Simulation Summit 2011 - Program

PROGRAM

2011 Simulation Summit November 3 - 5, 2011

Marriott Montréal Château Champlain

CONFERENCE SUPPORTERS

MARK YOUR CALENDAR

2012 Simulation Summit November 17-18, 2012, Ottawa, ON, Canada

Interprofessional Teams November 3-5, 2011 | Montreal, Canada

2011 Simulation Summit

THANK YOU TO ALL WHO SUPPORTED THE 2011 SIMULATION SUMMIT

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WELCOME Welcome to Montreal and the 2011 Simulation Summit, jointly hosted by the Royal College of Physicians and Surgeons of Canada, McGill University, and the Arnold and Blema Steinberg Medical Simulation Centre. This is the fourth Simulation Summit and under the leadership of Drs Susan Brien and Kevin Lachapelle, the Planning Committee has put together a rigorous academic program highlighting some of the best research and work in simulation-based medical education from Canada, the United States, and outside North America. As healthcare delivery is increasingly dependent on teams and teamwork, the 2011 Simulation Summit has directed its focus on the training and evaluation of Interprofessional Teams. We all realize the importance of good teamwork but often struggle to bring into practice true team-based simulation training and evaluation. We believe this summit will provide the participants with the necessary knowledge and skills to implement effective team training within their local environment The meeting is anchored by three internationally recognized experts in team training and evaluation; Drs Salas, Hunt, and Fried. Together with oral presentations, abstract presentations, video segments, workshops, and social events, there are ample opportunities to interact and learn from colleagues. Come and share what you know, we would love to hear it. Don’t forget to stay for the post-conference activities on Saturday. There will be three educational streams planned to meet the needs of simulation instructors, administrators and programmers. These workshops are open to anyone with an interest in simulation-based learning and will be offered in both English and French. The opening Reception will take place in Le Caf Conc’ room of the Marriott Château Champlain Thursday November 3, 17:00 hours. Everyone is invited and tickets are only $20 per person. Thank you to McGill University, the Arnold and Blema Medical Simulation Centre and our sponsors for their valuable support. We hope you enjoy the meeting!

Susan Brien, MD, MEd, CSPQ, FRCSC, CPE Royal College of Physicians and Surgeons of Canada

Kevin Lachapelle, MD, FRCSC McGill University/Arnold and Blema Medical Simulation Centre Interprofessional Teams November 3-5, 2011 | Montreal, Canada


Co-Chairs:

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2011 SIMULATION SUMMIT TABLE OF CONTENTS

ACCREDITATION

This event is approved for up to 10.5 + 5.5 post conference credits by the Centre for Continuing Health Professional Education (CCHPE). The Centre for CCHPE, Faculty of Medicine, McGill University is fully accredited by the Committee on Accreditation of Canadian Medical Schools. This event is an Accredited Group learning Activity as defined by the Maintenance of Certification program of the Royal College of Physicians and Surgeons of Canada. Through a reciprocal agreement between the American medical Association and the Royal College of Physicians and Surgeons of Canada, The Centre for CCHPE, Faculty of Medicine, McGill University designates this activity for AMA PRA Category 1 credit(s) up to the maximum number of credit hours noted above. Each physician should claim only those hours of credit that he/she actually spent at the educational activity.



Planning Committee ...................................................5 Selection Committee...................................................5 Educational Goals .......................................................5 Who Should Attend .....................................................5 Registration ................................................................6 Cancellations ..............................................................6 Poster Sessions ..........................................................6 Accommodation ..........................................................6 Exhibits ......................................................................6 Keynote speakers .......................................................7 Program .....................................................................8 Post-Conference Program ...........................................13 Business Meetings ......................................................18 Workshops .................................................................19 Abstracts: Oral Research Presentations ......................................29 Poster Presentations ..................................................39 Conflict of Interest .....................................................84 Floor Plan ...................................................................85

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2011 SIMULATION SUMMIT INTERPROFESSIONAL TEAMS PLANNING COMMITTEE Co-Chair: Susan Brien, MD, MEd, CSPQ FRCSC, CPE

Co-Chair: Kevin Lachapelle, MD, FRCSC

Linda Crelinsten, RN, MA Mark Daly, RRT, MA (Ed.) Ronald D. Gottesman, MDCM, FRCPC, FAAP, FCCM Leslie Graham, RN, BScN, MN, CNCC Vincent Grant, MD, FRCPC

Susanne Lajoie, PhD François Marquis, MD, FRCSC Viren N. Naik, MD, MEd, FRCPC Francesco Ramadori, MDCM, ABA (CCM), FCCP Melina Vassiliou, MD, M.Ed., FRCSC

SELECTION COMMITTEE (Abstracts, Workshops, Videos) Co-Chairs: Viren N. Naik, MD, MEd, FRCPC / Ronald D. Gottesman, MDCM, FRCPC, FAAP, FCCM Farhan Bhanji, MD, FRCPC Kevin Lachapelle, MD, FRCSC Susanne Lajoie, PhD Leslie Graham, RN, BScN, MN, CNCC Vicki LeBlanc, PhD Vincent Grant, MD, FRCPC Stanley J. Hamstra, PhD François Marquis, MD, FRCSC EDUCATIONAL GOALS The Simulation Summit 2011 invites health professionals to live and share the latest innovations with regard to learning opportunities focused on the simulation. Under the theme "The interprofessional teams," the summit this year is the educational objectives include: To advance the utilization of simulation for the assessment and evaluation of teams To promote the use of simulation to define learning gaps in teams To identify the opportunities to use simulation creatively to develop teams

WHO SHOULD ATTEND This 1-1/2 day conference is open to all individuals engaged in the field of simulation, from all healthcare disciplines. This includes: • Health professional educators with an interest in simulation • Simulation educators • Health profession education researchers • Simulation centre/program directors • CPD educators • CME planners



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REGISTRATION Category

Fee

Physician Student* Non-physician Reception

$450 $75 $150 $20 $150

Post conference (Saturday, November 5) *you will be contacted for confirmation of status

Registration will be located on the lower level of the Marriott Château Champlain Registration Hours:

Thursday, November 3 Friday, November 4

08:00-17:00 07:00-17:00

CANCELLATIONS A $25 administration fee will be charged for all cancellations. No refunds after September 28th. POSTER SESSIONS Poster sessions will take place in Salle de Bal room on Thursday and Friday (November 3rd and 4th). Authors will be at their poster during breaks. ACCOMMODATION Discounted rooms have been reserved at the Marriott Château Champlain. Online reservations: https://resweb.passkey.com/go/rcss Tel: (800) 200-5909 for reservations Rate: $179 Single/Double (taxes not included) EXHIBITS Please take time to visit the exhibits located in the Viger room and lower level Foyer. 〉 〉

〉 〉 〉 〉 〉 〉 〉

CAE Healthcare Canadian Network for Simulation in Healthcare

Covidien

DiscoveryCampus Laerdal Medical Canada Ltd. Limbs & Things, Inc. Practice Performance Innovation Unit (Royal College) Royal College of Physicians and Surgeons of Canada Simulab Corporation

Exhibit Hours:

Thursday, November 3 Friday, November 4

13:00-17:00 08:00-17:00 Interprofessional Teams November 3-5, 2011 | Montreal, Canada

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KEYNOTE SPEAKERS

Eduardo Salas, PhD • Pegasus Professor & University Trustee Chair Department of Psychology Institute for Simulation & Training University of Central Florida

