been sustained,
particularly in the absence of funding. It will also describe how different organizations can
make a simulation network serve their different needs and interests.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
58
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-27
Trauma Team Simulation Training - A Qualitative Analysis
Cope, Alexandra (Imperial College, London, London, GBR); Tang, Jessica (Imperial College, London, GBR);
Kneebone, Roger (Imperial College, London, GBR)
This study aimed to evaluate the face validity and perceived educational benefit of a teambased trauma assessment simulation. A strong need for simulation based training in trauma
assessment and management has arisen in the UK due to the creation of major trauma
units and centralisation of resources. This has left smaller units infrequently seeing major
traumas. In addition, there is an urgent need to adequately train trauma team leaders to
manage multi-disciplinary major trauma teams at the major trauma centres. Advanced
Trauma Life Support (ATLS) prioritises A, B, C and assumes a lone provider or minimal
support team; however within major trauma units multiple personnel assess and manage
injuries simultaneously. This study was designed to evaluate the realism and perceived
usefulness of a team trauma simulation.
The design of the simulation was based upon observational work in the Emergency
Department. It was a hybrid simulation involving an actor as a simulated patient, highly
realistic silicone wounds and changeable physical parameter monitoring.
Participants in the study were Emergency Department attendings and trainees. Video and
audio recordings of the simulation were made. All participants took part in a semi-structured
interview after the simulation.
We report preliminary data. Major themes were the usefulness of team based simulation
when preparing for in-hospital care compared with the ATLS lone provider model. The
simulation was highly realistic and provided multiple opportunities for key decision making
and leadership training. Feedback was an essential and highly valued part of the simulation
training.
Team simulation training for trauma appears to have face validity and is regarded as highly
useful in particular for trauma team leader training.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
59
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-28
High Fidelity Simulation to Complement Training in Pediatric Emergency Medicine
Bhanji, Farhan (Montréal Children's Hospital, Montréal, QC, CAN); Stewart, Jessica (Montreal Children's Hospital,
Montreal, CAN); Bank, Ilana (Centre for Medical Education, McGill University, Montreal, CAN)
Residents feel unprepared to lead the resuscitation of pediatric patients with life-threatening
cardiorespiratory dysfunction. Opportunities to learn in the clinical environment are limited
yet residents are expected to graduate with these important skills.
We aimed to determine if learners’ perceived ability to manage pediatric resuscitation
improved by taking our workshop.
Residents undertaking a 4-week Pediatric Emergency Medicine rotation at the Montreal
Children’s Hospital between August 2010 and April 2011 participated in a formative 2-hour
high fidelity simulation workshop, focusing on crisis resource management. This was
complemented by three 1-hour low-fidelity mock code sessions during the rotation - with
the use of summative, objectives-based, short answer pre-tests to maximize learning.
Residents were asked to complete an anonymous short questionnaire focusing on their
impressions of the learning experience immediately following a high fidelity simulation
workshop. Statements on the survey allowed responses of ‘completely agree’, ‘agree’,
‘uncertain’, ‘disagree’ or ‘completely disagree’.
87 learners undertook the workshop and completed the questionnaire. All subjects believed
the workshop was a positive learning experience (86 learners completely agreed and 11
agreed). More importantly, 75 learners completely agreed, and 22 agreed that they were
better prepared to address a similar scenario in the ER (no learner disagreed with the
statement).
High fidelity simulation workshops can improve learners’ perceived ability to deal with
similar scenarios in the clinical setting.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
60
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-29
Innovative In Situ Simulation and Educational Program to Improve Teamwork in Regional
STEMI Systems
Hall, Laura Lee (American College of Cardiology, Washington, DC, USA); Beaudin-Seiler, Beth (Western Michigan
University School of Aviation, Battle Creek, MI, USA); Dalski, Chet (Kellogg Community College EMS Program,
Battle Creek, MI, USA); Wright, Melanie (Duke University Human Simulation and Patient Safety Center, RaleighDurham, NC, USA)
Prompt reperfusion in ST-elevation myocardial infarction (STEMI) is critical to prevent
mortality and morbidity. Primary PCI is established as the optimal reperfusion therapy, if
delivered in a timely fashion at experienced, high-volume centers. However, most STEMI
patients are not brought to PCI facilities and fail to receive reperfusion within the critical
time period. Transfer of patients requires coordinated processes and communications
among and between multiple, multidisciplinary healthcare teams from one or more
emergency medical services (EMS) teams, the transferring hospital emergency department
(ED), and the ED and cardiac catheterization laboratory (cath lab) of the primary PCI
hospital. In this innovative program, the interactions of healthcare providers were filmed
from first medical contact with a patient actor through transport, and ED and cath lab
treatment, where an endovascular simulator was introduced. A teamwork expert also
monitored the simulation. An educational debriefing, led by a cardiologist expert in STEMI
systems and team-based care expert, was conducted using selected video segments
illustrating potential opportunities for improvement. Interactivity and collaborative
problem-solving was emphasized in the debriefing. The development and implementation of
this program will be reviewed along with requirements for and evidence of success.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
61
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-30 This poster will be featured in the Poster Flash Points session on Thursday,
November 3 at 16:40 hrs
The Role of Leadership in Establishing Mutual Trust and Team Coordination
Cruz-Panesso, Ilian (McGill University, Montreal, QC, CAN); Lachapelle, Kevin (McGill
University- Simulation Centre, Montreal, QC, CAN); Lajoie, Susanne (McGill University,
Montreal, QC, CAN)
This qualitative study examines the role of medical team leadership in building mutual trust
and coordinated behaviors among interdisciplinary members that perform uncertain and
interdependent tasks. An in-depth analysis of two interdisciplinary trauma team simulations
was conducted with the purpose of identifying leadership behaviors that enhanced or
reduced the development of mutual trust and coordinated actions. Team 1 and 2 were rated
as having very good or poor performance, respectively, by 4 instructors using crisis
resource management criteria. Coordination was measured in terms of unsolicited
information provided to other team members and overall reduction in overt communication.
