bluuebunny/crossref_metadata_2025_split huggingface dataset:
187 A Virtually Perfect Debrief? The Undergraduate COVID-19 Simulation Challenge
Authors: Wells Lyndon , Frost Emily , Waller Annabelle , Newbold David , Gray Victoria 
Published: January 2022

Feedback from undergraduate medical students recognizes high-fidelity immersive simulation-based education (SBE) as an opportunity to put clinical reasoning and behavioural skills into practice whilst guaranteeing patient safety. The tool used in SBE to bridge event experiences with meaningful reflection is the debrief. Debriefing is a facilitated reflection to guide learners through a process of detecting performance issues and exploring rationales for behaviours The aim of the study was to create pre-recorded high-fidelity simulation scenarios with the involvement of course participants, final-year medical students. Use the recorded scenarios to observe simulation, create meaningful discussion and explore both clinical and human factors.Three partially scripted scenarios were recorded involving medical, surgical and COVID-19-specific cases. This included intentionally scripted learning points, as well as unintended developments which generated additional learning. These videos were designed to be shown in a virtual setting or limited number group, therefore allowing for continued simulation training during the height of the pandemic. The virtual simulation session involved a moment-by-moment analysis of each scenario facilitated by a faculty member. This allowed for an observer-led debrief and more in-depth reflection.Most participants gave positive feedback on the perceived quality of this training modality, recognizing its potential to create an engaging environment for learning. There was recognition of its limitations; it cannot replace immersive simulation, however involving service users in the design and implementation enhanced the learning opportunities. The videos created a springboard for discussion encouraging the formation of emergent objectives, including reflecting on behaviours and attitudes. Faculty noted that students were more confident to identify and critique errors as well as challenge poor behaviours when they were not observing a peer. The participants represent a unique cohort of students whose training has been disproportionately affected by the pandemic. We hope that this course has gone some way to address this shortfall.
161 Absent in Body But Present in Spirit: Battling on When Both Learners and Faculty are Remote from the Simulation Centre
Authors: Bailey Paul , Evans Laura , Thorpe Amelia , McDonald Chris , Johnson Mike , Knight Paul , Howick Katie 
Published: January 2022

Over the last year, COVID-19 has constrained the capacity of education centres to deliver face-to-face simulation-based education (SBE). Restrictions on travel between NHS trusts necessitated development of remote simulation to allow learners to participate in training safely. The challenge to maintain training provision was increased due to the imposition of shielding requirements on a member of the education faculty requiring them to isolate at home over a 2-month period (February–April 2021).The aim of the study was to allow educators isolating at home to continue to support SBE, despite their physical absence from the training centre, by:
Simulating the patient role remotely.Facilitating debrief from home. Observing SBE within the simulation suite and supporting subsequent discussions using video conferencing platforms.Supporting delivery of human factors teaching sessions to Trust staff remotely.To deliver SBE remotely for learners with remote faculty rested on three key requirements:
Collaborative and iterative development of scenarios that could be delivered effectively for learners remotely utilizing expertise from the simulation centres education and technical teams. The creation of scenarios optimized for remote delivery.Effective communication and observation between remote faculty, centre-based staff and remote participants over Microsoft Teams (MST) to allow remote facilitation of debriefControlling and voicing the patient simulator from isolation at home via a desktop PC linked with simulation centre systems via a virtual private network (VPN) and utilizing the Zoom platform.Faculty member shielding requirements lasted for approximately 8 weeks and during that period they were able to support a range of SBE courses;
Foundation years doctors (supported 14 courses)Final-year medical students (supported 6 courses)Surgical nurses (supported 1 course)Burns speciality (supported 1 course)Acute care skills: Nurse OSCE provision (supported 4 courses)Human Factors teaching to trust staff (delivered 5 lectures)Key equipment:
PC with dual screens to allow MST and Zoom software to be managed simultaneously to allow response to participant communication and interactions in real time.Headset-Microphone to support effective fidelity within audio exchanges.The facility to contribute to educational provision was mutually advantageous to all members of the educational faculty:
Off-loading some of the burden of training from those within the centre.A positive influence on the mental health for the isolated.Making remote simulation work possible was through whole team collaborative working.
58 Neonatal Critical Care Communication Training Through Simulation: A Novel Regional Course for Neonatal Trainees
Authors: Aguirre Diana , Evans Davy , Negrine Robert , Philpott Alex , Nash Matthew 
Published: January 2022

