bluuebunny/crossref_metadata_2025_split huggingface dataset:
196 Plugged in Sim-Vr 360 Simulation with Headsets: How Does it Work?
Authors: Mason Tim 
Published: January 2022

Simulation is a technique employed to produce an experience without going through a real event We had used 360 videos for remote simulation and debrief for over 3 years but as face-to-face sessions started to reoccur, we wondered whether we could use these videos to engage learners using VR headsets for short immersive sessions with a targeted debrief.We used unscripted 360-degree scenarios of Paediatric emergency simulations, loaded onto Occulus-Go VR headsets. Between November 2020 and May 2020, we ran sessions for the paediatric and obstetric teams in North Devon district hospital, where groups of up to five learners watched a scenario, followed by a debrief led by a facilitator. We explored its acceptability, immersion and whether the debrief enriched the session through collecting feedback.We engaged 50 participants over 14 sessions. The majority of sessions occurred on night shifts. Twenty-nine staff including doctors, midwives, healthcare assistants and nurses gave feedback. All participants enjoyed the experience and wanted to do it again: 90% felt immersed and 97% enjoyed the debrief. A small minority found the experience strange and one had to stop watching because of motion sickness.Virtual sim with headsets is time-efficient, requires no bedspace and was engaging enough to be requested during out of hours shifts. Feedback proved it to be immersive, safe and enjoyable. It is cost-effective (not needing large numbers of staff or expensive manikins) and the experience reproducible. It was accessible for those who had previously been scared of simulation as they did not feel ‘judged’ and therefore may be a valuable adjunct to engaging those who have not in the past. Debrief was vital and allowed active discussion of learners’ own experiences as well as an exploration of the medicine prompted by being immersed in the scenario. Virtual simulation using headsets and 360 videos gives learners an experience without going through the real event and we feel that it is a valuable tool for engaging teams in simulation education. Through this project have established standards that could help others engage in projects such as this.
127 Caution and Context: COVID-19 as the Educational Focus for Inter-Professional Learning
Authors: Neill Kathryn , Ward Wendy L. , Dickinson Karen 
Published: January 2022

Traditionally our university-affiliated Office of IPE delivers a 3-phase (exposure, immersion, competence) inter-professional education (IPE) curriculum which is a graduation requirement for students. On 13 March 2020, on-site classes were suspended due to the first confirmed case of COVID-19 in the state. Faculty rapidly implemented alternative methods of instruction to complete coursework for the spring semester utilizing COVID-19 as the educational focus and hosting these learning events on the virtual platform.The aim of the study was to lean into the educational opportunities provided by the global pandemic to continue to provide high-quality IP education including simulation, crafting these educational events to meet the pandemic needs of our community.During the COVID-19 pandemic, healthcare students and faculty stepped forward with a desire to serve during this health crisis. Several public health support programmes were provided by the academic health centre and IP educational activities were crafted around these. Such programmes included: a 1–800 COVID-19 hotline providing rapid access to health screening to assist the community in understanding when and where they should access the healthcare system for testing or care; a Contact Tracing Call Center to identify those with exposure and risk and counsel next steps; and provision of public health information regarding the virus and the vaccine. IP Faculty developed a series of IP simulations to provide students with the knowledge and skills necessary to serve in these public health support areas. These simulations were all structured utilizing an initial brief (detailing Interprofessional Education Collaborative (IPEC) domains and Patient- and Family-Centered Care principles), followed by scenario-specific education such as IP team review of screening algorithm and decision tree for hotline and call centre work, with subsequent standardized patient (SP) interaction, and finally IP debriefing. Five simulations involving 190 students occurred. Evaluation metrics collected included pre-/post-Interprofessional Collaborative Competencies Attainment Survey (ICCAS), evaluation of learning objectives, SP interaction and simulation methodology via Likert scale, and identification of themes from qualitative response items.Inter-professional simulation training activity via an online platform supported student learning for COVID-19 disease information, screening algorithm and decision tree tools and telemedicine delivery. The rapidly implemented virtual training prepares students to graduate whilst also supporting the state during this public health crisis. This work provides a template by which curricula can pivot to meet the needs of all key stakeholders during a time of global crisis.
16 Exploring the Benefits of Teaching Ultrasound-Guided Vascular Access to Paediatricians
Authors: Ranaweera Melanie , Carey Brian 
Published: January 2022