Elizabeth (Betsy) Hunt, MD, MPH, PhD • Assistant Professor of Anesthesiology and Critical Care Medicine • Assistant Professor of Pediatrics Johns Hopkins School of Medicine • Director of the Johns Hopkins Medicine Simulation Center

Gerald M. Fried, MD, FRCSC • Chairman, Department of Surgery McGill University • Surgeon-in-Chief McGill University Health Centre


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PROGRAM

DAY 1 08:00 - 17:00 13:00 – 13:15

THURSDAY, NOVEMBER 3

SALLE DE BAL

REGISTRATION

Lower Level Foyer Susan Brien, MD Kevin Lachapelle, MD Moderator: Kevin Lachapelle

Welcome

Opening Plenary

13:15 – 14:15

Simulation based team training and evaluation Learning objectives: Following this presentation the learner will be able to: • Define the components and process of teamwork • Identify metrics of simulation-based teamwork • Discuss the tools available to assess teams

13:55 – 14:15

Teamwork has become an obsession in many industries. But, what do we know about teamwork, team training and team performance measurement after several decades of research? This presentation will highlight what we know about the science and practice of teamwork so far. It will provide insights to those in those in practice as to what contributes to team effectiveness in organizations and how to assess it. Q&A

14:15 – 15:00 15:00 – 16:00

Eduardo Salas, PhD

POSTER SESSION/ EXHIBIT VIEWING / BREAK Oral Research Presentations: Training and Evaluation

Moderator: Viren Naik

15:00 – 15:11

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Within-team debriefing versus instructor-debriefing for interprofessional simulation-based education: A prospective randomized trial

15:11 – 15:22

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Emotions, cognitive load, and learning outcomes during simulation training

Kristin Fraser

15:22 – 15:33

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A new attitude questionnaire designed to evaluate undergraduate health professional students attitude toward the relevance of simulation, IPE, and the precepts of teamwork

Elaine Sigalet

15:33 – 15:44

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Standardized actors as performance evaluators in simulation-based multiple mini-interviews for selection for entry into medical school: would the same candidates get in?

15:44 – 15:55

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16:00 – 16:40

Team training in trauma (3T): A model for evidence-based interdisciplinary crisis management training curricula Video Presentations

Sylvain Boet

Laura Easty

Itay Keshet Moderator: Francesco Ramadori

16:00 – 16:10

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Multidisciplinary Simulation at the University of Ottawa - A Meeting of the Minds in the ER

David Glenn Posner

16:10 – 16:20

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Development of a Low Cost Simulator

16:20 – 16:30

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Teaching Acute Communication and Teamwork using web-based Video Clips of a dramatized obstetrical emergency

David Berger Richardson

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Trauma Team Training in Distributed Simulation (DS) - A low-cost, portable and immersive environment

16:30 – 16:40

Neil Cowie Alexandra Cope


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PROGRAM

DAY 1 16:40 – 17:00

16:52-17:00 17:00-1830

THURSDAY, NOVEMBER 3 Poster Flash Points

SALLE DE BAL Moderated by: François Marquis

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Simulation in the Canadian context: Perceptions of program directors and university administrators

Vicki LeBlanc

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Simulation for family centered care : improving caregiver skills, self-efficacy and quality of life using a practice-until-perfect simulation intervention for seizure management in the home environment

Elaine Sigalet

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The role of leadership in establishing mutual trust and team coordination Q&A

OPENING RECEPTION Featuring the McGill residents jazz trio

Ilian CruzPanesso

LE CAF CONC’


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PROGRAM DAY 2

FRIDAY, NOVEMBER 4

08:00 – 08:30

POSTER SESSION / EXHIBIT VIEWING / BREAKFAST

08:30 – 09:30

Work-based simulation training: Overview of a multidisciplinary professional curriculum Learning objectives: Following this presentation the learner will be able to : • Define in-situ simulation • Discuss methods of integrating in-situ and lab based simulation into curricula • Describe the utilization of simulation to advance the safety and quality agenda

09:11 – 09:30 09:30 – 10:30

In-situ simulation is an effective form of team-based training but it is not a magic bullet. There are inherent risks, benefits and advantages to insitu training and these issues must be understood prior to embarking on point of care training. The success of such a program is truly a team effort involving design, delivery, logistics and evaluation Q&A Oral Research Presentations: Simulation-based metrics

Moderated by: Vincent Grant Elizabeth Hunt, MD

Moderated by: Ronald Gottesman

09:30 – 09:41

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Gender differences in spatial abilities in medical students entering their residency programs – a five-year experience

09:41 – 09:52

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A comparison of the Ottawa GRS and the ANTS scale for evaluating performance in Crisis Resource Management simulation scenarios

Rachel Fisher

09:52 – 10:03

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Mastery versus standard proficiency targets for basic laparoscopic skill training: effect on skill transfer and retention

Nicoleta Kolozsvari

10:03 – 10:14

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Psychometrics of a behavioral marking system for obstetrical teams

Deborah Tregunno

10:14 – 10:25

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From bench to bedside: effective knowledge translation with incorporation of a novel debriefing tool into the new 2011 PALS instructor manual and course Q&A

10:25 – 10:30 10:30 – 10:45

POSTER SESSION/ EXHIBIT VIEWING / BREAK

10:45 – 12:15

Concurrent Workshops (repeated in the afternoon) W-1 Scripted debriefing for teams: optimizing the impact of postsimulation debriefing using a standardized debriefing script

W-2 Interprofessional team training: using simulation to teach professionalism

W-3 Valid, reliable, and fair simulation-based assessment: what you need to know and think about

Jean Langlois

Adam Cheng

Adam Cheng, Elizabeth Hunt, Vincent Grant, Farhan Bhanji, Jonathan Duff Michelle Chiu, Simone Crooks, Amy Fraser, Daniel Power Saleem Razack, Farhan Bhanji, Yvonne Steinert, Meredith Young


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W-4 Creative scenario design: taking interprofessional simulation to the next level

M. Dylan Bould, Sylvain Boet, Glen Posner, Scott Reeves

W-5 Innovative simulation; strategies for developing interprofessional competencies

Eleanor Riesen, Debra Clendinneng, Michelle Morley, Susan Ogilvy, Mary Ann Murray

W-6 Watch one, do (a simulated) one, teach one: integrating video and other tools into procedural skills curricula

Melina Vassiliou, Yo Kurashima

W-7 All for one and one for all: The challenges of simulation for interprofessional teams (French)

François Marquis, Pierre Cardinal

W-8 Debriefing hi-fidelity simulations

Viren Naik, Megan Hayter, Zeev Friedman, Jordan Tarshis

W-9 Nursing simulation: taking it to the next level and beyond

12:15 – 13:30

POSTER SESSION/ EXHIBIT VIEWING / LUNCH

13:30 – 15:00

Concurrent Workshops W-1 Scripted debriefing for teams: optimizing the impact of postsimulation debriefing using a standardized debriefing script

W-2 Interprofessional team training: using simulation to teach professionalism W-3 Valid, reliable, and fair simulation-based assessment: what you need to know and think about

W-4 Creative scenario design: taking interprofessional simulation to the next level

Leslie Graham, Sandra Goldsworthy, B. Nicole Harder

Adam Cheng, Elizabeth Hunt, Vincent Grant, Farhan Bhanji, Jonathan Duff Michelle Chiu, Simone Crooks, Amy Fraser, Daniel Power Saleem Razack, Farhan Bhanji, Yvonne Steinert, Meredith Young M. Dylan Bould, Sylvain Boet, Glen Posner, Scott Reeves