Challenging conversations occur frequently within neonatology The aim of the study was to design a communication skill simulation course for neonatal trainees.We collected feedback from 10 neonatal trainees and 15 consultants regionally. 53% of consultants and no trainees had received formal communication skills training. Lack of confidence was the highest discussing end of life, post-mortem consent, breaking bad news and conflict resolution. Further feedback from 21 parents and 45 staff locally highlighted lack of privacy, sensitivity, clarity, consistency and empathy as areas to develop. We first trialled a virtual simulation workshop on antenatal counselling during the COVID-19 pandemic. A pre-recorded scenario was played and debriefed live. Two candidates then took part in a scenario, in break-out rooms, followed by a smaller group debrief. A face-to-face course was then developed. The day, designed for eight candidates, began with an introduction session focussed on psychological safety followed by ‘trauma-informed communication’ by a clinical psychologist. The candidates were then split into two groups for scenarios. Each had the opportunity to lead a scenario. Faculty utilized role play with a standardized faculty ‘parent’ and block simulation with an actor. The Diamond Model was used for debrief. A workshop on ‘post-mortem consent’ and a talk from a parent about their neonatal journey were also included.Ten trainees attended the virtual workshop. Nine strongly agreed that the pre-recorded and 10 that the live sessions were useful. All strongly agreed/agreed that the virtual learning environment worked well, was safe and comfortable, the debriefs were structured and educational, and that attendees’ confidence in antenatal counselling had improved. Seven candidates attended the face-to-face course. All strongly agreed/agreed that the sessions were relevant to their practice and skills learnt were transferrable. Self-rated confidence improved in all communication themes. All candidates strongly agreed that the learning environment was safe and supportive. Candidates found both methods of simulation valuable, four preferred block simulation. All would recommend the course to their colleagues. We addressed a training gap by developing this course. Despite using different styles of teaching and adapting to virtual training during the COVID-19 pandemic, feedback was consistently positive suggesting that flexibility enhances learning. A similar course could be developed in other regions to continue to strengthen communication skills training.
106 How the COVID-19 Pandemic has Changed Departmental Teaching in a Tertiary Hospital
Authors: Powell Sarah , Kasfiki Eirini , Blackmore Andrew , Wright David 
Published: January 2022

Pressure from the COVID-19 pandemic on healthcare has had a detrimental effect on the delivery of teaching to junior doctors. During a time when teaching is needed more than ever the constraints of a pandemic have made this challenging. Parallel to this patient safety remains a cause for concern in healthcare systems worldwide The aim of the study was to create an educational programme for the acute medical unit to allow flexibility of learning whilst incorporating key lessons from significant incidents.Our initial approach was to gain an understanding of the problem by consulting the multi-disciplinary team. We spoke with a range of healthcare professionals working on the acute medical unit to identify concerns relating to SIs: in particular, the governance lead was key in this. Following this, we consulted junior doctors using questionnaires to explore the challenges they faced working on AMU. The design of the scenarios is based around two SIs per scenario for a total of five scenarios and all scenarios were based around the management of common conditions seen on AMU. We opted for an interactive ward round style teaching with a particular focus on key skills such as prescribing and taking bloods. With the help of our colleagues at Hull Institute of Learning & Simulation (HILS) the scenarios were filmed in 1 day and later edited to produce a short video.We have designed and created a VR360 teaching programme that combines with departmental induction allowing junior doctors to access learning from anywhere in the world and immerse themselves on AMU. Feedback has been positive so far and we hope to expand this simulation-based learning to allow to include additional topics.
76 Benefits and Challenges of Inter-Professional Education Within the Emergency Department <i>in situ</i> Simulation
Authors: Gooding Sarah 
Published: January 2022

A comprehensive literature review was performed to critically evaluate the benefits and challenges of inter-professional education (IPE) in the Emergency Department (ED) and within A literature review was carried out for manuscripts within my institution’s high-quality online library, as part of a post-graduate assignment. Search terms included keywords: ‘interprofessional education’, ‘interprofessional teams’, ‘simulation’, ‘emergency medicine’, and ‘healthcare’. A total of 23 peer-reviewed manuscripts were identified spanning a publication range of 22 years (1998 to 2020). Analysis of the literature resulted in the identification of 7 subject headings as most relevant to IPE. These subject headings were ‘patient safety’, ‘patient flow’, ‘learning outcomes’, ‘professional identities’, ‘organization’, ‘technology enhanced learning’ and ‘faculty’.EDs are demanding IPE occurs frequently in
33 Infant Abduction: Live Simulation Drills Explore The Risk in The Maternity Unit
Authors: Quayle Alexandra , Harrison Nick , Gaunt Keeley , McGuffie Rochelle 
Published: January 2022