The results show that leadership behaviors of Team 1 included active information gathering
and interpretation of the mechanism of injury, explicit assignation of roles before and during
the simulation, verification of actions demanded, communication of relevant information in
an unsolicited base by all team members, leaders hands-off and maintenance of a frontal
position with visual control. In contrast, leadership behaviors of Team 2 were characterized
by open-ended demands, fixation errors, cross-checking done by other team members,
neglected feedback and integration of information, loss of control as demonstrated by
hands-on behavior which resulted in the emergence of a second leader who threatened the
legitimacy of the assigned leader. Lack of leadership behaviors constrained the flow of
communication, limiting opportunities for creating a climate of trust among team members
and increasing of overt communication, hence decreasing coordination. These results
highlight the importance of developing specific leadership training for ensuring trust and
coordination among team members.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
62
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-32 This poster will be featured in the Poster Flash Points session on Friday, November 4 at 16:15 hrs
Effects of the level of clinical supervision on team resuscitation and resident learning during
simulated ICU scenarios:
Piquette, Dominique (Sunnybrook Health Sciences Centre, Toronto, ON, CAN); Fowler, Rob (Sunnybrook Health
Sciences Centre, Toronto, ON, CAN); Regehr, Glenn (Center for Education Scholarship, UBC, Toronto, ON, CAN);
Dale, Craig (Sunnybrook Health Sciences Centre, Toronto, ON, CAN); LeBlanc, Vicki (Wilson Centre, Toronto, ON,
CAN)
This study explored the relationships between level of clinical supervision during simulated
acute resuscitation and resident learning, patient outcomes, and team outcomes.
Residents were randomized to a distant, immediately available, or direct level of
supervision. They completed a simulation scenario under supervision followed by a similar
scenario without supervision. Resident learning was assessed by two independent raters
who scored residents’ unsupervised performance using a global rating score (GRS) and a
checklist. Patient outcomes included 'time to correct abnormal vital signs' and 'definitive
management'. Team outcomes included nurses' level of satisfaction and diagnostic accuracy
during supervised scenarios.
Fifty-three residents, 24 supervising ICU fellows, and 25 ICU nurses were recruited. During
the supervised scenarios, distantly-supervised residents had lower checklist scores
compared with immediately-available and direct levels of supervision (61% vs. 77% vs.
72%; p<0.01). Patient and team outcomes were equivalent across the 3 levels of
supervision. During the unsupervised scenarios, neither resident performance (mean GRS
4.13 vs. 4.5 vs. 4.17; p=0.53; mean checklist score 65% vs. 73% vs. 68%; p=0.11) nor
patient outcomes were different between groups. Predictors of resident performance during
unsupervised scenarios included resident level of training (p=0.03), checklist scores
(p<0.01) and percentage of tasks completed by residents (p=0.001) during the supervised
scenarios, but not the level of supervision (p>0.34).
Direct level of supervision may improve immediate patient care. However, higher
percentage of tasks completed by residents during supervised scenario was associated with
distant level of supervision and better subsequent unsupervised performance.
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POSTER PRESENTATIONS – SALLE DE BAL
P-34 This poster will be featured in the Poster Flash Points session on Friday, November 4 at 16:15 hrs
The Effects of Operating Room Team Dynamics on Trainee’s Ability to Challenge Authority:
Measuring Health Advocacy with Patient Simulation
Sydor, Devin (Department of Anesthesiology, The Ottawa Hospital, University of Ottawa, Kingston, ON, CAN);
Bould, M Dylan (Department of Anesthesiology, Children’s Hospital of Eastern Ontario, University of Ottawa,
Ottawa, ON, CAN); Naik, Viren N (Department of Anesthesiology, The Ottawa Hospital, University of Ottawa,
Ottawa, ON, CAN); Burjorjee, Jessica E (Department of Anesthesiology and Perioperative Medicine, Kingston
General Hospital, Queen’s University, Kingston, ON, CAN); Arzola, Christian (Department of Anesthesiology, Mt.
Sinai Hospital, University of Toronto, Toronto, ON, CAN); Hayter, Megan Alexandra (Department of Anesthesiology,
St. Michael’s Hospital, University of Toronto, Toronto, ON, CAN); Friedman, Zeev (Department of Anesthesiology,
Mt. Sinai Hospital, University of Toronto, Toronto, ON, CAN)
Background: Operating room (OR) communication is important for team functioning and
patient safety. Status asymmetry between team members is a contributor to communication
breakdown and a threat to patient safety. We investigated how hierarchy in the OR team
influences an anesthesia resident’s ability to challenge an unethical decision by a staff
anesthesiologist in a simulated crisis scenario.
Methods: We prospectively randomized 40, postgraduate years (PGY) 2-5, anesthesia
residents at the University of Ottawa to a videotaped simulated crisis scenario with a
confederate OR team practicing a hierarchical team structure (group H) versus a
nonhierarchical team structure (group NH). The scenario allowed residents several
opportunities to challenge their staff anesthesiologist administering blood to a Jehovah’s
Witness.
Three independent, blinded raters scored the performances using the modified AdvocacyInquiry Score (AIS). The primary outcome was comparison of the best-responses AIS
between groups H vs. NH. Secondary outcomes included comparison of best AIS by PGY and
the percentage in each group that checked blood and administered blood.
Results: The AIS did not differ between groups (p=0.883) but significantly improved from
PGY 2-5 (p=0.042). The rates of checking blood (70% vs. 90%, p=0.114) and
administering blood (65% vs. 60%, p=0.402) were not significantly different between
groups.
Discussion: This study did not show any effect of OR team hierarchical structure on
residents challenging authority, however the mean best-response AIS were average in
quality. The worryingly high rates of blood checking and administration in both groups may
reflect lack of training in challenging authority with implications for patient safety.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-35
A Case-Study Exploring the Role of Affect and Culture in Communicating Bad News:
Technology Triggers for Problem Based Learning and Practice
Lajoie, Susanne (McGill University, Montreal, QC, CAN); Lu, Jingyan (University of Hong Kong, Hong Kong, CHN);
Cindy, Hmelo-Silver (Rutgers State University of New Jersey, New Brunswick, NJ, USA); Wiseman, Jeffrey (McGill
University, Montreal, QC, CAN); Chan, Lap Ki (University of Hong Kong, Hong Kong, CHN); Cruz-Panesso, Ilian
(McGill University, MONTREAL, QC, CAN); Poitras, Eric, (McGill University, MONTREAL, QC, CAN); Ranellucci, John
(McGill University, MONTREAL, QC, CAN); Kazemi, Maedeh (McGill University, MONTREAL, QC, CAN)
A case study is presented of an international technology rich learning module that uses a
problem based learning video based approach to trigger student learning issues about
giving bad news to HIV patients. The role of emotion and culture is explored in this context.