W-5 Innovative simulation; strategies for developing interprofessional competencies

Eleanor Riesen, Debra Clendinneng, Michelle Morley, Susan Ogilvy, Mary Ann Murray

W-6 Watch one, do (a simulated) one, teach one: integrating video and other tools into procedural skills curricula

Melina Vassiliou, Yo Kurashima

W-7 All for one and one for all: The challenges of simulation for interprofessional teams (French) W-8 Debriefing hi-fidelity simulations

François Marquis, Pierre Cardinal Viren Naik, Megan Hayter, Zeev Friedman, Jordan Tarshis


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W-9 Nursing simulation: taking it to the next level and beyond

Leslie Graham, Sandra Goldsworthy, B. Nicole Harder

W-10 Human interruptus: Tech + talk (integrating human and medical simulation)

Nancy McNaughton, Diana Tabak, Kerry Knickle

15:00 – 15:15

POSTER SESSION/ EXHIBIT VIEWING / BREAK

15:15 – 16:15

How individual task oriented skills drive team performance Learning objectives: By the end of the session, the learner will be able to: • Define three levels of performance as it relates to skills acquisition • Understand the importance of evaluating and validating metrics of performance in the simulated and clinical environment • Discuss methods and tools to evaluate performance in the simulated and clinical environment.

15:56 – 16:15 16:15 -16:35

16:27 – 16:35 16:35 – 17:00

This presentation will illustrate an experience teaching technical skills to individuals, incorporating the concepts of simulation and objective metrics of performance. These principals led to the development of metrics of performance in the clinical setting so that transfer of training from the simulated setting to the clinical environment could be evaluated. These learning programs have extended from specific skills to entire procedures. The logical segue is to extend these principals of teaching and objective measurements to situations where the completion of a procedure requires the choreographed performance of the team to achieve an effective outcome. Q&A Poster Flash Points

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Effects of the level of clinical supervision on team resuscitation and resident learning during simulated ICU scenarios

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The effects of operating room team dynamics on trainee’s ability to challenge authority: Measuring health advocacy with patient simulation Q&A

Closing Remarks and Awards

 

Moderated by: Melina Vassiliou Gerald Fried, MD

Moderated by: Leslie Graham Dominique Piquette Devin Sydor

Susan Brien, MD Kevin Lachapelle, MD

Best Presentation Award Arnold Steinberg

PLEASE REMEMBER TO COMPLETE YOUR EVALUATION


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POST CONFERENCE PROGRAM OUTLINE

Participants should meet at the Arnold and Blema Steinberg Medical Simulation Centre to pick up registration materials. A guide will bring you to the New Residence Hall at McGill.

DAY 3

SATURDAY, NOVEMBER 5

08:00-09:00

Workshops: McGill University New Residence

08:30–09:00 09:00–15:30

Steinberg Simulation Centre

REGISTRATION

BREAKFAST Instructor Workshop (Bilingual): Debriefing strategies following team training simulation: This is a full day workshop designed for the non-beginner (beginners are welcome). The workshop will review: 

principles of good debriefing



various methods and approaches to debriefing, and allow for a large component of hands on practice among participants.

McGill University New Residence McGill University New Residence, Prince Arthur B, Level C Facilitated by: Kevin Lachapelle, François Marquis, Farhan Bhanji, Ronald Gottesman, Francesco Ramadori

The initial plenary will be in English while the hands on component will be in separate into French and English. We will be using live but scripted scenarios using standardized actors. Breakouts French: Capacités d’observation Breakouts English: Observational Skills 09:00–15:45

Simulation Program Administrators Workshop (English): One day workshop for simulation program administrators and mangers covering various topics of interest

McGill University New Residence, Prince Arthur A, Level C Facilitated by: Linda Crelinsten, Michelle Morley, Lisa Satterthwaite, Kim Tardioli, Jordan Tarshis Kevin Thomas

08:30 – 09:00 09:00 – 15:45

Workshop – Arnold and Blema Steinberg Medical Simulation Centre

Steinberg Simulation Centre

BREAKFAST Programmers Workshop – (Français) Comment bâtir un scénario efficace et réaliste de simulation haute fidélité : outils et astuces de la technologie

Facilitated by: Guylaine Neveu

La programmation sera fondée sur la technologie Leardal, mais les principles peuvent être appliqués à tous les types de technologie. Les cours seront fondés sur les scenarios, les methods et l’experiénce de l’Université McGill. 09:00 – 15:45

Programmers Workshop – (English)

Facilitated by: Kevin King

How to Construct an Effective and Realistic High-Fidelity Simulation Scenario: Technology tools and Tricks Programming will be based on Laerdal technology but the principles can be applied to all types of technology. Course will be based on McGill’s scenarios, methods, and experience. 16:00 – 16:30

Tour

Arnold and Blema Steinberg Medical Simulation Centre Interprofessional Teams November 3-5, 2011 | Montreal, Canada

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POST CONFERENCE PROGRAM Saturday, November 5, 2011 Instructor Workshop

Debriefing Strategies Following Team Training Simulation

Facilitated by: Kevin Lachapelle, MD, François Marquis, MD, Farhan Bhanji, MD, Ronald Gottesman, MD, Francesco Ramadori, MD McGill University Residence – Prince Arthur B, Level C

09:00 - 15:30

Particpants should meet at the Arnold and Blema Steinberg Medical Simulation Centre to pick up registration materials. A guide will bring you to the New Residence Hall at McGill University.

Language:

The initial plenary will be in English while the hands-on component will be divided into French and English. We will be using live but scripted scenarios using standardized actors.

CanMED Roles: Medical Expert, Communicator, Collaborator, Manager, Health Advocate Debriefing is an important tool to optimize experiential learning. It is a process which allows for learner self-reflection and growth. Debriefing utilizes techniques which can be learned and refined with practice. Although sparingly used following clinical activities, debriefing is the cornerstone of simulation-based teaching, especially following team training using high fidelity simulation. For simulation instructors, the “debrief” is frequently the most difficult aspect of simulationbased activities. This workshop will allow participants to gain insight into the debriefing process and share their debriefing knowledge and experience through interactive simulation scenarios. This workshop will allow participants to practice debriefing skills and allow participants to receive feedback from faculty, peers, and standardized healthcare professionals. Goal: The goal of this workshop is to have participants implement effective debriefing strategies following high–fidelity simulation team-training scenarios. At the 1. 2. 3. 4. 5. 6.

end of this workshop, the participant will be able to: List unique characteristics of an interprofessional team Define and contrast the process of debriefing and feedback. List characteristics of a good ‘debrief’ List 4 components of a structured debriefing Improve observational skills for effective debriefing Appropriately use rating scales and video for effective debriefing • Relating back to scenario objectives 7. Apply effective strategies for a good ‘debrief’ 8. Apply effective strategies for problems encountered during debriefing. For instance: • Scenario breakdown • Emotions • Talkative individual • Non-receptive individual/group (it’s not real/not like my environment) • Silent individual/group • Conflict among group members • Debriefer “stuck” Interprofessional Teams November 3-5, 2011 | Montreal, Canada

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Debriefing Strategies Following Team Training Simulation SATURDAY, NOVEMBER 5, 2011 09:00 – 09:15 09:15 – 10:00