Child abduction is poorly defined in the UK. Legislation varies, defining offences of child abduction, kidnapping and child stealing/plagium. Rabun Proactive planning, security and staff training are required to reduce this risk, and a live simulation was utilized to test these elements, identify risks and provide solutions.A staff member, unknown to the maternity team, was admitted to the ward and gave birth (simulated to a baby girl). Ward staff were informed that there was a restraining order on her partner who was not permitted to visit. An educator from the Clinical Simulation team was tasked with gaining access to the maternity unit, abduct the baby and make their way to a hospital exit and to the car. With the support of Clinical and Governance Midwives, an unannounced live drill was conducted to analyse:
Security of the unitStaff adherence to local policy – proactive planningConflict management and challengeObservation analysis identified:
Access to the maternal unit was gained through tailgating with no challenge from staff.Access to the mother’s room, despite being in close proximity to the midwives’ station, went unchallenged.Staff did not engage or challenge abductor despite a team member identifying concern.Activation of local policy was slowed due to handover time. Lack of awareness of who has called who.Communications between staff members occurred through non-secure social media applications.Security cameras ineffective due to relay of images to a different locationEscape from the unit made easy by unlocked corridors.Certain staff groups unsure of their role.The identification of latent risks in resources and staffing alongside having confidence with protocols and decision-making has illustrated potential serious risks to both mother and baby. This clinical simulation has allowed us to address and provide recommendations to resolve these by highlighting urgent reassessments of security, proactive planning and staff development to ensure the reality of abduction is minimized.
176 Does High-Quality Learning Need High-Fidelity Simulation? Experience from Obstetric Theatres Preparing for the First Wave of COVID-19
Authors: Schnieke-Kind Christopher , Wise Arlene , Stevenson Karen , Alexander Nicki , Theodosiou Kate 
Published: January 2022

In early 2020, medical teams globally faced the challenge of preparing for an unprecedented clinical situation. As well as the predicated scale and severity of the COVID-19 pandemic clinical teams were generally inexperienced in dealing with an infectious agent of this nature. Simulation, particularly high-fidelity, plays an important role in preparing for novel, high-stakes situations. However, at this time, all clinical departments were simultaneously occupied with such preparation. This placed unprecedented demand on resource-dependant, high-fidelity simulation. Here we share our use of multiple simulation modalities, ranging from low- to high-fidelity, to prepare our multi-disciplinary obstetric theatre team for the arrival of the COVID-19 pandemic.The aim of the study was to prepare the local team to manage COVID obstetric patients within the theatre environment, particularly in the context of obstetric emergencies. This preparation must take the form of both institutional learning (the creation of a standardized protocol specifically adapted for obstetric theatres) and individual learning (familiarity by individual team members with guidelines and their roles within them).Multiple modalities of simulation were utilized (This programme of multiple interlinked simulation modalities allowed the creation of a coherent, comprehensive and practical protocol for the management of COVID patients in obstetric theatres in advance of encountering such patients in reality. This protocol was found to be satisfactory to a group of local subject matter experts prior to the arrival of the pandemic. As management of COVID obstetric patients became more familiar, this protocol was reviewed. It was found that no significant alterations were required, indicating that, despite utilizing only a single, high-fidelity simulation session, the original programme of development had pre-empted many of the practical issues that would otherwise only have been discovered later through real-world practice. Individual learning is more challenging to define, but feedback suggested both a greater familiarity with guidelines by individual learners and was able to identify targets for more specific training (e.g. donning/doffing, definitions of aerosol-generating procedures).High-fidelity is often viewed as the highest form of simulation for effective learning. However, its undertaking has a high resource cost. Our experience demonstrated that low-fidelity, less resource-demanding modalities provide significant benefits to both individual and institutional learning.
32 Using a Simulation Environment to Assess the Usability of a Novel Medical Device During the Covid-19 Pandemic
Authors: Sa-Couto Carla , Nicolau Abel , de Sousa Carolina , Cruz Nuno 
Published: January 2022