Mixed groups of medical students from Canada and Hong Kong work with facilitators from
each country. Technology supports PBL through the use of transparent examples of how
experts solve cases involving physician-patient communication. Adobe connect supports the
international model through synchronous video interaction and shared applications. After
the instructional sessions, each student practices giving bad news to standardized patients
using video-conferencing tools. Students receive feedback on their physician-patient
communication from experts assessing their performance. The case study supports several
types of data analyses. Pre-post test measures address students’ motivation and ability to
identify the important aspects of physician-patient communication. The instructional
discourse will be analyzed for: the type of affective content considered pertinent to each
case, cultural differences between Canada and Hong Kong students, and types of instructor
facilitation. The practice discourse with standardized patients examines student ability to
transfer what they have learned from the instructional models to patient communication
skills. We anticipate that medical students will improve their ability to regulate physicianpatient communication. Such regulation will include cognitive, metacognitive, and emotional
regulation of knowing what to do and when to do it, and knowing how to communicate in a
manner that is most appropriate given a set of circumstances.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-36
The Delphi: A Novel Method to Determine Core Content for the Pediatric Emergency
Medicine Simulation Core Curriculum
Bank, Ilana (Department of Pediatric Emergency Medicine, Centre for Medical Education, Steinberg (McGill) Medical
Simulation Centre, McGill University, Montreal, QC, CAN); Cheng, Adam (Alberta Children's Hospital, KidSIMASPIRE Simulation Program, Calgary, AB, CAN); McLeod, Peter (Professor, Medicine and Pharmacology, McGill
University, Montreal, QC, CAN); Bhanji, Farhan (Department of Pediatrics, Centre for Medical Education, Steinberg
(McGill) Medical Simulation Centre, McGill University, Montreal, QC, CAN)
Learning objectives for the 2-year Pediatric Emergency Medicine (PEM) program have been
defined by the Royal College of Physicians and Surgeons of Canada (RCPSC), but the
methods to teach core content are left to the discretion of each program. Simulation-based
training is used as part of the PEM curriculum at several Canadian fellowship programs but
consensus-based learning objectives have never been formally developed at a national
level.
We describe the use of the Delphi consensus building process to define the content for
simulation-based training within the PEM curriculum.
We amalgamated the PEM core content topics of the RCPSC and American Board of
Pediatrics. Three simulation experts reduced the list of 300 topics to 200 by excluding
irrelevant material. The starting list of 200 topics was refined by current and immediatepast PEM program directors, and site-specific simulation experts (n=25) participating in the
3-round Delphi process.
Our Delphi process required experts to rate the suitability of simulation as a pedagogical
tool for each topic using a 4 point Likert scale. The cumulative results of this first iteration
were re-sent to the experts asking them to reconsider their ratings while reflecting on the
opinions of the other group members. This process was repeated a second time when
consensus was reached.
To our knowledge, this is the first time the Delphi process has been used to build consensus
on the core content for a national PEM simulation curriculum.
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-37
The Effect of Mental Practice on Crisis Resource Management: A Simulation Study
Afsari, Mahnaz (University of Toronto, St. Michael's Hospital, Toronto, ON, CAN); Boet, Sylvain (University of
Toronto, St. Michael's Hospital, Toronto, ON, CAN); Chiu, Michelle (University of Ottawa, Ottawa Civic Hospital,
Ottawa, ON, CAN); Riem, Nicole (Kantonsspital Liestal, Liestal, CHE); Sebbane, Moustapha (University of Toronto,
St. Michael's Hospital, Toronto, ON, CAN); Hayter, Megan (University of Toronto, St. Michael's Hospital, Toronto,
ON, CAN)
Background: Mental practice (MP) or the ‘symbolic rehearsal of physical activity in the
absence of any gross muscular movements’ has been used in sport and music to enhance
performance. In healthcare, MP has been demonstrated to improve technical skills
performance of surgical residents. However, its effect on crisis resource management (CRM)
skills has yet to be investigated. This study aimed to investigate the effect of MP on nontechnical skills performance during simulated crisis scenarios. We hypothesized that MP
would improve performance of non-technical skills for CRM during a simulated crisis.
Methods: Following REB approval, 40 anesthesia residents were recruited. After
standardized orientation to the simulated environment, subjects were randomized to either
the intervention group who participated in 20 minutes of MP or the control group. The MP
group actively rehearsed a MP script which highlighted key CRM elements. The control group
was not exposed to MP but had a 20 minute session that consisted of an educational task
unrelated to CRM. Subsequently each subject managed a high-fidelity simulated operative
crisis. Using the validated ANTS scale, two independent blinded raters evaluated the nontechnical skills performance of the participants. A Mann-Whitney test was used to compare
the non-technical skills performance between the two groups.
Results: The recorded scenarios are currently under analysis and, if accepted, the results
will be presented at the 2011 Simulation Summit meeting.
Conclusion: MP has the potential to be an easily implementable tool at little cost that
might improve non-technical skills performance of anesthesia residents. Further studies
should determine the effect of MP on actual crisis performance.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
67
ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-38
Experience with Use of a Pig Model in a Groin Hernia Operation Training in Surgical
Education
Carlsen, Charlotte (Aarhus University, Aarhus N, DNK); Lund, Lars (Viborg Hospital, Viborg, DNK); Gaarden,
Morten (Viborg Hospital, Viborg, DNK); Lindorff-Larsen, Karen (Aalborg Hospital, Aalborg, DNK); Charles, Peder
(Center of Medical Education, Aarhus, DNK)
Background: In the Danish surgical specialist education programme there has been no
formal or skills training in groin hernia (Lichtenstein). As part of a PhD we have designed a
formal training course in this field involving theory and hands-on training in plastic
phantoms as well as in anaesthetized pigs.
Methods: We designed a course for doctors in their first year of specialty training for
general surgery. We included a theoretical lesson, a videotaped operation and hands-on
training with use of a hernia trainer, a plastic model of a groin hernia. In the afternoon we
included training in pigs with congenital hernias in the inguinal region (usually male pigs).
This gave us the possibility of supervising and training dissection techniques in real tissue.
Results: Fifteen first year specialty trainees in general surgery have been enrolled in the
course so far. All have been very content with the curriculum and especially the possibility
of practicing in real tissue and the supervised feedback.