Paediatric vascular access can be notoriously difficult due to small vessels and patient cooperation. Studies have shown ultrasound (US) guided technique to be a more successful method in experienced hands, especially in children with difficult access To date, there have been no studies exploring the experience and significance of US-guided vascular access training amongst district general hospital (DGH)-based UK paediatricians. We aimed to evaluate this within our DGH.Small-group US vascular access simulation sessions were led by our accredited and experienced paediatric advanced nurse practitioner (ANP). Participants learned to map veins and practiced US cannulation technique on the gelatinous ‘phantom’ model. A questionnaire asked attendees to evaluate confidence levels before and after sessions, and open-space for qualitative comments.Thirty-eight paediatricians attended sessions; of whom, 75% had never conducted US vascular access and 96% did not feel confident. Following sessions, 100% of participants felt significantly more confident and would attempt this on real patients (Figure 1). Qualitative comments showed that they valued sessions: ‘good opportunity to practice vein mapping and cannulation on gel model’. All participants felt that this should be taught routinely within paediatric training. Five participants used this new skill in real patients, following the sessions.Confidence level pre- and post-sessions, n = 38This study demonstrates the effectiveness and usefulness of delivering US-guided vascular access training to DGH paediatricians. It enabled improved self-reported confidence, which translated into improved patient care in real-life scenarios. Following its success, we intend on running this as an ongoing session. For clinicians wanting to utilize their skill on real patients, this will be supervised by our ANP. We recommend that all UK paediatricians train in US vascular access to enable optimal care for paediatric patients in all hospital settings. However, further research in a larger cohort of participants is required. We also recognize the variability in available expertise and equipment in all units to undertake the training. The importance and role of US-guided paediatric vascular access are still lacking in recognition and demands wider acceptance.
31 Debriefing strategies for inter-professional simulation
Authors: Holmes Catherine , Mellanby Edward 
Published: January 2022

Inter-professional education is becoming more common worldwide and simulation is one way in which this can effectively take place A literature search (see Figure 1) was performed to prompt discussion around debriefing after inter-professional simulation (IPS) and identify the challenges that this IPS debriefing poses and some potential strategies to overcome these. Gaps in the research were also identified. The papers included were analysed by the authors and key themes were identified.The results of the literature search included 20 papers from 2013 to 2019. Four themes relevant to inter-professional debriefing identified during analysis were: ‘The Debriefer’, ‘Method of Debriefing’, ‘The Learner’ and ‘Psychological Safety’. Several challenges around debriefing after IPS have been identified in the literature, including larger groups of debriefers; inter-professional and larger learner groups; multiple debrief tools and psychological safety including hierarchy issues. Potential strategies to overcome them include an inter-professional debriefing team; a lead debriefer; and learner-centred debriefs with a clear structure. Gaps in the research include challenges around having more than one debriefer including around the psychological safety of participants; whether we should be using the same debriefing tools/practices in IPS as well as other forms of simulation; ensuring a balance between inter-professional learning outcomes and individual learner needs; and the effect of hierarchy in debriefing after IPS.Multiple gaps in the research were identified and there is a need for further research in this area to improve our understanding. Identifying firm answers or rules to follow for every debrief is unlikely to be useful, but a framework to consider the challenges and strategies to overcome them may benefit educators in this area.
102 Haunted House: The Dangers and Ghosts of The Lived Environment
Authors: Neill Kathryn , Morris Duston , Knight Debbie , de Gravelles Pamela , Holland Angel , Ward Wendy , Dickinson Karen 
Published: January 2022

Accurate assessment of potential hazards and challenges within a home environment is essential to ensure the safety of our patients both post-discharge from hospital and within the community. Inter-professional education in this area allows students to learn from, with and about each other to provide more effective patient care. COVID-19 challenged the Arkansas Interprofessional Education Consortium (ARIPEC) to develop meaningful inter-professional activities while minimizing COVID-19 risk The aim of the study was to create and deliver a novel virtual home assessment simulation for inter-professional learners to improve the performance of home assessments state-wide.Faculty from three universities created rooms within a simulated home assessment environment illustrating patient characteristics, hazards, habits and interpersonal considerations. Each university created and video recorded one simulated room (kitchen, bedroom and living room) which were combined in one video to represent a home. Students received pre-course material including education on the INHOMES tool and learning objectives before the virtual learning event. The brief included education on the importance of home assessment and the INHOMEs tool. The simulated home video was played to all students who subsequently were split into break-out rooms with facilitators. In inter-professional groups, students created action plans for immediate needs and for when weight-bearing status allowed increased mobility and identified professionals required to meet needs. Following this debriefs occurred in break-out rooms and then as a large group to summarize and identify take-aways. All students completed a pre-/post-questionnaire including the Interprofessional Collaborative Competency Attainment Survey (ICCAS) and evaluation of simulation methodology, home assessment and overall impression. Mean scores for 5-point Likert scores are reported.In total, 400 students participated in the 2021 event, including medical, pharmacy, physician assistant, dental hygiene, communication science disorders, physical and occupational therapy, addiction studies, respiratory care, radiography, public health, sonography and nursing. All ICCAS metrics increased pre- to post-evaluation. See Student evaluation data from the simulated home environment assessment activityOur results demonstrate that a video-recorded simulated home environment event is successful in supporting the development of an inter-professional action plan for a home assessment using the INHOMES assessment tool. The collaborative creation of this event was essential due to the COVID-19 pandemic, but the efficacy for learning demonstrates the utility of this approach in the post-pandemic area. Virtual simulations increase accessibility for inter-professional learners to learn from, with and about each other for the benefit of our patients.
177 Going Upstream: Key Considerations When Moving a Face-to-Face Simulation Module and Assessment to Virtual Delivery
Authors: Thackray Debbie , Monk Frances , Hamilton Carrie 
Published: January 2022

