Simulation Learning

5 Simulation educators discuss their experiences in facilitating Simulation

and

Answer your queries regarding this approach to learning

HEALTH EDUCATION &TRAINING INSTITUTE

Health Care simulation is

• Bridge between classroom learning &

real-life clinical experience

• Students/health care professionals have a safe zone to learn or practice

• Freedom to make errors or different decisions – AND learn from these and their peers

• Able to use simple role-play, low tech or high tech manikins, task trainers, simulated patients

HEALTH EDUCATION &TRAINING INSTITUTE

Styles of Simulation

• Task trainers

• Manikins

• Simulated patients (actors, standardised patients)

• Hybrid patients: use of a mannequin with a simulated patient

• Other hybrid simulations (simulated patient and part task trainer)

• Virtual worlds (virtual and augmented reality)

• Gaming

Jolly B, Nestel D, Sprick C, Module C2: Training simulation educators The NHET-Sim Program (2012) www.nhet-sim.edu.au

HEALTH EDUCATION &TRAINING INSTITUTE

Identify

• Who are your learners?

• Who are your educators?

• Who are your simulation specialists?

• What is your simulation environment?

Jolly B, Nestel D, Sprick C, Module C2: Training simulation educators The NHET-Sim Program (2012) www.nhet-sim.edu.au

HEALTH EDUCATION &TRAINING INSTITUTE

Educator skills

• Debriefing

Different ways, new tools, science of debriefing with in-depth skills

all created an awareness of the ‘unknown’

• Networking

Mentored approach with educators, networks formed within & outside LHDs, training/learning within interprofessional group, expanded to multidisciplinary training (more than faculty to faculty), learn how other health disciplines work

• Improved Confidence

In dealing with infrequent clinical situations with potentially catastrophic outcomes

• Skills

Increased facilitator skills – expanded communication concepts

HEALTH EDUCATION &TRAINING INSTITUTE

The Ideal Simulation

• Imitation of a real-world process or system

• Clinicians practise procedure or routine in a simulated learning environment (SLE) before treating patients

• Safe

• Planned process, objectives and learning outcomes

• Uses reflective practice

• Powerful and sustained learning

HEALTH EDUCATION &TRAINING INSTITUTE

Simulation phases

Preparation

Briefing

Simulation activity

Debriefing/

feedback

Reflection

Evaluation

Jolly B, Nestel D, Sprick C, Module C2: Training simulation educators The NHET-Sim Program (2012) www.nhet-sim.edu.au

HEALTH EDUCATION &TRAINING INSTITUTE

Roles in simulation

• The lead educator (facilitator) – experienced in simulation

methodology, technical skills and takes lead debrief

• The Educator in Role (e.g. Mask ed)

• Simulated Patient

• The Technician

• Learners

• Clinicians (and other experts)

• Technicians/Simulation specialists

• Confederates

• Observers

• Administrators

Simulated Patient Methodology

• Role-play as a patient

• Standardise performance

• Respond to feedback

• Understand educational principles

• Provide feedback

• Part of the faculty

• Involved in the debrief

Variations...

– Unpaid or paid

– Lay or health people

– Professional actors

– Clinical teaching associates

– Simulated v standardised

Ref: Nhet Sim C5 Module. Health Workforce Australia and Monash University

HEALTH EDUCATION &TRAINING INSTITUTE

The Basic Assumption…

Participants here are all• intelligent• well trained• care about doing their best• want to improve

Centre for Medical Simulation Boston

HEALTH EDUCATION &TRAINING INSTITUTE

Confidentiality Safe Learning Environment

Confidentiality agreements each time

• Create a safe learning environment - OK to make mistakes

• What happens here stays here

• Guided reflection of the simulation at debrief

• Once debrief is over, it’s over

• Next stage of learning is learner dependant post simulation

• Participants requested not to disclose details of scenarios -works better if participants do not anticipate what is going to happen

Jolly B, Nestel D, Sprick C, Module C2: Training simulation educators The NHET-Sim Program (2012) www.nhet-sim.edu.au

HEALTH EDUCATION &TRAINING INSTITUTE

Cultural and Psychological Safety

• Simulation is a safe environment for learners

• Learners can make mistakes

• Confidentiality agreements signed

• Scenario has cultural, psychological and physical risk

• Risk is acknowledged and mitigation incorporated into scenario

• Confederate in place to ensure learner, educator and equipment safety

HEALTH EDUCATION &TRAINING INSTITUTE

Debriefing –

what is it and why is it important?

• To report on the emotions and behaviours of the simulation

• To provide a space for structured reflection through facilitated feedback

• To clarify and consolidate insights and learnings from simulation

• For the participant to ‘take away’ their own learnings and convert to behavioural change in the clinical setting

• Multiple models of debriefing

• Debriefing and feedback are different

HEALTH EDUCATION &TRAINING INSTITUTE

Debriefing process

• Vent

• Acknowledge emotions

• What happened (phases)

• What was done well

• What could have been better (at each phase)

• Relevance to experience

• What has been learned

• Transfer to clinical settings

• Revisit emotions

Nhet Sim C2 Module. Health Workforce Australia and Monash Univ.

HEALTH EDUCATION &TRAINING INSTITUTE

Health Education and

Training Institute

Connected Teaching and Learning Webinars Series II

Maureen Winn April 2017

Available at http://www.heti.nsw.gov.au/Nursing-and-

Midwifery/Webinars/

Challenges AND benefits of Simulation-based Education

Challenges• Perceived to be expensive• Specialist educators and

technicians• Specialist skill set to develop

and deliver scenarios • Equipment and physical

infrastructure• Time consuming to develop• Limited access to skilled

educators and simulation centres

Benefits• Experiential yet safe learning• Can be powerful learning• Can develop skills of

educators• Can be inexpensive• Scenarios can be repeated• Learning moment is sustained• Learnings equate to

behaviour change• Can be standardised for

examination purposes

HEALTH EDUCATION &TRAINING INSTITUTE

How to become a

Health Simulation Educator

• Health and Education qualifications and/or experience

• NHET-Sim – www.nhet-sim.edu.au

• Simulation Australasia (including the Australian Society for Simulation in Health) www.simulationaustralia.org.au

• Sim-Net – www.simnet.org.au

• Post graduate studies

HEALTH EDUCATION &TRAINING INSTITUTE

Post Graduate Programs…GRAD CERT

• Clinical Education and Teaching, University of New England www.my.une.edu.au/courses/2012/courses/GCCET

• Clinical Education, Flinders University www.flinders.edu.au/courses/rules/postgrad/gcce.cfm

• Clinical Education and Simulation, Macquarie University www.courses.mq.edu.au/2016/postgraduate/certificate/graduate-certificate-of-clinical-

• Health Care Simulation Education Australian Catholic University www.acu.edu.au/courses/2017/postgraduate/graduate_certificate_in_healthcare_

• University of Tasmania, Monash University, University of Western AustraliaGRAD DIP

• Clinical Education University of Melbourne www./excite.mdhs.unimelb.edu.au/award_courses/grad_dip_in_clinical_education