Introductions and Goals Plenary • • • • •

Debriefing; why, what, who, and when Structured vs. non-structured debriefing Debriefing techniques Observational skills, rating scales and forms; defining performance gaps The difficult debrief

10:00 – 10:15 10:15 – 11:00

Break English Observational skills This will be short and snappy video examples of actual scenarios and debriefing situations highlighting various techniques and approaches to debriefing

11:00 – 11:15 11:15 – 12:00

Break English Debriefing View and practice debriefing scenarios (easy to medium difficulty) practice with standardized healthcare professionals

12:00 – 13:00 13:00 – 15:00

15:00 – 15:30

French Capacités d’observation Des exemples vidéo très brefs et percutants de scénarios et de situations de débreffage réels feront ressortir diverses techniques et démarches de débreffage

French Débreffage Voyez des scénarios de débreffage (niveau de difficulté allant de facile à moyen) et exercez-vous à les utiliser avec des professionnels de la santé standardisés Lunch

English Debriefing Debriefing highlighted with standardized healthcare professionals

French Débreffage Séance de débreffage avec des professionnels de la santé standardisés

Group feedback and Wrap up

Optional: Following the workshops, there will be a tour of the Arnold and Blema Steinberg Medical Simulation Centre at 3575 Parc Avenue, Suite 5640 from 16:00-16:30


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POST CONFERENCE PROGRAM Saturday, November 5, 2011

Workshop for Simulation Program Administrators

Facilitated by: Linda Crelinsten, RN, MA, Michelle Murray, Lisa Satterthwaite, Jordan Tarshis McGill University Residence – Prince Arthur A, Level C

09:00 - 15:45

Particpants should meet at the Arnold and Blema Steinberg Medical Simulation Centre to pick up registration materials. A guide will bring you to the New Residence Hall at McGill University.

Target Audience: Language: CanMED Roles:

Directors, managers and coordinators of simulation programs English Manager, Communicator

Learning Objectives: Upon completion of this workshop simulation staff will have a better understanding of the infrastructure required for a successful program or centre. Participants will: • Gain a better understanding about how to build a team with diverse skill sets and improve staff training. • Discuss opportunities for revenue generation and the relationship that is required with their institution, hospital or university. • Review health and safety issues in simulation centres and identify the different policies and procedures required to work with the human patient simulators, versus cadavers and animal tissue. • Compare and contrast the different accreditation processes and evaluate what is the best fit for their simulation program. Each session will begin with a short presentation by a panel followed by participant discussion and Q & A. SATURDAY, NOVEMBER 5 09:00 – 09:30 09:30 – 10:30

Welcome and Introductions

McGill University Residence Linda Crelinsten

Staffing: How do we find the right help?

10:30 – 10:45

Break

10:45 – 11:45 11:45 – 12:45

Revenue Generation: What we charge for, what should we charge for? Lunch

12:45 – 13:45

Surgical Skills Labs: What are the health and safety issues

13:45 – 14:45

Accreditation: by whom, when, how to?

14:45 – 15:30

Should we have a support network?

15:30 – 15:45

Wrap-up and follow-up

Optional: Following the workshops, there will be a tour of the Arnold and Blema Steinberg Medical Simulation Centre at 3575 Parc Avenue, Suite 5640 from 16:00-16:30 Interprofessional Teams November 3-5, 2011 | Montreal, Canada

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POST CONFERENCE PROGRAM Saturday, November 5, 2011 Programmers Workshop

How to Construct an Effective and Realistic High-Fidelity Simulation Scenario: Technology Tools and Tricks Facilitated by: Guylaine Neveu, RRT (Français), Kevin King, CCP(F), MBA(CAN) (English) Arnold & Blema Steinberg Medical Simulation Centre Target Audience: Language: CanMED Roles:

09:00 - 15:45

Simulation programmers, technicians and instructors Concurrent workshops English and French Medical Expert, Collaborator, Communicator

Abstract: Educators work hard to develop learner centered-objectives, scenarios and curricula. They focus on identifying learning gaps, giving feedback, and providing an environment for good debriefing. Central to the success of this educational activity is a simulation scenario which provides clinically relevant situations that seamlessly create a realistic living environment into which learners are immersed. This does not happen by chance. It occurs through careful and realistic programming based on learner objectives, understanding the functionality of your mannequin, applying special effects to improve realism, and being able to troubleshoot common technical problems which occur during a scenario. This workshop will focus on how to bring to life a simulation scenario so that it is effective, realistic, and provides the necessary platform for learning. This will be done via hands-on work with programming scenarios, learning the tricks of creating special effects, and actual trouble shooting technical problems. Goal: The overall goal of the workshop is to provide participants with the necessary knowledge and skill to program and create a simulation scenario Objectives: The workshop is divided into three parts: • How to program an educational scenario • Understand what your mannequin can and cannot do • Understand how your mannequin program functions • List principles of scenario building • Link learning objectives to your high-fidelity • Using advanced features • Realism. Tricks of the trade • Environmental Realism • Moulage • Special Effects • Incorporating Standardised Actors • Scenario Trouble Shooting • List ten typical problems and how to fix them Interprofessional Teams November 3-5, 2011 | Montreal, Canada

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BUSINESS MEETINGS By invitation only 08:00-17:00

WEDNESDAY, NOVEMBER 2, 2011 Canadian Pediatric Simulation Network For information, contact: Dr. Ronald Gottesman at: [email protected] or Dr. Vincent Grant at: [email protected]

13:00-17:00

08:00-12:00

Industry Roundtable For information, contact John Parker at: [email protected] or Linda Crelinsten [email protected]

Montreal Marriott Château Champlain Maisonneuve A

THURSDAY, NOVEMBER 3, 2011 Canadian Network for Simulation in Healthcare For information, contact, Linda Crelinsten at:

Montreal Marriott Château Champlain

[email protected] 07:30-12:00

Arnold & Blema Steinberg Medical Simulation Centre

Huronie A&B (Plaza level)

Royal College Simulator Instructor Training Committee

Montreal Marriott Château Champlain Terrace (Plaza level)


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WORKSHOPS Thursday, November 3, 2011 Deliberate Practice: simulated families help meet communication outcomes

Facilitated by: James Downar, MD, Patti O’Brien, Assistant Director Professional Affairs, Royal College

Friday, November 4, 2011 W-1 Scripted Debriefing for Teams: Optimizing the impact of post-simulation debriefing using a standardized debriefing script

Facilitated by: Adam Cheng, MD, Elizabeth Hunt, MD, Vincent Grant, MD, Farhan Bhanji, MD, Jonathan Duff, MD

W–2 Interprofessional Team Training: Using simulation to teach professionalism Facilitated by: Michelle Chiu, MD, Simone Crooks, MD, Amy Fraser, MD, MSc, MHPE, Daniel Power, MD, CCFP (EM)

W–3 Valid, Reliable and Fair Simulation-based Assessment: What you need to know and think about

Facilitated by: Saleem Razack, MD, Farhan Bhanji, MD, Yvonne Steinert, PhD, Meredith Young, PhD

W–4 Creative Scenario Design: Taking interprofessional simulation to the next level

Facilitated by: M. Dylan Bould, MB, ChB, FRCA, MEd, Sylvain Boet, MD, MEd, Glenn Posner, MD, Scott Reeves, PhD

W–5 Innovative Simulation Strategies for Developing Interprofessional Competencies

Facilitated by: Eleanor Riesen, RN, PhD, CPsych, Debra Clendinneng, Michelle Morley, Susan Ogilvy, Mary Ann Murray

