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Simulation to improve patient care
Published in Frances Rapport, Robyn Clay-Williams, Jeffrey Braithwaite, Implementation Science, 2022
Mary D. Patterson, Ellen S. Deutsch
System improvement using implementation science is a newer frontier for simulation. Simulated patient care can help bridge the gap between evidence-based practice, or Work-as-Imagined, and Work-as-Done (Hollnagel, Wears, and Braithwaite 2015), particularly when simulations are conducted in situ, involving actual patient care providers in patient care locations using patient care equipment. In situ simulation can contextualize and potentially improve efficacious processes to achieve real-world effectiveness (Learning Collaborative for Implementation Science in Global Brain Disorders). Debriefing, an essential component of learning from simulations, can explore the interactions between participants and their work systems. Recently, simulations have been conducted to understand adaptations of best practices needed to care for patients infected with COVID-19 (Daly Guris et al. 2020). The COVID-19 pandemic provided a “crash course” in the value of in situ simulation to test and implement a bewildering variety of protocols and processes. Because in situ simulation engages frontline workers and seeks their perspectives during debriefing, a more accurate understanding of the obstacles and adaptations required to adopt new processes is achieved.
The Simulated Patient – your walking, talking learning tool
Published in Ramesh Mehay, The Essential Handbook for GP Training and Education, 2021
Fiona Dudley, Miriam Hawkins, Emma Storr, Mary Davis, Maggie Eisner
The primary function of your simulated patient is as a learning tool, but it is important to remember they are a human one! Just as a carpenter would sharpen their chisels before working with them, so must you prepare your simulated patient before the session. Although all simulated patients should have received general training, they work broadly and will not necessarily have an understanding of the specific requirements of your organisation, your learners or your session. Therefore, it’s important that you take the time to familiarise them accordingly. The better your communication with the simulated patient, the more likely it is that they will provide you and the group with the material you need and the easier it will be to work as an effective team. If there are points crucial to the scenario, it is as well to reiterate them before the session; for example, emphasising the negative responses to some medical history questions. So, if the clinical diagnosis is anaemia, you may wish to highlight the importance of answering depression screening questions in the negative to avoid misleading the trainee.
Cost-effective simulation
Published in Kieran Walsh, Liam Donaldson, Cost Effectiveness in Medical Education, 2021
Jean Ker, George Hogg, Nicola Maran
Public expectations have changed over the past 40 years. Many patients have also become increasingly involved in the education of healthcare practitioners using simulation—either in real or simulated patient roles. The public have an increasing awareness of the training and education of competent healthcare practitioners, and many healthcare education organisations have lay members on their boards. For patients, the obvious (and welcome) cost of simulation is having the best-trained workforce delivering care.
Exploration of students’ reaction in medical error events and the impact of personalized training on the speaking-up behavior in medical error events
Published in Medical Teacher, 2023
Yi-Chun Chen, S. Barry Issenberg, Yu-Jui Chiu, Hui-Wen Chen, Zachary Issenberg, Yi-No Kang, Che-Wei Lin, Jen-Chieh Wu
On the course day, students took a pre-simulation test that they had to pass, before participating in the simulation scenario. Faculty assisted students through discussing and instructing them with the course material if they could not pass the pre-simulation test at their first attempt. To avoid their unfamiliarity of the simulation scenario, students were oriented about the simulation setting and their task to manage the simulated patient, but were not informed that there was going to be a medical error event. Immediately after being briefed about the clinical condition of the simulated patient, each student entered the simulation scenario to interact with a full-body computerized mannequin, a standardized nurse, and the standardized senior physician. Students were expected to evaluate and treat the PSVT patient who either had stable vital signs in the non-life-threatening scenario or unstable vital signs in the life-threatening scenario with the standardized nurse. After a student ordered the correct medicine, the standardized nurse prepared it, and then the senior physician would enter the simulation scenario and order an incorrect medication for the patient. If the student did not speak up to the error event, the nurse delivered the incorrect medicine. If the student did speak up to the error event, the senior physician would initiate discussion with the student about their suggestion for treatment option.
Are Clinicians Confident in the Risk Assessment of Suicide?: A Systematic Literature Review
Published in Archives of Suicide Research, 2022
Admittedly, it is difficult to develop an appropriate paradigm to assess clinician confidence in a scenario that has the pressures of real life suicide risk assessment. Undoubtedly a causal model would produce significant ethical issues, hence there is much reliance on individuals believing that vignettes or simulated patient scenarios are real and not fabricated cases. Gale et al. (2016) explicitly state that participants were led to believe the cases of vignettes were real life, whereas Regehr et al. (2016) used standardized patients and it was unclear whether the participants were aware of this or whether they believed they were truly assessing suicidality. It has been suggested that simulated patients can replicate stressful medical workplace scenarios (Harvey, Bandiera, Nathens, & LeBlanc, 2012) but it is unclear whether a clinician’s confidence would be different in a scenario where the responsibility is truly real. Advancements in technology, such as virtual reality, have already provided successful training alternatives (Rizzo & Shilling, 2017) and hence may provide a more realistic simulation for research purposes too.
Twelve tips for teaching brief motivational interviewing to medical students
Published in Medical Teacher, 2018
Elizabeth J. Edwards, Amy J. Bannatyne, Ashley C. Stark
Well-defined learning objectives are essential for each step of the curriculum. In our program, the learning objectives for the initial 2-hour workshop are as follows: describe common health behavior change theories, identify common influences on peoples’ decisions about their health and recognize the need for an evidence-based approach to behavior change counseling. The learning objective for the role-play triads is as follows: demonstrate principles of brief motivational interviewing during a role-play, and for the small-group practice sessions: demonstrate effective counseling skills during a 10–12 minute brief motivational interviewing consultation with a simulated patient. It is recommended that simulated patient cases are taken from real-world examples, such as, patients overcoming ambivalence to quitting smoking, reducing alcohol, increasing exercise, improving diet, observance of safe sex practices, adherence to medication, and the like.