© 2010 Healthcare Simulation South Carolina healthcaresimulationsc.com Hybrid Task Training...

© 2010 Healthcare Simulation South Carolina • healthcaresimulationsc.com

Hybrid Task Training Simulation with Objective-based Outcomes

for Mastery-based Learning

Presented by

John J. Schaefer, III, MD

Frances W. Lee, DBA

Heidi H. Schmoll, RN, MSN-Ed


Session Learning Objectives

1. Describe "hybrid simulation" and how it can be applied to task trainers

2. Define the “mastery-deliberate practice” educational teaching model

3. Design a program in which hybrid simulation with preprogrammed grading scenarios could be used to create a mastery-deliberate practice educational teaching experience with documented objective-based outcomes.

4. Incorporate hybrid simulation into a new or existing program to support a mastery-deliberate practice educational teaching model.


Session Outline

1. Introduction (10 minutes)

2. Creating a Hybrid Simulation Course (30 minutes)

3. Interactive, Hands-on Exercises with eight interactive stations (30 minutes)

4. Incorporating Hybrid Simulation into new or existing programs (20 minutes)

5. More Hands-on with Questions/Answers (30 minutes)


Charleston, SC Medical University of South Carolina


Conflicts of Interest Disclosure:

John Schaefer, MD:– Patent royalties from Laerdal Medical Corp.

(SimMan/Baby/3G)– Non majority owner of SimTunes (outlet for MUSC

simulation copyrightable material) – Publishing contract with Lippincott through MUSC– Simulation Copyright royalties through MUSC– Grant support from Duke Endowment, Fullerton

Foundation, SC Nursing Deans & Directors


Conflicts of Interest Disclosure:

• Frances W. Lee, DBA– Publishing contract with Lippincott through MUSC – Simulation Copyright royalties through MUSC

• Heidi H. Schmoll, RN, MSN-Ed– Publishing contract with Lippincott through MUSC– Simulation Copyright royalties through MUSC


Hybrid Simulation Definition

• Hybrid simulation is “a blend of two or more different forms of simulation.”


Hybrid Simulation Definition—in this case take:

High fidelity simulator “Operating System” Any task trainer

+

=


Hybrid Task Training Simulation

In this session we are specifically combining the software that runs a high fidelity simulator with non-computerized task trainers (e.g. an IV arm) to create a simulation system that supports:

• running objective based scenarios, • providing feedback, • accessing educational support materials and • reviewing recorded video during debriefing.


Mastery-Deliberate Practice Educational Model Definition

“It’s not practice that makes perfect----it’s perfect practice that makes perfect”

Coach Vincent Lombardi


Mastery-Deliberate Practice Educational Model Definition

The mastery-deliberate practice education model is a training model incorporating formal, repeated exercises with feedback until the learner displays proficiency in a skill, technique or assessment. In this application we are using structured, dynamic hybrid simulations to support deliberate practice to a specified level of mastery.


Hybrid Simulation Skills Lab Concept

Trainee A•Performs task•After practice both review performance•Then switches roles with Trainee B

Trainee B•Runs simulation practice scenario•Logs steps from list in menu•Pulls up debriefing

Accessible to Trainees:

Task curricula (multimedia)

Immediate feedback Objective evaluationVideo feedback


NG Tube Insertion


Key features of the Hybrid Simulation Model

• Simulation scenarios provide deliberate practice with feedback (e.g. video, sound, documents, pictures, vital signs) displayed on the simulated patient monitor to the student learner.



• Another student (the student operator) runs the easy-to-run, menu-based scenario from a laptop computer. The scenario software provides feedback to the learner based on the training objectives. Note: Running the scenario and seeing feedback provides a benefit to student operator as well as the student learner.



• The students alternate roles as learner and operator until both master the learning objectives. This set up may also foster healthy competition and helpful interaction.



• The students may also use the laptop computer to access web-based, or other curricula, built around objectives when appropriate.



• One facilitator (e.g. upper level student, teaching assistant, or teacher) can supervise multiple stations, providing individual help as needed.



• If documentation of student mastery is desired, the facilitator can run a summative evaluation using the same or similar station set up.