W–6 Watch One, Do (A Simulated) One, Teach One: Integrating Video and Other Tools into Procedural Skills Curricula Facilitated by: Melina Vassiliou, MD, M.Ed., Yo Kurashima, MD, PhD

W–7 All for One, and One for All: The Challenges of Simulation for Interprofessional Teams Facilitated by: François Marquis, MD, Pierre Cardinal, MD

W–8 Debriefing the High-Fidelity Simulations

Facilitated by: Viren Naik, MD, Megan Hayter, MD, MEd, Zeev Friedman, MD, Jordan Tarshis, MD

W–9 Nursing Simulation: Taking it to the next level and beyond

Facilitated by: Leslie Graham RN, BScN, MN, CNCC, Sandra Goldsworthy, RN, BScN, MSc, CMSN, B. Nicole Harder, RN, BN, MPA

W–10 Human Interruptus: Tech + Talk (Integrating human and medical simulation)

Facilitated by: Nancy McNaughton, MEd, PhD, Diana Tabak, MEd (S), Kerry Knickle, LLM (ADR) Interprofessional Teams November 3-5, 2011 | Montreal, Canada

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WORKSHOPS

Thursday, November 3, 2011 Deliberate Practice: simulated families help meet communication outcomes Facilitated by: James Downar, MD, Patti O’Brien, Assistant Director Professional Affairs, Royal College Neufchatel Target Audience: Level: Language:

10:00 o 12:00 All allied health professionals involved in simulation-based education Beginner / Intermediate English

CanMED Roles: Communicator, Collaborator, Health Advocate Learning Objectives: Upon the completion of this session, participants will be able to: 1. Describe the practical advantages of using standardized patients in simulation based education 2. Discuss the relevance of this simulation format in acquiring knowledge, enhancing comfort when dealing with conflict, and improving communication skills. 3. Identify important considerations and success factors for implementation of standardized patient simulations as an educational strategy. Supporting patients and family members in end-of-life decision making requires a certain degree of proficiency in communication and conflict management skills. These skills can be difficult to acquire and even more difficult to apply. Teaching these skills to health care providers is a challenging task, one that has been undertaken using a variety of teaching strategies. Adding standardized patient simulation as an experiential learning activity to the teacher’s tool kit can provide a realistic opportunity for learners to apply knowledge, enhance their comfort level and engage in reflective practice. This workshop is geared toward simulation instructors and medical educators who are interested in using this type of simulation to enhance and reinforce CanMEDS roles outside the medical expert role. Attendees will have the opportunity to participate in/or observe a simulated conversation about end-of-life decisions and will participate in a hands-on session where they will begin identifying practical considerations for imbedding this type of simulation into their own curriculum.


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Friday, November 4, 2011 W-1 Scripted Debriefing for Teams: Optimizing the impact of postsimulation debriefing using a standardized debriefing script

Facilitated by: Adam Cheng, MD, Elizabeth Hunt, MD, Vincent Grant, MD, Farhan Bhanji, MD, Jonathan Duff, MD Target Audience: Level: Language: CanMED Roles:

All allied health professionals involved in simulation-based education Beginner / Intermediate English Medical Expert, Communicator, Collaborator, Health Advocate, Scholar, Professional

Learning Objectives: Upon the completion of this session, participants will be able to: 1. Describe the theory behind existing debriefing scripts; 2. Discuss the importance of debriefing scripts; 3. Apply a debriefing script to enhance learning from post-simulation debriefing. Effective post-simulation debriefing helps teams understand the basis of their actions and ultimately, close performance gaps that were identified during the simulation. Our team of investigators (EXPRESS collaborative) has developed and studied a debriefing script which improves acquisition of knowledge and behavioural skills when used by novice debriefers. This workshop is geared towards simulation instructors who are interested in improving the quality of debriefing sessions by using a simple and generalizable debriefing script for simulation-based education. We will briefly examine the theory behind scripted debriefing, introduce the debriefing script, and then allow hands-on opportunity for participants to learn how to use the debriefing script.


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Friday, November 4, 2011 W–2 Interprofessional Team Training: Using simulation to teach professionalism

Facilitated by: Michelle Chiu, MD, Simone Crooks, MD, Amy Fraser, MD, MSc, MHPE, Daniel Power, MD, CCFP (EM) Target Audience: Level: Language: CanMED Roles:

This interprofessional, intermediate level workshop would be of interest to faculty looking to gain skills and practical knowledge on how to use simulation to teach professionalism Intermediate English Professional, Communicator, Collaborator

Learning Objectives: By the end of this workshop participants will be able to: 1. Define professionalism; 2. Identify the strengths/limitations of how simulation can be used to teach this competency; 3. Develop a relevant “professionalism” scenario including learning objectives. Professionalism is a competency required of all health professionals, yet it is one that is challenging to teach and evaluate. Many national and provincial regulators have demanded that this needs to be addressed at all educational levels and in all medical and allied-health specialties. Simulation provides the ideal setting to teach, observe and assess this specific competency in a safe and controlled environment. How can simulation be used to teach professionalism for teams? In this interactive workshop, a trigger video will be shown which highlights specific aspects of professionalism within a team. The video will serve to promote group discussion on the definition of professionalism. Workshop participants will be divided into four facilitated breakout groups, with each group designing and developing a simulation scenario that addresses a professional learning need. A tailored scenario template will be used that documents: learning objectives, scenario setup, scenario implementation and debriefing points. Each group will present their approach to a different professionalism problem and by the end of the workshop, participants will bring home four fully developed scenarios to trial at their own centre. Participants must consent to share their work with other participants of this workshop.


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Friday, November 4, 2011 W–3 Valid, Reliable and Fair Simulation-based Assessment: What you need to know and think about Facilitated by: Saleem Razack, MD, Farhan Bhanji, MD, Yvonne Steinert, PhD, Meredith Young, PhD Target Audience: Level: Language: CanMED Roles:

Health professions educators who currently use or are interested in using simulation-based evaluation tools Beginner / Intermediate Plenary in English. Discussion and small group work is bilingual Medical expert, Communicator, Collaborator, Manager, Health Advocate, Scholar, Professional

Learning Objectives: By the end of this workshop participants will be able to: 1. Develop simulation-based evaluation strategies to assess performance; 2. Describe the common psychometric indicators used in interpreting results of simulationbased assessments. Ideal assessment strategies should be systematically aligned to curricular outcomes, thereby not only measuring student achievement, but also playing an integral role in learning and teaching. Increasing curricular focus in the health professions on authentic practice-based assessment contexts makes simulation-based assessment particularly attractive as a tool for performance assessment. Simulation offers a unique learning environment that challenges learners to perform in an authentic clinical encounter with no risk to patient care. Well-designed simulation based assessment also offers the opportunity to evaluate students’ performance in realistic contexts, with the potential for rational linkage between what students are taught (curriculum) to curricular outcomes, and ultimately, through attention to the authenticity of the design, to their practice as professionals. In designing effective and valid simulation-based assessment tools educators must bring together two discrete bodies of knowledge –that of simulation-based educational interventions (considering contextual factors such as authenticity and fidelity), and that of the interpretive sciences of the psychometrics of performance-based evaluation (considering factors such as reliability, validity, generalizability, equity and bias). The authors have designed an interactive case-based workshop in which participants will explicitly consider the design of simulation-based assessment tools through these two lenses, understanding the importance of both and the relationship between them. Simulation-based assessment is being used in a wide variety of settings, from primary health professions education to the assessment of practicereadiness for international medical graduates and, as such, carries with it many important equity and bias concerns that must also be considered in the design of fair and valid tools. We will present a framework for educational assessment tools evaluation, and participants will have the opportunity to enhance their understanding of the design of authentic, fair and valid simulation based assessment tools by applying this framework to the cases of simulation-based assessment presented and from their own contexts.


