SIMULATION IN PREHOSPITAL EDUCATION

KIM D. MCKENNA M.ED. RN EMT-P

OBJECTIVES

• List simulation modalities • Outline benefits and barriers to use of simulation in

EMS education • Describe benefits of interprofessional simulation • Identify benefits and draw-backs to mass casualty

simulations

WHAT IS SIMULATION? Techniques that imitate prehospital patient situations and are designed to demonstrate procedures, decision-making, and critical thinking. Jeffries, 2005; McKenna et al. 2015

ADVANTAGES OF SIMULATION

• Provides ‘standard’ experiences

• Allows practice for low frequency high-risk situations

• Permits skill development without patient risk

BARRIERS TO SIMULATION

• Faculty training • Personnel

support • Equipment

31% of programs have

simulation equipment sitting idle or unused

SUPER, McKenna et al. 2015

HOW DO WE USE SIMULATION?

• Hiring or promotion

• Skills

• Situational awareness

• Improving safety

• Communication

• Clinical decision-making

• Remediation

• Promoting team work

HOW DO WE USE SIMULATION?

• Hiring or promotion

• Skills

• Situational awareness

• Improving safety

• Communication

• Clinical decision-making

• Remediation

• Promoting team work

HOW DO WE USE SIMULATION?

• Hiring or promotion

• Skills

• Situational awareness

• Improving safety

• Communication

• Clinical decision-making

• Remediation

• Promoting team work

MASS CASUALTY INCIDENT TRAINING

• Goals should be to improve core response competencies such as • Communication • Incident management • Triage

• Should include multiple disciplines to prevent “silos”, identify problems, and build teams

Glow et al., 2013

2010 - MASTERCARD INTERNATIONAL

INTERPROFESSIONAL SIMULATION?

BENEFITS

• More positive attitudes toward teamwork and collaboration

• Improved relationships

• Role clarification

• Viewing others in a positive manner

BARRIERS

• Scheduling

• Class size

• Program proximity

• Administrative buy-in

• Faculty resistance

• Scope of practice boundaries

2011 – STRUCTURAL COLLAPSE – KMART

2011 – STRUCTURAL COLLAPSE – KMART

Mayday

MEMC – MANUFACTURER WITH HAZMAT

MANUFACTURER WITH HAZMAT

MANUFACTURER WITH HAZMAT

TORNADO AFFECTING A WIDE AREA - 2013

Augusta Missouri

Bus collision with car Patients were guests at a winery Night-time challenges

2014 - RACTAC

St. Charles Community College

GOAL: RESPOND TO A MASS SHOOTING EVENT

• Four stations followed by a scenario • Triage • Moving patients • “Walking with police” • Chest decompression/TK

application

TORNADO IN A RURAL PARK

CARDIOCEREBRAL RESUSCITATION – 2015 LINDENWOOD UNIVERSITY

Objectives: Introduce pit crew approach to resuscitation Use feedback modes to improve CPR effectiveness Review MACC procedure Practice a variety of scenarios. Review incident command

CARDIOCEREBRAL RESUSCITATION

FUTURE GOALS

• CCR refresher training November • Planning meeting for 2016 MCI scheduled in

January • Plan to introduce SALT triage

REFERENCES

• Gaba, D. M. (2004). The future vision of simulation in health care. Qual Saf Health Care, 13(13). doi:10.1136/qshc.2004.009878

• McKenna, K. D., Carhart, E., Bercher, D., Spain, A., Todaro, J., & Freel, J. (2015). Simulation use in paramedic education research (SUPER): a descriptive study. PEC, 9. doi:10.3109/10903127.2014.995845

• McKenna, K. D., Carhart, E., Bercher, D., Spain, A., Todaro, J., & Freel, J. l. Factors Related to Paramedic Program Interprofessional Simulation. Poster Presentation. The International Meeting on Simulation in Healthcare. New Orleans, LA., January, 2015. Abstract published in Simulation in Healthcare. 9(6), December, 2014.