Interactive, Hands-on Exercises with eight interactive stations (30 minutes)

1. NG Tube Insertion (2 stations)

2. Urinary Catheter Insertion (Male)

3. Urinary Catheter Insertion (Female)

4. IV Therapy (2 stations)

5. Lumbar Puncture (2 stations)


NG Tube Insertion


Diagnostic Lumbar Puncture


Interactive, Hands-on Exercises with eight interactive stations (goal)

1. Look at the curricula

2. Run the scenario

3. Stop and go to debrief

4. Note objective formative feedback and grade

5. Try from perspective of operator then task performer

6. We will rotate stations


Variations of method

• B-Line• EMS• METI vision• Power Point


IV. Incorporating Hybrid Simulation into new or existing programs (20 minutes)

Station requirements (see Fig. 1)

1. Moveable table and chairs, with minimum dimensions: 48" W * 60" L, alternatively 72" L for extra space if room size accommodates. Serves two students per table. Tables may be grouped as rows or combinations of four tables.

2. Laptop computer with a connected monitor, speakers, and a wireless or USB mouse. USB camera is optional for recording.

3. The appropriate task trainer.

4. Laerdal simulator operating software loaded on the computer (or B-Line/EMS/METIvision)


Room Requirements for a 32-student Hybrid Simulation Skills Lab

1. Seats 32 students at 16 workstations.

2. Front of classroom supports one or two projectors and screens or white boards to review assignments (generally web-based) before starting and to review how to run scenarios. Table area in the front of the classroom should contain elements of two workstations to support summative grading by teaching assistants for other evaluators. Facilitators can also use this table in front of classroom with a central, well-laced pan-tilt-zoom camera to demonstrate techniques to students.

3. Podium with wireless microphone to allow demonstration or speaking from podium.

4. Ceiling speakers.

5. Appropriate computer technology to support audiovisual integration systems such as B-Line SimCapture.

6. Controllable lighting to dim lighting at front of classroom where projector screens are located (controlled from front of classroom near podium).

7. Floor has recessed tracks in a grid representing rows and columns of table layout to support power and data needs to stations.

8. Room supports wireless environment with high bandwidth and traffic (up to twenty computers per room.)

9. Space (closets) for task trainer storage and support located on two sides of room.

10. Four sinks are located in storage area around four corners of the room to allow hand washing related to task training. Soap and paper towel dispensers are needed to support 32 students. Glove boxes are also located on counter top near sinks. Note: May want to consider six sinks with three per side to avoid traffic jam at sinks.

11. Room (with task trainers removed) can be used as classroom or testing room as needed.

12. Estimated room dimensions: approx. 40' * 50'.


Greenville Technical College Project

Faculty were trained in May of 2011

Pilot was performed in June, 2011

Faculty debriefed to discuss feedback from students’ survey and improvements to the hybrid simulation

After IRB approval, the study began in September, 2011

September, October, and November 2011 was performed with ease


GTC Project (Continued)

December retention was performed on the September group

Over 100 students have participated in the study with another 100 students anticipated to complete this January, March, and April

Faculty use a laptop with the high-fidelity Nasogastric Tube Insertion Scenario

All faculty evaluate any student since the scenario is standardized


Logistics

Students are divided into two groups and staggered for time

Students are randomly paired for practice

Students are allowed to practice until they feel they are comfortable

They are randomly chosen for evaluation

Faculty evaluate the students


Results Thus Far

Only the group with retention data collected thus far is presented (N = 37)

No critical steps were missed during evaluation

Averages Scores

Practice 1 90.7%

Practice 2 97.5%

Practice 3 98.9%

Evaluation 99.5%

Retention 82.9%


Feedback

Over 80% of students enjoyed the experience

Faculty feedback described student as “…more confident to perform the skill in the clinical setting” and “…better prepared for the skill and not apprehensive to performing the skill…”


Is this magically easy to do?

“Success is like anything worthwhile. It has a price. You have to pay the price to win and you have to pay the price to get to the point where success is possible. Most important, you must pay the price to stay there.”

Vince Lombardi

© 2010 Healthcare Simulation South Carolina healthcaresimulationsc.com Hybrid Task Training...

Documents

Transcript of © 2010 Healthcare Simulation South Carolina healthcaresimulationsc.com Hybrid Task Training...