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Friday, November 4, 2011 W–4 Creative Scenario Design: Taking interprofessional simulation to the next level

Facilitated by: M. Dylan Bould, MB, ChB, FRCA, MEd, Sylvain Boet, MD, MEd, Glenn Posner, MD, Scott Reeves, PhD Target Audience: Level: Language:

Anyone involved in or interested in becoming involved in interprofessional simulation Intermediate Plenary in English. Small groups bilingual

Learning Objectives: At the end of the session, participants will be able to: 1. Design scenarios that highlight interprofessional elements of care; 2. Consider hybrid simulation to optimize learning objectives; 3. Recognize and implement the concept of ‘sociological fidelity’. Interprofessional collaboration in healthcare involves the development of a shared mental model between team members. Simulation-based education with an interprofessional group allows learning within the same team structure that the learners will experience in the clinical realm giving the opportunity to accurately reproduce team interactions. The learning objectives and scenarios are the foundation of simulation and it is essential that these elements focus on aspects that are missing from sessions that are limited to professional silos. However, to effectively focus on these interprofessional elements, educators must do more than just getting learners from different healthcare professions in the simulator together. This workshop will focus on how to design learning objectives and simulation scenarios that will maximize the learning opportunities of interprofessional simulation, with the ultimate goal of improving team performance and therefore patient safety. We will discuss (1) the importance of involving an interprofessional team of educators in scenario design, (2) how to target the shared mental model, (3) how hybrid simulations can be an effective way of reproducing a full range of tasks for a team, (4) how to recognize when simulation is unintentionally reproducing existing power relationships and hierarchies in healthcare and how to optimally implement the concept of sociological fidelity. Participants will have the opportunity to practice creating learning objectives and scenarios in small groups with subsequent discussion with the whole group.


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Friday, November 4, 2011 W–5 Innovative Simulation Strategies for Developing Interprofessional Competencies

Facilitated by: Eleanor Riesen, RN, PhD, CPsych, Debra Clendinneng, Michelle Morley, Susan Ogilvy, Mary Ann Murray Target Audience: Level: Language: CanMED Roles:

All Intermediate English Communicator, Collaborator, Professional

Learning Objectives: At the end of the session, participants will be able: 1. Identify the benefits and challenges of using virtual reality simulation; 2. Describe strategies for incorporating virtual reality simulation in healthcare curricula; 3. Practice evaluating team performance in a virtual reality simulation. Simulation experiences in online immersive worlds enhance learners' abilities to develop teamwork and communication skills. We will describe the process of creating, implementing and evaluating an innovative educational program in a virtual world where learners interact as avatars. Participants in this session will practice evaluating a team simulation in virtual reality, discuss the results and future implications.

W–6 Watch One, Do (A Simulated) One, Teach One: Integrating Video and Other Tools into Procedural Skills Curricula Facilitated by: Melina Vassiliou, MD, M.Ed., Yo Kurashima, MD, PhD Target Audience: Level: Language: CanMED Roles:

All Beginner / Intermediate Bilingual Medical Expert, Communicator, Collaborator

Learning Objectives: At the end of the session, participants will be able: 1. Recognize the importance of learner motivation in the acquisition and retention of procedural skills; 2. Effectively integrate video into procedural skills training Create simulation-based curricula that combine different genres of simulation (hybrid); 3. Observe and evaluate student performance and provide feedback during and after a simulated procedure or skill.


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Friday, November 4, 2011 W–7 All for One, and One for All: The Challenges of Simulation for Interprofessional Teams Facilitated by: François Marquis, MD, Pierre Cardinal, MD Target Audience: Level: Language: CanMED Roles:

Multidisciplinary Teams Intermediate French Communicator, Collaborator, Manager

Learning Objectives: Upon completion of this session participants will be able to: 1. Understand the unique challenges in creating high-fidelity simulations for multidisciplinary teams; 2. Adapt the content of both simulations and debriefings to the multidisciplinary paradigm.

W–8 Debriefing the High-Fidelity Simulations

Facilitated by: Viren Naik, MD, Megan Hayter, MD, MEd, Zeev Friedman, MD, Jordan Tarshis, MD Level: Language: CanMED Roles:

Intermediate English Communicator, Collaborator, Manager

Learning Objectives: Upon completion of this session participants will be able to: 1. Use different strategies to get through difficult debriefings; 2. Adapt debriefing strategies to different simulation situation; 3. Adapt debriefings for ‘debriefers’.


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Friday, November 4, 2011 W–9 Nursing Simulation: Taking it to the next level and beyond

Facilitated by: Leslie Graham RN, BScN, MN, CNCC, Sandra Goldsworthy, RN, BScN, MSc, CMSN, B. Nicole Harder, RN, BN, MPA Target Audience: Level: Language:

All members of the interprofessional team Intermediate English

Learning Objectives: At the end of the session, participants will be able to: 1. Identify barriers and opportunities to interprofessional simulation; 2. Discuss the appropriateness of interprofessional simulation within a variety of contexts; 3. Create a variety of sample outlines of a interprofessional simulation. Interprofessional education has become the new buzz word in healthcare. Adopting a team approach to optimize patient safety, hospitals and academic institutions hone their skills using simulation. In designing team based simulations, important questions such who are members of the inter-professional (IP) team need to be addressed. When designing IP simulation balancing role recognition with role confusion needs to be considered. In this workshop, the controversies of IP simulation are illuminated. Engaging in group discussion barriers and opportunities will be explored. The participants will create a sample of an IP simulation unique to their work environment.


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Friday, November 4, 2011 W–10 Human Interruptus: Tech + Talk (Integrating human and medical simulation)

Facilitated by: Nancy McNaughton, MEd, PhD, Diana Tabak, MEd (S), Kerry Knickle, LLM (ADR) Target Audience: Language: CanMED Roles: Professional

All English Medical Expert, Communicator, Collaborator, Health Advocate,

Learning Objectives: Upon the completion of this session, participants will be able to: 1. Describe a conceptual model illustrating the continuum and intersections of human and medical simulation; 2. List the relevant and practical applications of different simulation modalities along the continuum; 3. Engage in or observe a hybrid simulation applying the conceptual model. Technical procedural and communication skills are seldom taught together but are required to be integrated in clinical practice. Engaging living and medical simulation modalities in teaching and assessment practices can contribute to the depth of clinical learning across a spectrum of skills, knowledge and behaviour. This workshop will provide a conceptual model for thinking about where and how to integrate human simulation with other simulation modalities along a continuum of learning. Participants will be invited to reflect on factors influencing effective implementation of different simulation modalities and opportunities for enhancing existing simulation curricula at their institutions. Technical expertise and communication skills for interacting with the patient, family and health care team will be explored via participation in or observation of a hybrid simulation.