Conclusion: By using an animal model with congenital hernia in the inguinal region we
have been able to design a new and relevant course for doctors in specialty training. This
course offers the possibility of training in a model that imitates a human groin with relevant
dissection of a “real” hernia which gives a good base for a clinical training programme.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-39
Five Partners, Eleven Simulations, One Massive Event: How We Walked the Talk to Build
Unlimited Interprofessional Education Opportunities
King, Sharla (University of Alberta, Edmonton, AB, CAN); Greidanus, Elaine (University of Alberta, Edmonton, AB,
CAN); Ansell, Dawn (NorQuest College, Edmonton, AB, CAN); Foisey-Doll, Colette (MacEwan University, Edmonton,
AB, CAN); Magus, Sam (Northern Alberta Institute of Technology, Edmonton, AB, CAN); Reid, Andrew (Alberta
Health Services, Edmonton, AB, CAN)
A unique partnership among four post-secondary educational institutions and a health
service provider was formed to develop, deliver, and evaluate interprofessional educational
learning experiences in three different simulation environments. The goal of the partnership
was to prepare students to work in a collaborative team environment upon entering the
workforce, with a focus on developing interprofessional competencies of communication and
role clarification. Scenarios were created that focused on transitions in care and patient
safety. Two key aspects of the project were curriculum and faculty development.
Representatives from the partners formed working groups to develop modules in the three
simulation learning environments: virtual world, mannequin-based and standardized
patients. A storyboard was developed that followed a single patient from a vehicle collision
to discharge home, highlighting key transitions in care. One scenario was developed for
each simulation environment, based on this storyboard. Instructors from all institutions
were trained to debrief the learning experiences focusing on the interprofessional teamwork
skills, rather than clinical skills. The modules were delivered over a 2-year period using 2
different methods: students from across the institutions participated together in either a
single simulation ‘bootcamps’ or a one day simulation event with 11 scenarios. This
presentation provides an overview of the project and the various developmental stages.
Results from the evaluation of the simulation-based learning experiences are presented.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-40
Development of a Comprehensive Set of Assessment Tools for Evaluation of Procedural
Skills in Internal Medicine
Walzak, Alison (Department of Medicine, University of Calgary, Calgary, AB, CAN); Brindle, Mary E. (Department of
Surgery, University of Calgary, Calgary, AB, CAN); Schaefer, Jeffrey (Department of Medicine, University of
Calgary, Calgary, AB, CAN); Bacchus, Maria (Department of Medicine, University of Calgary, Calgary, AB, CAN);
Ma, Irene W. Y. (Department of Medicine, University of Calgary, Calgary, AB, CAN)
As part of a systematic approach to developing a comprehensive set of validated
assessment tools for the seven bedside procedures mandated by the Royal College of
Physicians and Surgeons of Canada for Internal Medicine, this study aims to validate and
determine the reliability of two assessment tools for lumbar puncture (LP).
A twenty-one item checklist was created and revised based on input from an expert panel
(N=6, consisting of a neurologist, emergency physician, general internist, adult
hematologist, pediatric hematologist, and an anesthesiologist) using the modified Delphi
method. Standard setting was completed using the Angoff and Ebel methods. Two trained
reviewers independently evaluated 20 videotaped trainee performances using both the
checklist and a previously validated Global Rating Scale (GRS).
The intra-class correlation coefficients of each item on the checklist ranged from 0.78 to
perfect agreement, with 15 of 21 items demonstrating perfect agreement. Using the GRS,
the intra-class correlation coefficients ranged from 0.35 to 0.97. The Cronbach’s alpha for
the checklist and GRS were 0.16 and 0.90 respectively. The Angoff method yielded a
minimum performance level (MPL) of 65% with poor agreement of competency compared to
the GRS (Kappa=0.06; p=0.45), while the Ebel method demonstrated a MPL of 80% and
Kappa=0.07 (p=0.64).
In conclusion, the inter-rater reliability was high for both the LP checklist and GRS, while
the internal consistency of the checklist was low. There was poor agreement of competency
between the MPL using the checklist and GRS. Reasons for the low internal consistency of
the checklist and the lack of agreement on competency deserve further study.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-41
Death of a Manikin: Adverse Effects on Learning and Mechanisms
Fraser, Kristin (University of Calgary, Calgary, AB, CAN); Huffman, James (University of Calgary, Calgary, AB,
CAN); Ma, Irene (University of Calgary, Calgary, AB, CAN); McIlwrick, Joann (University of Calgary, Calgary, AB,
CAN); Wright, Bruce (University of Calgary, Calgary, AB, CAN); McLaughlin, Kevin (University of Calgary, Calgary,
AB, CAN)
We hypothesized that manikin death during a simulation scenario for final year medical
students would increase emotional distress and thereby increase cognitive load; and that
this would lead to poorer learning outcomes.
This was a prospective intervention study in which final year medical students attended a
simulation session on “Approach to altered level of consciousness (LOC) in a patient with
salicylate overdose”. Groups of 5 students were randomly allocated to one of two groups,
Death (D) or No Death (ND) of the manikin in the last 3 minutes of the scenario.
Following the debriefing, students completed an assessment of emotional states, based on
the circumplex model of emotion and a 9-point Likert scale of cognitive load. The students
were examined 3 months later on a simulator during a 10-minute OSCE station dealing with
altered LOC as part of their scheduled summative clerkship exam.
A total of 116 students attended the simulation session on Altered LOC and are included in
the analysis. Group D students reported being more nervous, upset, sad, and depressed (p
< 0.05 for all), and had higher cognitive load (7.63 vs. 7.25, p = 0.03) than ND students.
On the final OSCE examination, ND students were significantly more likely to pass the OSCE
station than D students (86.9% vs. 70.9%, p = 0.03).
Death of the manikin impaired the medical student’s ability to transfer key information
taught in the simulation session. It is likely that emotional distress increases cognitive load
to a point past that which is optimal for learning.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-42
Perceptions and Experiences of Nursing Students' Learning in High-Fidelity Simulation
Harder, B. Nicole (University of Manitoba, Winnipeg, MB, CAN); Paul, Pauline (University of Alberta, Edmonton, AB,
CAN); Ross, Carolyn (University of Alberta, Edmonton, AB, CAN)
Much of the emerging literature in simulation use is focused on the outcomes of participants
engaging in high-fidelity simulation (HFS). This includes performance outcomes evaluated
by a variety of means, as well as looking as confidence levels after participating in
simulation experiences. Very little has been written that looks at the experiences and
perceptions of student learning as they engage in simulation, and what either enhances or
impairs student learning in simulation. This presentation will focus on some of the
discoveries that were presented in the discussion section of an ethnographic study
Ethical approval was obtained from two large academic institutions prior to the study. A
focused ethnography was used to address the purpose of this study: to understand what
happens to student learning during HFS from the perspectives of nursing students and
nursing educators. The target population included faculty and students familiar with highfidelity simulation (HFS). The specific research questions that were used to guide this study
were:
1. What are faculty and students’ views of the use of HFS on student learning?
2. What is it like to engage in simulated clinical experiences as a student?
3. What is it like to engage in simulated clinical experiences as an instructor?
4. What factors either enhance or impair the simulated experience?
Results: Learning from mistakes? How many is too many? What should the ensemble cast
look like? What about the environment? Realism? These are some of the discoveries that
will be presented.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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POSTER PRESENTATIONS – SALLE DE BAL
P-43
New Dog, New Tricks: Trends in FLS Performance for Incoming Surgery Residents
Kolozsvari, Nicoleta (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University,
Montreal, QC, CAN); Kaneva, Pepa (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation,
McGill University, Montreal, QC, CAN); Cao, Jiguo (Department of Statistics and Actuarial Science, Simon Fraser
University, Burnaby, BC, CAN); Vassiliou, Melina (Steinberg-Bernstein Centre for Minimally Invasive Surgery and
Innovation, McGill University, Montreal, QC, CAN); Fried, Gerald (Steinberg-Bernstein Centre for Minimally Invasive
Surgery and Innovation, McGill University, Montreal, QC, CAN); Feldman, Liane (Steinberg-Bernstein Centre for
Minimally Invasive Surgery and Innovation, McGill University, Montreal, QC, CAN)
The goal of this study was to determine whether incoming surgery residents have improved
fundamental laparoscopic skills compared to those of previous years.
The initial Fundamentals of Laparoscopic Surgery (FLS) performance of first-year residents
between 2003 and 2008 were identified from a prospective database. Linear regression was
used to determine the effect of incoming year on performance of the five FLS tasks (peg
transfer, pattern cut, endoloop placement, suture with extracorporeal knot and, suture with
intracorporeal knot) and total score. Statistical significance is defined as p<0.05.
Sixty-five first-year residents were identified from the database. Total FLS score improved
over time (r=0.39, p=0.001). Scores for peg transfer did not significantly change, but
scores for pattern cutting (r=0.37, p=0.002), endoloop placement (r=0.36, p=0.004),
suture with EC (r=0.32, p=0.02) and suture with IC (r=0.26, p=0.03) all significantly
improved over the five years.
Baseline fundamental laparoscopic skills for incoming surgery residents appear to have
improved over a five year period. While no distinct program based intervention was
identified to explain this higher baseline performance, it may be due to greater interface
with technology, increased clinical laparoscopic exposure, or the availability of laparoscopic
simulation in medical school.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-44
A High Fidelity Simulation Model for Beating Heart Surgery Training
Laflamme, Maxime (Montreal Heart Institute, Montréal, QC, CAN); Girard, Alain (Montreal Heart Institute, Montréal,
QC, CAN); Cartier, Raymond (Montreal Heart Institute, Montréal, QC, CAN)
Introduction: Teaching surgical skills is classically based on gradual responsibility. In the
current era patients are older, frailer and have more comorbidities than decades ago. This
impacts the faculty's tolerance for surgical resident autonomy. Using simulation models
offer the trainees the opportunity to increase their confidence and surgical skills outside the
surgical theatre. We propose a beating heart model to teach technical skills in off-pump
coronary artery bypass (OPCAB) surgery.
Methods: Our model consists of an air pressurized expandable silicone simulated heart
connected to a modulator to control the strength and frequency of the contraction. Two
millimetre diameter rubber tubes are connected to a perfusing system and positioned on the
anterior, lateral, and posterior walls of the model simulating the 3 major coronary vessels.
The surrogate heart is fixed on a pivot inside the mediastinum and can be bent in different
positions reproducing surgical exposures used during OPCAB surgery.
Results: Experts in beating heart surgery confirm the reliability of the model. The three
basic movements seen in beating heart surgery (myocardial contraction, pericardial
transmission motion related to the lung inflation-deflation cycle and coronary artery
stretching during contraction) were reproduced. Perfusing the coronary network raises the
level of technical difficulty to what is normally seen in clinical cases. Disposable substitute
coronary vessel allows immediate graft patency assessment.
Conclusion: Our simulation model confirms the likelihood of reproducing, ex-vivo, surgical
situations. Simulation models should be part of modern surgical program armentarium
devoted to perfect trainee’s coaching.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-45
Using Simulation to Train Junior Psychiatry Residents to Work with Agitated Patients: A
Pilot Study
Zigman, Daniel (McGill University, Montreal, QC, CAN); Young, Meredith (McGill University, Montreal, QC, CAN);
Chalk, Colin (McGill University, Montreal, QC, CAN)
Objective: Psychiatry residents report feeling inadequately trained to work with agitated
patients. This article examines the influence of introducing a new simulation based learning
intervention on junior psychiatry residents.
Methods: Postgraduate-Year-1 and -2 psychiatry residents were invited to participate in a
new 2.5 hour simulation-based learning intervention focused on evaluating and managing
agitated patients. Questionnaires consisting of closed- and open-ended questions were used
to explore the influence of the activity on resident self assessed knowledge, comfort and
competence.
Results: Twelve residents out of a possible 22 participated. They reported increases in selfassessed understanding of safety procedures, causes of agitation, verbal de-escalation and
pharmacotherapy (means: 5.1, 5.0, 5.7 and 4.9, respectively; scale: 1 = much worse to 7
= Much better). Pre/post comparison of ratings indicates that residents also reported
increases in comfort and perceived competence both evaluating and managing agitated
patients following the intervention (main effect of pre- versus post-intervention; F(1,10) =
16.53, p < 0.005). In open-ended questions, anxiety and lack of experience were common
issues mentioned prior to the intervention. Following the training, participants reported
improvements in knowledge and skills and reported appreciating feedback. However, some
indicated the need for continued practice and suggested that anxiety was still prominent.
Residents found the intervention useful.
Conclusions: Simulation may be well suited to teaching residents to work with agitated
patients, but more research is needed to determine whether this kind of educational
intervention can lead to changes in patient care.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-46
Becoming an Educator in Simulation – Current Status and Future Directions
Ng, Elaine (Hospital for Sick Children, Toronto, ON, CAN); Kotsakis, Afrothite (Hospital for Sick Children, Toronto,
ON, CAN)
Objective: To determine the impact of the Debriefing Workshop (DW), benchmark current
status of simulation education and determine the need for educational interventions.
Methods: Five one-day DWs were held in 2010 for interprofessional groups. Research
ethics board approval was obtained. A web-based 20 question survey was sent by email to
all the participants at least six months after their attendance. Qualitative and quantitative
data were generated using open-ended questions and 5-point Likert scale anchored at both
positive and negative ends.