It was a recognized challenge of lack of ventilators needed to face COVID-19 worldwide. Although ventilators are sparse, self-inflating manual resuscitators are widely available in-hospital services, providing a rapid response to respiratory depression. Based on this, a device (PNEUMA) This work describes the use of a simulation environment to test the usability of a novel device to automate self-inflating manual resuscitators.The usability study was divided into two parts: (1) participants followed a protocol with instructions for assembling and using the system in a non-clinical context (Usability testing. Left panel – assembly of the system (part I); right panel – use of the system in an immersive clinical simulation environment (part II).A convenience sample (two MDs and six RNs) from an intensive care unit of a tertiary Portuguese hospital participated in the test. Usability testing showed that the system was easy and timely assembled, with low complexity of use (e.g. not requiring external help). The clinical scenario tested the transition between spontaneous and mechanical ventilation, and ventilatory parameters’ control, using PNEUMA. All participants reported that the controllable parameters (I:E, RR, Vol, PIP, Plat, and PEEP) were relevant and easy to change. Participants suggested the inclusion of patient parameters such as the tidal volume and lung compliance. Participants also suggested improvements, such as the inclusion of pressure alarms and a more user-friendly interface. All participants reported that they would be willing to use the device for emergency use.The reported study resulted in recommendations and ameliorations of the device, before its use in real settings, in the context of the COVID-19 pandemic. The use of simulation environments for device/systems’ testing provides a timely and standardized approach, enabling a safer clinical practice.
75 No Time To Train? The Use of Simulation to Develop a Pathway and Deliver Training for Emergency Surgery in Maternity During the COVID-19 Pandemic
Authors: Shiels Sally , Choi Desiree , Baxter Linden , Higham Helen 
Published: January 2022

The COVID-19 pandemic presented healthcare workers with a challenge to provide safe clinical care while protecting staff and coping with an evolving situation. The use of simulation to devise and test emergency pathways is well recognized in the literature Recognizing the need to develop a safe pathway, with a limited evidence base, we sought to test the hypothesis that a combination of table-top and This programme involved three phases: pathway development, safety testing and team training. The initial phase was a simulated table-top scenario of a parturient requiring a Category 1 Caesarean delivery under general anaesthetic. This pathway was then used to create a structured simulation scenario to test its suitability. The debrief sessions for each explored three themes: (1) pathway feasibility; (2) timing and (3) feedback.The table-top simulation took place on 11 March. Team-specific outcomes highlighted the logistics of early senior escalation and the rationalization of staff and equipment in theatre. We also recognized deficits in the amount and correct use of personal protective equipment (PPE). Staffing levels and limitations in communication were also key findings. The subsequent The initial phases of the COVID-19 pandemic provided a fertile ground for team consolidation and planning that promoted collaboration in one of the most multi-professional areas of any hospital: the maternity unit. Involvement of all teams meant that deficits in training could be identified early, and changes could be adapted rapidly. The simulations also demonstrated to staff that it was possible to safely deliver a baby within the timeframe. Recognizing that this was not an isolated problem, we shared our resources publicly helping teams in the USA, Laos, Australia and UK to develop their own protocols. Importantly, it improved our response to the second wave.
60 Talking Under Cover: A Virtual Workshop to Improve Communication in PPE
Authors: John Sini 
Published: January 2022

Since 15 June 2020, all hospital staff were mandated by the government to wear a facemask in hospital and it looks like they will remain a permanent feature in healthcare for the foreseeable future. There is a significant body of research about the plethora of adverse effects that wearing masks can have on verbal communication The aim of the study was to develop an interactive virtual workshop aims to improve the verbal communication of healthcare staff whilst wearing Personal Protective Equipment (PPE).We delivered 14 workshops from March 2021 to May 2021 to 80 participants. First, we discussed the barriers that healthcare workers are up against when they are working in Personal Protective Equipment (PPE) and then speak about vocal anatomy and how speech is created. The workshop then focusses on how to make speech clearer whilst also advising healthcare staff on how to look after their voice. To ensure the workshop is interactive, there are a number of exercises that the participants perform and videos of COVID cardiac arrest simulations are used to discuss the potential speech and communication errors in PPE which could affect patient safety in an emergency. Finally, we also incorporated a patient’s perspective in designing this course. They offered very helpful suggestions regarding verbal and non-verbal communication when communicating with patients in PPE, which are often overlooked by healthcare professionals but immensely valuable to improve patients’ and staff experience.We invited hospital departments to book on to the virtual training and collected electronic feedback from participants. As a result of this feedback, we hope to be able to provide face-to-face training in the future and incorporate simulation in the workshops so that participants can practice what they have learnt with higher fidelity and we are better able to understand how the added burden of cognitive bandwidth will influence people’s communication.