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ORAL RESEARCH PRESENTATIONS – SALLE DE BAL Thursday, November 3

15:00 - 16:00

Within-Team Debriefing versus Instructor-Debriefing for Interprofessional Simulation-based Education: A Prospective Randomized Trial

Boet, Sylvain (The Ottawa Hospital, Ottawa, ON, CAN); Bould, M Dylan (Children’s Hospital of Eastern Ontario, Ottawa, ON, CAN); Sharma, Bharat (Allan Waters Family Patient Simulation Centre, Toronto, ON, CAN); Reeves, Scott (Li Ka Shing International Healthcare Education Centre & Li Ka Shing Knowledge Institute of St Michael’s Hospital, Toronto, ON, CAN); Naik, Viren (The University of Ottawa Skills and Simulation Centre, Ottawa, ON, CAN); Triby, Emmanuel (Faculté de Sciences de l’Education, Strasbourg, FRA); Grantcharov, Teodor (Allan Waters Family Patient Simulation Centre, Toronto, ON, CAN)

Objective: This study compared the effectiveness of within-team debriefing (led by the individuals of the team itself without external instructor) to that of instructor debriefing on interprofessional team performance during a simulated operating room (OR) crisis. Methods: After IRB approval, 120 participants were grouped into 40 teams consisting of one anesthesia resident, one surgical resident and one staff circulating OR nurse. An actor played the scripted role of an OR scrub nurse. All teams managed a simulated crisis scenario (pre-test). Teams were then randomized to either a within-team debriefing or an instructor debriefing. In the within-team debriefing group, the teams reviewed the video of their scenario by themselves with a debriefing guide based on the Ottawa Global Rating Scale. The teams in the instructor debriefing group reviewed their scenario, guided by a trained instructor. Immediately following debriefing, all teams were recorded managing a different intraoperative crisis scenario (post test). After data collection, three blinded expert examiners rated all performances in a random order using the validated TEAM scale. Results: A two-way, mixed ANOVA detected a significant improvement in team performance from pre-test to post-test (p=.008) with no significant effect of the debriefing type received (p=.91). The effect of debriefing modality showed no interaction with respect to pre or post test performance (p=.52). Conclusion: Within-team debriefing results in measurable improvements in team performance in simulated crisis scenarios, and may be as effective as instructor team debriefing for interprofessional team-based simulation, which could improve costeffectiveness and flexibility of scheduling.


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15:00 - 16:00

Emotions, Cognitive Load, and Learning Outcomes During Simulation Training

Fraser, Kristin (University of Calgary, Calgary, AB, CAN); Ma, Irene (University of Calgary, Calgary, AB, CAN); Wright, Bruce (University of Calgary, Calgary, AB, CAN); McLaughlin, Kevin (University of Calgary, Calgary, AB, CAN)

Our objective was to assess the emotional reaction and cognitive load of learners during simulation training, and the association between these and learning outcomes. Participants were 84 first year medical students at the University of Calgary training on a cardiorespiratory simulator (Harvey). We used an eight item rating scale to assess students’ emotional reaction to training, and a nine-point Likert-type rating scale to assess cognitive load. We evaluated diagnostic performance on the same simulated clinical findings one hour after training. We used factor analysis to identify the principal components of emotion, and multiple linear regression to study the association between emotion and cognitive load, and cognitive load and diagnostic performance. We identified two principal components of emotion, representing “enjoyment” and “anxiety”. We found a significant positive association between both enjoyment and anxiety and cognitive load (regression coefficient [95%CI] 0.66 [0.31, 0.01], p < 0.001 and 0.47 [0.13, 0.82], p = 0.007, respectively). There was a non-linear (inverted U) relationship between cognitive load and diagnostic performance, with significantly lower diagnostic performance for students in the highest cognitive load tertile (p < 0.001). Emotions experienced during simulator training are associated with perceived cognitive load, which is, in turn, related to learning outcomes. Specifically, learning outcomes decline with high levels of cognitive load. Further studies are needed to evaluate aspects of simulation that contribute to emotions and cognitive load so that we can maximize learning outcomes.


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15:00 - 16:00

A New Attitude Questionnaire Designed to Evaluate Undergraduate Health Professional Student Attitudes Toward the Relevance of Simulation, IPE, and the Precepts of Teamwork

Sigalet, Elaine (University of Calgary, Community Health Science, Division of Medical Education and KidSIM ASPIRE Research Team, Calgary, AB, CAN); Grant, Vince (University of Calgary, Faculty of Medicine, and KidSIM ASPIRE Research Team, Calgary, AB, CAN); Robinson, Traci (KidSIM-ASPIRE Pediatric Simulation Research Program, Alberta Children's Hospital, University of Calgary KIDSIM Program Alberta Children's Hospital, Calgary, AB, CAN); Donnon, Tyrone (University of Calgary, Community Health Science, Division of Medical Education and KidSIM ASPIRE Research Team, Calgary, AB, CAN)

There is no standardized measure in health professional education to evaluate attitudes of participants to the learning modality used to deliver interprofessional education (IPE). The KidSIM Attitude Toward Teamwork in Training Utilizing Designed Educational Simulation (ATTITUDES) Questionnaire was developed to assess learners’ attitudes towards relevance of simulation in teaching IP teamwork, the IPE, and the concepts of teamwork. A quasiexperimental pre-test/post-test research design was used. Consenting undergraduate students (n=196) from nursing, medicine and respiratory therapy completed the questionnaire prior to and immediately after engaging in two scenarios of pediatric critical illness (sepsis, seizure, anaphylaxis or asthma). All learning was conducted as an interprofessional team. There were highly significant increases in the value placed on an IPE curriculum, utility of simulation in teaching IPE, and the role of teamwork in delivering patient care (each p < 0.001) in all student groups. The internal reliability coefficient (Cronbach’s alpha) of the KidSIM ATTITUDES questionnaire was α = .95. An exploratory factor analysis resulted in a five-factor solution accounting for 61.6% of the variance. Factors suggest we measured relevance of simulation (α = 0.83), relevance of IPE (α = 0.90), communication (α = 0.84), roles and responsibilities (α = 0.86) and situation awareness (α = 0.77). The reliability of the IPE and teamwork subscales are higher than reported on other questionnaires, particularly the roles and responsibility factor previously reported to be < .50. These results support the value of high-fidelity simulation as a learning modality for IPE, and the reliability and construct validity of the newly developed KidSIM ATTITUDES questionnaire.


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15:00 - 16:00

Standardized Actors as Performance Evaluators in Simulation-Based Multiple MiniInterviews for Selection for Entry into Medical School: Would the Same Candidates Get In?

Easty, Laura (McGill University, Montreal, QC, CAN); Moreau, Louis-Charles (McGill University, Montreal, QC, CAN); Young, Meredith (McGill University, Montreal, QC, CAN); Kagan, Lisa (Arnold and Blema Steinberg Medical Simulation Centre, Montreal, QC, CAN); Razack, Saleem (McGill University, Montreal, QC, CAN)

Objective: Applicant performance evaluation by standardized actors (SA’s) has not been previously reported on in the setting of multiple mini-interviews (MMI’s) for medical student selection. We compared the reliability of evaluations made by SA’s vs. expert evaluators (admissions board members) in this context. Methods: Expert Evaluators and SA’s rated student performance on a 5-item, 7-point modified Likert scale (5th item always being a ‘global suitability for medicine’ rating). Reliability was examined using generalizability theory, and consistency across SA’s’ and Experts’ ratings was examined using Spearman rank (ρ). Results: Total station scores correlated positively between the two evaluator groups (r=.71, p65% it improved the way they communicated and introduced them to new colleagues. Half the participants had successfully implemented a teaching session using simulation. Seventy-seven % indicated use of knowledge and skills from DW in real life events. Time was identified as the main barrier to utilize simulation in education for 71% of those surveyed. Scenarios and debriefing skills were not definite barriers. Themes emerged from the open ended questions revealing a need for advanced and refresher courses and practice opportunities to enhance debriefing skills. Conclusions: The one-day DW enabled educators to utilize simulation as a teaching tool and debriefing skills have been translated to daily practice. It led to development of new courses and enabled collaboration to foster interprofessional education and networking. The need for continuing education in debriefing was identified.