‘Preparing for on-call’ is a level 6 physiotherapy module delivered face-to-face to enable synthesis of respiratory knowledge and application to real ‘on-call scenarios’, preparing students for the transition into clinical practice. Due to lockdown, we could not deliver this module face-to-face and changed it to a ‘virtual delivery’ for teaching and assessment.The aim of the study was to deliver a face-to-face SBE module and assessment virtually.We used the principles of SBE design We achieved a ‘virtual on-call experience’ by involving SPs, confederate nurse facilitators and physiotherapy clinical educators working synchronously with students via Microsoft Teams. With teaching groups of eight, we kept to the principles of SBE by pre-briefing, running a realistic scenario with clear learning outcomes, followed by a debrief facilitated by the nurse and physiotherapy educator. Students were able to rehearse their clinical reasoning by ‘thinking out-loud’; these preparatory ‘virtual on-call scenarios’ enabled them to become familiar with ‘performing’ on Teams. This ‘process-familiarity’ led to a preparedness, professionally and psychologically for their subsequent ‘virtual on-call assessments’. Four on-call scenarios were delivered in this module, enabling the learning outcomes to be achieved via this method of delivery. The virtual on-call assessment was run in three virtual rooms on Teams, with an SP, a clinical educator as an examiner, a confederate nurse, and one student in each room. The assessment scenario ran for 30 minutes replicating the normal examination time, giving students the opportunity to rehearse the skills they had learnt in the module. Additional supportive information was given to the students by sharing a ‘patient monitor’ (screenshots from the ALS Laerdal manikin monitors). In total, 28 assessments were achieved in 1 day, with two taken separately for extenuating circumstances. Student feedback has been positive with all students passing, enabling graduation this summer.
115 On-Call Bleep Simulation for Final-Year Medical Students
Authors: Patel Krishan , Badiani Krupa , Jaffar Farah , Ismail Joanna 
Published: January 2022

A common concern amongst final-year medical students is the on-call shifts as a Foundation Year 1 (FY1) doctor. With a large focus on knowledge, clinical and communication skills, and practical procedures, there is little in the medical curriculum to cover the non-technical skills required whilst on-call such as prioritization. A novel teaching programme was devised to help develop students’ confidence and preparedness for these shifts. This The aim of this course was to prepare final-year medical students for their on-call duties as FY1 doctors. This includes developing confidence with the technical aspects of on-calls such as managing the acutely unwell patient, as well as the non-technical skills expected from bleep-related tasks such as responding, prioritization and escalation.A total of five sessions were delivered from September to December 2020 for final-year medical students. Twelve simulated on-call ‘activities’ were designed mirroring real tasks commonly encountered as an FY1 on-call. These activities were spread across the hospital involving the medical wards as part of the A total of 17 students completed the on-call bleep simulation. Only a third of the candidates had used a bleep prior to the session. Pre-course, 66.6% of candidates responded feeling not confident about being on-call as an FY1. Encouragingly, following the simulation, 100% felt more confident about being on-call. During the open feedback sessions, students valued the use of hospital wards, practicing procedures under time pressure, and performing handovers. This on-call bleep simulation was very well received and improved students’ confidence and preparedness for being on-call as an FY1 from August 2021. Students commented on how invaluable this training was. This on-call bleep simulation will continue to be implemented as part of the final-year teaching provided at the trust.
124 The Use of Simulation in Improving Stroke Recognition, Assessment and Management
Authors: Jaffar Farah , Hashmi Madiha , Aweid Basaam 
Published: January 2022