Results: Response rate was 22/26 (84.6%; 9 nurses, 7 respiratory technologists, 5
physicians, 1 simulation coordinator). Simulation was used for teaching by 19/22 (86%)
surveyed. More than 85% reported DW had a high to very high impact on their knowledge
on debriefing, and on the way they taught with simulation. For >65% it improved the way
they communicated and introduced them to new colleagues. Half the participants had
successfully implemented a teaching session using simulation. Seventy-seven % indicated
use of knowledge and skills from DW in real life events. Time was identified as the main
barrier to utilize simulation in education for 71% of those surveyed. Scenarios and
debriefing skills were not definite barriers. Themes emerged from the open ended questions
revealing a need for advanced and refresher courses and practice opportunities to enhance
debriefing skills.
Conclusions: The one-day DW enabled educators to utilize simulation as a teaching tool
and debriefing skills have been translated to daily practice. It led to development of new
courses and enabled collaboration to foster interprofessional education and networking. The
need for continuing education in debriefing was identified.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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POSTER PRESENTATIONS – SALLE DE BAL
P-47
Learning to Collaborate Remotely, in Real Time, Through a Platform of Integrated
Simulation Devices.
Joy, Aislinn (School of Medicine, University College, Cork, Cork, IRL); Hynes, Helen (Medical Education unit,
University College, Cork, Cork, IRL); Ellaway, Rachel (North Ontario School of Medicine, Sudbury, CAN); Topps,
David (University of Calgary, Calgary, CAN); Lachapelle, Kevin (McGill Simulation Centre, University of McGill,
Montreal, CAN)
The Health Services Virtual Organisation (HSVO) platform is a web-based network of
integrated simulation devices, through which scenarios can be built, for the education of
healthcare students and staff. From April 2010 to October 2010, third year medical students
at University College Cork (Ireland) participated in seven Simulation Challenges with
students from three different medical schools (NOSM, McGill, U of O) in Canada.
The analysis of observed activities during these sessions will be described elsewhere. Here
we report preliminary results of a qualitative analysis of the learner perspective, as part of
ongoing longitudinal follow up, via focus group interviews. Learning styles and approaches
as measured by the index of Learning Styles Questionnaire and ASSIST questionnaire
respectively were also completed and will be correlated to interview responses (work in
progress).
From an affective and learning perspective, mixed cultural teams, telemedicine scenarios
where sites had a distinct role, and virtual patient cases with inbuilt feedback mechanisms,
were most appreciated. It was felt that real life video footage also added to the authenticity
of an experience. A competitive approach to the learning design, between different cultural
groups at remote sites, actually reduced collaboration during the simulation exercise, from
the Irish students’ perspective. But when this happened, these students actually learned
more about and from students in Canadian schools, by comparing differences of approach to
the same scenario.
For best collaborative teamwork during remote simulation challenges though, the
overwhelming recommendation from this group of students is to mix a cohort of students
from each site, to form multicultural teams that can work together.
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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POSTER PRESENTATIONS – SALLE DE BAL
P-48
Simulation-Based Curriculum for Laparoscopic Inguinal Hernia Repair
Kurashima, Yo (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Arnold and Blema Steinberg Medical
Simulation Centre, McGill University, Montréal, QC, CAN); Kaneva, Pepa (Steinberg-Bernstein Centre for Minimally
Invasive Surgery and Arnold and Blema Steinberg Medical Simulation Centre, McGill University, Montréal, QC,
CAN); Feldman, Liane (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Arnold and Blema Steinberg
Medical Simulation Centre, McGill University, Montreal, QC, CAN); Fried, Gerald (Steinberg-Bernstein Centre for
Minimally Invasive Surgery and Arnold and Blema Steinberg Medical Simulation Centre, McGill University, Montreal,
QC, CAN); Vassiliou, Melina (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Arnold and Blema
Steinberg Medical Simulation Centre, McGill University, Montreal, QC, CAN)
The purpose of this study is to develop and validate a comprehensive curriculum for the
training and evaluation of laparoscopic inguinal hernia repair (LIHR). We developed a tool to
measure performance during LIHR called the Global Operative Assessment of Laparoscopic
Skills–Groin Hernia (GOALS-GH). GOALS-GH can be used to assess transabdominal
preperitoneal (TAPP) or totally extraperitoneal (TEP) repairs. It is a 5-item global-rating
scale. We then designed a low-cost physical model: Laparoscopic Inguinal Hernia Simulator
(LIHS). LIHS represents accurate anatomic relationships and allows learners to perform
each step of LIHR. To evaluate the reliability and validity of these tools, 17 novices and 8
experienced surgeons were assessed by observers, attending surgeons and self in the OR
and/or on the simulator using GOALS-GH. To prepare participants, we conducted a hernia
course with pre and post tests, and a step-by-step instructional video of the procedure. The
inter-rater reliability of GOALS-GH was greater than 0.7 for all raters in the OR and
simulator. The internal consistency of GOALS-GH items was 0.97 in the OR and 0.96 in the
simulator. The mean GOALS-GH score for experienced surgeons was significantly higher
compared to novices in both environments. The correlation between GOALS-GH scores in
the OR and the simulator was 0.81 (p< 0.01, n= 12). Thirty-three general surgery residents
participated in the hernia course. Their knowledge about LIHR improved after the course.
GOALS-GH is a reliable and valid measure of the skills required for LIHR and may be used
with the LIHS as an educational tool. Combined with a basic course and instructional video,
these tools can be integrated into a comprehensive curriculum that may help to improve the
learning curve for LIHR.
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November 3-5, 2011 | Montreal, Canada
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-49
The Academic Half-Day Redesigned - Incorporating Simulation, Promoting CanMEDS and
Developing Self-Directed Learners
Di Genova, Tanya (Montréal Children's Hospital, Montréal, QC, CAN); Valentino, Pamela (Hospital for Sick Children,
Toronto, ON, CAN); Gosselin, Richard (Montreal Children's Hospital, Montreal, QC, CAN); Bhanji, Farhan (Montréal
Children's Hospital, Montréal, QC, CAN)
In 2009-2010, McGill University's Pediatrics Residency Program revamped its Academic
Half-Day based on concerns that included an overemphasis on subspecialty content,
exclusive use of didactic lectures and 'opportunistic' topics based on interests of 'volunteer'
instructors. Novel instructional methods included monthly simulation sessions to learn
CanMEDS competencies, increased involvement of Residents as Teachers and the
implementation of a 'Systems-based' Curriculum using Division Directors to determine who
should deliver objectives-based content.