Stroke remains the second leading cause of death worldwide and an important diagnosis requiring early recognition and action for optimal clinical outcomes which are time dependent The aim of the course was to inform about the local stroke pathways, ensure juniors are comfortable with recognition of stroke and to develop the non-technical skills required in stroke management, thus enabling skill acquisition in a safe environment.An innovative course was created using SimMan 3G with a focus on ensuring high fidelity to overcome the limitations associated with the practical aspect of stroke assessment in a mannequin. Five scenarios were created to last 15 minutes: three of which involved acute stroke diagnosis and two about stroke ‘mimics’. These scenarios included the involvement of a junior doctor, an acting nurse and acting members of the multi-disciplinary team as required. The debrief following each scenario would cover the technical aspects of management and self and group reflections. To add to the fidelity when assessing a mannequin for neurological conditions, we ensured that slurred speech could be mimicked, weakness in the limbs was showcased and facial asymmetry represented with innovative techniques using the mannequin.Two sessions have been delivered involving nine junior doctors and this has been implemented as a regular course for junior doctors and nurses. All attendees felt more confident with stroke recognition, awareness of stroke mimics and of the local pathways when managing patients with acute stroke.The positive feedback received and the outcome that all attendees felt more confident following the course suggest that stroke recognition and management can be learnt using simulation with a focus on the human factors required to optimize patient care. We hope to continue delivering this course to junior doctors rotating through the hospital and hope to open it up to the wider multi-disciplinary team including nursing staff, healthcare assistants and therapists with a focus on recognition and escalation. Dissemination of learning on local pathways and management using simulation is effective and can impact patient care.
143 The Use of an Audio-Visual Streaming Solution to Deliver Portable COVID Compliant <i>in situ</i> Simulation Training
Authors: Thompson Elizabeth , Thompson Ross , Bartle David 
Published: January 2022

Safe training in the current clinical workplace requires careful participant proximity management. Delivering simulation in a confined clinical environment can impact scenario fidelity and affect psychological safety The aim of the study was to assess the practical efficacy of a portable AV streaming solution to enable real-time The Scotia Medical Observation and Training System (smots™) offers a portable AV solution with flexibility, through the addition of cameras and microphones as required, to create bespoke simulation viewing. Smots™ was incorporated into the Smots™ was an effective platform to meet our aims. Delivery users reported smots™ to be reliable in streaming the AV footage to a target audience in a remote debriefing room. The system was compact, easily transportable and had a low burden of training to achieve user competence. Participant feedback was positive, in that the system provided good AV clarity and narration, thereby enabling a successful training evolution. Smots™ offers a reliable capability to stream simulation scenarios to an alternative viewing area with the ability to be relocated as needed. Local wireless broadcasting range is finite and may limit users’ ability to stream information to discrete departments within a larger trust. Mitigation is possible using a secondary streaming platform or integrating it into a secure internal Wi-Fi or ethernet network. Assistance from trust information technology departments is recommended and this capability is something our team will consider as a future option. Expanding connectivity is an effect multiplier, offering distanced, streamed training across trusts and regions, as well as the inclusion of participants working from home. The portable nature of this smots™ solution offers flexibility for rapid deployment to areas of novel clinical capability and community partnerships. This system has proved exceptionally useful during a prolonged period of social distancing, enabling ongoing high-efficacy
29 Reducing Risk: Simulation-Based Clinical Systems Testing to Determine New Hospital Readiness for Anaesthesia Services
Authors: Girish Sadhu Narasimha Murthy , Reid Leah , Khalid Fouzia 
Published: January 2022

The newly built Women’s Wellness and Research Center (WWRC) replaced the pre-existing Women’s Hospital (WH) as the only provider of tertiary maternity care for the residents of Qatar. The pre-existing WH was smaller, with a 12-bay emergency department, 3 operating theatres, 12 delivery rooms and 220 beds, in shared rooms. The new WWRC facility is significantly bigger, with a 28-bay emergency department, 7 operating theatres over two floors, 26 delivery rooms and 240 private inpatient rooms catering for around 18,000 deliveries per year. New systems, designed over only a few months, would need to promote that same level of high-quality patient care but in a newer, larger and unfamiliar facility.The aim of the study was to identify and mitigate clinical systems risks, relevant to anaesthesia services, by running The ‘WWRC Anesthesia Activation Team’ was established to conduct Approximately 110 hours of simulation were conducted in sites relevant to anaesthesia. Many of the participants had never experienced simulation before but nearly everybody complimented its usefulness and debriefing was unanimously constructive. Testing identified 143 discrete latent safety threats (LST) and were categorized under Facility, Workflow, Personnel, Process, Equipment and Technology (Table 1). Fifty-four LSTs were due to systems that were incomplete at the time of testing but would be completed by the time services commenced. The remaining 89 were significant LSTs which could have resulted in significant clinical incidents. After mitigation of LSTs, the areas were simulation tested again to confirm threat elimination. WWRC was opened only after all areas of concern were addressed. A year after moving, a review of all the changes recommended from the simulation-based systems testing was conducted. It showed that there were no anaesthesia-related clinical incidents in those areas.Our experience confirms that simulation can identify Latent Safety Threats (LST) prior to a major move to a new facility