A post-implementation on-line survey was sent to all 18 second and third year pediatric
residents who had been exposed to both curricula. This survey was designed to determine
the impact of the new curriculum on their ability to retain information, acquire CanMEDS
competencies of a General Pediatrician, and to assess the effect on their self-directed
learning. Responses were recorded on a 5-point Likert scale from strongly disagree to
strongly agree.
Fifteen of 18 residents completed the survey (83%). The 'Systems-based' schedule was
preferred by all pediatric residents. Seventy-nine percent of the residents agreed that the
simulation sessions were useful to learn the CanMEDS competencies and 64% agreed that
the new curriculum better supported learning in a clinical setting. Importantly, 64% of
Residents voluntarily read more around the topics presented and 71% agreed they better
retained the content compared to the 'old' curriculum.
Given the survey results, we propose that our comprehensive, systems-based interactive
format, with integrated 'CanMEDS simulation' sessions is practical, while allowing a more
learner-centered educational experience that may promote the development of life-long
learning skills.
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-50
Simulation-Based Education for the Rehabilitation Professions: A Scoping Review
Yeung, Euson (University of Toronto, Department of Physical Therapy, Toronto, ON, CAN)
Technology plays an important role in health professions education. The literature shows
that simulation-based education (SBE) has shaped curriculum, education policy and
research in medicine and nursing. To date, little is known about how SBE can benefit the
rehabilitation professions. A comprehensive review of what is currently known about
simulation research and the use of SBE in the rehabilitation professions will inform program
developers and researchers about questions that remain unaddressed. The objectives of this
review are to 1) determine the extent, range and nature of SBE in rehabilitation education,
and 2) to identify gaps in the literature on the use of SBE in rehabilitation. A scoping review
methodology was used to search the published and grey literature in relevant databases,
reports, position papers, and abstracts from relevant conference proceedings and networks.
Two authors reviewed the list of abstracts against inclusion criteria which were use of
simulation, pre- or post-licensure education, and involvement of rehabilitation professionals
or students. Included articles were retrieved for full review, data extraction and analysis
using Alkin’s Evaluation Theory Tree. Subsequent qualitative content analysis revealed that
only 3 types of simulations are being used in rehabilitation education but SBE may have a
role beyond that of developing and assessing procedural skills. Although research has
examined the effectiveness of SBE in rehabilitation education, its potential to influence
processes that address broader curricular goals have yet to be examined in detail. A
program evaluation framework is suggested for program developers and researchers to
consider as a more holistic approach to addressing educational research gaps in
rehabilitation.
P-51
Partnering for Success - Open Doors 2012
Mullins-Richards, Paula (Memorial University of NL, St. John's, NL, CAN)
Simulation is not simply mannequins. A multidisciplinary approach to include high fidelity
simulators, standardized patients, surgical skills, low fidelity simulation and distributive
education tools can create a unique environment to attract multiple partners. We all can
research templates from any good business school, academic texts or the internet to
provide the required contents and processes to create a first rate strategic and business
plan for our centres. It is most important to ensure you have identified the stakeholders,
forged lasting partnerships both within and outside your institution prior to the preparation
of both sets of plans.
Memorial University of NL new Clinical Learning Center will open its doors in 2012 and you
bet we are excited! During our presentation you will learn of how our dream of a 15,000 sq
ft facility is now our reality - and all of the unique twists and turns along the way. This is a
presentation about sharing facilities and resources which are not limited to capital
equipment, materials and human resources. Partnering for Success will also explore unique
opportunities for funding that would not normally be open.
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-52
Making It Real: 3-D Simulation Immersion in Radiation Therapy
Cherryman, Fiona (The Michener Institute, Toronto, ON, CAN); Niblett, Brad (The Michener Institute, Toronto, ON,
CAN); Bandali, Karim (The Michener Institute, Toronto, ON, CAN)
Simulation offers bridging opportunities to immerse students safely into clinical scenarios
without impacting quality patient care. Radiation Therapists are practitioners who interact
equally with patients and technology to deliver specialized oncology care. The Virtual
Environment Radiotherapy Training System (VERT) facilitates student learning in an
immersive environment through interactions with virtual patients and radiation therapy
equipment. The Michener Institute is the first VERT installation site in North America.
Students create individualized patient treatment plans using a true clinical system and
import them directly into VERT. Although Michener is in the early stages of embedding VERT
into the curriculum, initial qualitative data gathered through focus groups has been positive.
Preliminary feedback shows faculty incorporated VERT and its enhanced visualization tools
for abstract concepts successfully especially for experiential and visual learners. During
initial curriculum development, faculty selected and expanded clinical cases into the VERT
platform to illustrate key concepts and competencies. Students indicated a preference for
this hands-on learning approach over traditional book learning. We anticipate increasing the
utilization of the VERT platform throughout the curriculum providing students an interactive
risk-free environment to examine clinical concepts, anatomical specifics and achieve
competencies. Further research is required to assess impact on student learning with the
aim to improve skill acquisition and theory retention and thereby increase setup accuracy
and reproducibility ultimately leading to improved patient safety and outcomes.
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-53 This poster will be featured in the Poster Flash Points session on Thursday, November 3 at 16:40 hrs
Simulation in the Canadian Context: Perceptions of Program Directors and University
Administrators
LeBlanc, Vicki (Wilson Centre- University of Toronto, Toronto, ON, CAN); Brydges, Ryan (Wilson Centre- University
of Toronto, Toronto, ON, CAN); McNaughton, Nancy (Standardized Patient Program - University of Toronto,
Toronto, ON, CAN); Piquette, Dominique (Wilson Centre- University of Toronto, Toronto, ON, CAN); Sharma,
Bharat (Department of Surgery - University of Toronto, Toronto, ON, CAN); Bould, Dylan (University of Ottawa,
Ottawa, ON, CAN)
Objective: Within the context of the FMEC: PG Project, the goal of this study was to
explore the practical realities of postgraduate simulation-based education in Canada.
Methods: Seventeen simulation program directors and university administrators were
interviewed about their conceptualization of the central tenets of simulation, and how they
integrate simulation in the Canadian postgraduate system. Transcripts of semi-structured
interviews were analyzed using an iterative inductive thematic approach.
Results: Simulation is perceived as an important and necessary component of postgraduate
training, to target skills and behaviours difficult to acquire through traditional training, and
to reduce risks to patients. However, for the theoretical advantages of simulation to be fully
realized, interviewees called for improvements: 1) Investment in faculty development to
improve the uptake and effective use of simulation. 2) Integration of simulation more
thoughtfully into existing curricula, and across specialties & modalities. 3) Evolution of
research beyond description towards justification and clarification of how to optimally use
simulation. There was broad agreement that simulation is ideal for training in an
interprofessional context. However, postgraduate simulation-based interprofessional
education (IPE) is resource intensive and logistically challenging, with education competing
with service commitments. For theoretical advantages of IPE simulation to be realized,
interviewees argued for stakeholders to prioritize this form of teaching.
Conclusion: Within Canada, further developments in faculty development, integration,
research, and simulation for IPE are advocated to optimize the effectiveness of simulationbased education.
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ABSTRACTS
POSTER PRESENTATIONS – SALLE DE BAL
P-54 This poster will be featured in the Poster Flash Points session on Thursday, November 3 at 16:40 hrs
Simulation for Family Centered Care: Improving Caregiver Skills, Self-Efficacy and Quality of
Life using a Practice-Until-Perfect Simulation Intervention for Seizure Management in the
Home Environment
Sigalet, Elaine (KidSIM-Aspire Pediatric Simulation Research Program, Alberta Children's Hospital, University of
CalgaryKIDSIM Program Alberta Children's hospital, Calgary, AB, CAN); Chatfield, Jenn (KidSIM-Aspire Pediatric
Simulation Research Program, Alberta Children's Hospital, University of CalgaryKIDSIM Program Alberta Children's
hospital, Calgary, AB, CAN); Grant, Vince (KidSIM-Aspire Pediatric Simulation Research Program, Alberta Children's
Hospital, University of CalgaryKIDSIM Program Alberta Children's hospital, Calgary, AB, CAN); Koot, Deanna
(KidSIM-Aspire Pediatric Simulation Research Program, Alberta Children's Hospital, University of CalgaryKIDSIM
Program Alberta Children's hospital, Calgary, AB, CAN); Robinson, Traci (KidSIM-Aspire Pediatric Simulation
Research Program, Alberta Children's Hospital, University of CalgaryKIDSIM Program Alberta Children's hospital,
Calgary, AB, CAN); Cheng, Adam (Alberta Children's Hospital, KidSIM-ASPIRE Simulation Program, Calgary, AB,
CAN)
This study examines the impact of utilizing a novel Family Centered Care focused high
fidelity simulation intervention to deliver seizure management teaching on caregiver
performance, perceptions of self-efficacy, and quality of life. This intervention will engage
practice until perfect ideology congruent with the principles of family centered care doctrine,
providing an opportunity for caregivers to practice managing seizures until they verbalize
comfort with skills and knowledge. We hypothesize that participants in the intervention
group will demonstrate improved performance with emergent seizure management, report
greater confidence, and enhanced quality of life compared to participants in the control
group who receive traditional discharge education.
An experimental two-group pretest/posttest randomized controlled research study will be
used to compare participant responses to both types of curriculum. We will recruit primary
caregivers of children with underlying seizure disorders being cared for at the Alberta
Children's Hospital. We anticipate a sample size of 98 subjects to support a two-tailed
alpha of 0.05, beta of 0.20, resultant power of 80%, predicting a moderate effect size of ≥
0.40. The effect size is based on health professional research. This study is a work in
progress. Preliminary results are expected January 2012.
To date, simulation-based education has focused primarily on health professionals as
learners. Our study aims to assess the impact of a simulation-based intervention in
caregivers. We anticipate that our practice-until-perfect simulation-based intervention will
demonstrate improved caregiver performance, self-efficacy and quality of life, and thus
pave the wave for caregiver-based simulation interventions in other contexts as well.
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CONFLICT OF INTEREST
Last
Cheng
First
Adam
Fried
Harder
Gerald
B. Nicole
Kolozsvari
Nicoleta
Kurashima
Yo
LeBlanc
Vicki
Marquis
Piquette
François
Dominique
Riesen
Sigalet
Eleanor
Elaine
Declaration
Research grants from Laerdal Foundation of Acute Medicine and the Heart &
Stroke Foundation
Speaker honorarium form Olympus Endoscopy
Adjunct faculty member with a simulation manufacturer (METI) adjunct
faculty member with a simulation manufacturer (METI)
SAGES Research Grant. The Steinberg-Bernstein Centre for Minimally
Invasive Surgery and Innovation receives an unrestricted educational grant
from Covidien. Salary support from the McGill Surgeon Scientist program
Steinberg-Bernstein Centre for Minimally Invasive Surgery receives an
unrestricted educational grant from COVIDIEN.
The FMEC PG Project was funded by Health Canada and managed by the
AFMC, the CFPC, le CMQ & the Royal College. The authors acknowledge the
support of the University of British Columbia, University of Toronto & McGill
University.
Local PI for two GSK studies
Funded by the Network of Excellence in Simulation for Clinical Teaching and
Learning
Grants from NSERC, AVAYA and Virtual 3D Crafting
Grant from the Alberta Children's Hospital Foundation through the division of
Family Centered Care.
Authors not listed above do not have any relationships with commercial entities to disclose.
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FLOOR PLAN
Marriott Château Champlain
Interprofessional Teams
November 3-5, 2011 | Montreal, Canada
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FLOOR PLAN
Arnold and Blema Steinberg Medical
Simulation Centre
Location:
3575 Parc Ave, Suite 5640
(Lower Level of “Les Galeries Du Parc” LaCité shopping mall)
We are located at the southeast corner of Parc Avenue and Prince Arthur in the “Les
Galeries Du Parc” LaCité shopping mall. Upon entering the main entrance of the mall, take
the stairs down to the food court level and proceed to the right. The Medical Simulation
Centre is located diagonally across from Le Metro grocery store.
If you have trouble locating the Centre, please call 514-398-8978.
If you are coming by car you can park in the garage located at Les Galeries du Parc. There
are two entrances to the parking garage, both on the east side of Parc Avenue, one located
just north of Milton, the other located just north of Prince Arthur near the McGill New
Residence. You can then take the elevator to the shopping mall level and follow the signs to
the Medical Simulation Centre. We are located across from the Metro grocery store.
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FLOOR PLAN
McGill Residence – New Residence Hall
3625, ave Parc, Niveau C, Salle de bal
Particpants should meet at the Arnold and Blema Steinberg Medical Simulation
Centre to pick up registration materials. A guide will bring you to the New
Residence Hall at McGill University.
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Health Sciences Simulation Centre
2012 SIMULATION
SUMMIT
NOVEMBER 17 – 18, 2012
OTTAWA, ONTARIO
Ottawa Convention Centre
Westin Ottawa
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