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POSTER PRESENTATIONS – SALLE DE BAL P-47 Learning to Collaborate Remotely, in Real Time, Through a Platform of Integrated Simulation Devices.

Joy, Aislinn (School of Medicine, University College, Cork, Cork, IRL); Hynes, Helen (Medical Education unit, University College, Cork, Cork, IRL); Ellaway, Rachel (North Ontario School of Medicine, Sudbury, CAN); Topps, David (University of Calgary, Calgary, CAN); Lachapelle, Kevin (McGill Simulation Centre, University of McGill, Montreal, CAN)

The Health Services Virtual Organisation (HSVO) platform is a web-based network of integrated simulation devices, through which scenarios can be built, for the education of healthcare students and staff. From April 2010 to October 2010, third year medical students at University College Cork (Ireland) participated in seven Simulation Challenges with students from three different medical schools (NOSM, McGill, U of O) in Canada. The analysis of observed activities during these sessions will be described elsewhere. Here we report preliminary results of a qualitative analysis of the learner perspective, as part of ongoing longitudinal follow up, via focus group interviews. Learning styles and approaches as measured by the index of Learning Styles Questionnaire and ASSIST questionnaire respectively were also completed and will be correlated to interview responses (work in progress). From an affective and learning perspective, mixed cultural teams, telemedicine scenarios where sites had a distinct role, and virtual patient cases with inbuilt feedback mechanisms, were most appreciated. It was felt that real life video footage also added to the authenticity of an experience. A competitive approach to the learning design, between different cultural groups at remote sites, actually reduced collaboration during the simulation exercise, from the Irish students’ perspective. But when this happened, these students actually learned more about and from students in Canadian schools, by comparing differences of approach to the same scenario. For best collaborative teamwork during remote simulation challenges though, the overwhelming recommendation from this group of students is to mix a cohort of students from each site, to form multicultural teams that can work together.


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POSTER PRESENTATIONS – SALLE DE BAL P-48 Simulation-Based Curriculum for Laparoscopic Inguinal Hernia Repair

Kurashima, Yo (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Arnold and Blema Steinberg Medical Simulation Centre, McGill University, Montréal, QC, CAN); Kaneva, Pepa (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Arnold and Blema Steinberg Medical Simulation Centre, McGill University, Montréal, QC, CAN); Feldman, Liane (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Arnold and Blema Steinberg Medical Simulation Centre, McGill University, Montreal, QC, CAN); Fried, Gerald (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Arnold and Blema Steinberg Medical Simulation Centre, McGill University, Montreal, QC, CAN); Vassiliou, Melina (Steinberg-Bernstein Centre for Minimally Invasive Surgery and Arnold and Blema Steinberg Medical Simulation Centre, McGill University, Montreal, QC, CAN)

The purpose of this study is to develop and validate a comprehensive curriculum for the training and evaluation of laparoscopic inguinal hernia repair (LIHR). We developed a tool to measure performance during LIHR called the Global Operative Assessment of Laparoscopic Skills–Groin Hernia (GOALS-GH). GOALS-GH can be used to assess transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) repairs. It is a 5-item global-rating scale. We then designed a low-cost physical model: Laparoscopic Inguinal Hernia Simulator (LIHS). LIHS represents accurate anatomic relationships and allows learners to perform each step of LIHR. To evaluate the reliability and validity of these tools, 17 novices and 8 experienced surgeons were assessed by observers, attending surgeons and self in the OR and/or on the simulator using GOALS-GH. To prepare participants, we conducted a hernia course with pre and post tests, and a step-by-step instructional video of the procedure. The inter-rater reliability of GOALS-GH was greater than 0.7 for all raters in the OR and simulator. The internal consistency of GOALS-GH items was 0.97 in the OR and 0.96 in the simulator. The mean GOALS-GH score for experienced surgeons was significantly higher compared to novices in both environments. The correlation between GOALS-GH scores in the OR and the simulator was 0.81 (p< 0.01, n= 12). Thirty-three general surgery residents participated in the hernia course. Their knowledge about LIHR improved after the course. GOALS-GH is a reliable and valid measure of the skills required for LIHR and may be used with the LIHS as an educational tool. Combined with a basic course and instructional video, these tools can be integrated into a comprehensive curriculum that may help to improve the learning curve for LIHR.


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POSTER PRESENTATIONS – SALLE DE BAL P-49 The Academic Half-Day Redesigned - Incorporating Simulation, Promoting CanMEDS and Developing Self-Directed Learners

Di Genova, Tanya (Montréal Children's Hospital, Montréal, QC, CAN); Valentino, Pamela (Hospital for Sick Children, Toronto, ON, CAN); Gosselin, Richard (Montreal Children's Hospital, Montreal, QC, CAN); Bhanji, Farhan (Montréal Children's Hospital, Montréal, QC, CAN)

In 2009-2010, McGill University's Pediatrics Residency Program revamped its Academic Half-Day based on concerns that included an overemphasis on subspecialty content, exclusive use of didactic lectures and 'opportunistic' topics based on interests of 'volunteer' instructors. Novel instructional methods included monthly simulation sessions to learn CanMEDS competencies, increased involvement of Residents as Teachers and the implementation of a 'Systems-based' Curriculum using Division Directors to determine who should deliver objectives-based content. A post-implementation on-line survey was sent to all 18 second and third year pediatric residents who had been exposed to both curricula. This survey was designed to determine the impact of the new curriculum on their ability to retain information, acquire CanMEDS competencies of a General Pediatrician, and to assess the effect on their self-directed learning. Responses were recorded on a 5-point Likert scale from strongly disagree to strongly agree. Fifteen of 18 residents completed the survey (83%). The 'Systems-based' schedule was preferred by all pediatric residents. Seventy-nine percent of the residents agreed that the simulation sessions were useful to learn the CanMEDS competencies and 64% agreed that the new curriculum better supported learning in a clinical setting. Importantly, 64% of Residents voluntarily read more around the topics presented and 71% agreed they better retained the content compared to the 'old' curriculum. Given the survey results, we propose that our comprehensive, systems-based interactive format, with integrated 'CanMEDS simulation' sessions is practical, while allowing a more learner-centered educational experience that may promote the development of life-long learning skills.


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POSTER PRESENTATIONS – SALLE DE BAL P-50 Simulation-Based Education for the Rehabilitation Professions: A Scoping Review Yeung, Euson (University of Toronto, Department of Physical Therapy, Toronto, ON, CAN)

Technology plays an important role in health professions education. The literature shows that simulation-based education (SBE) has shaped curriculum, education policy and research in medicine and nursing. To date, little is known about how SBE can benefit the rehabilitation professions. A comprehensive review of what is currently known about simulation research and the use of SBE in the rehabilitation professions will inform program developers and researchers about questions that remain unaddressed. The objectives of this review are to 1) determine the extent, range and nature of SBE in rehabilitation education, and 2) to identify gaps in the literature on the use of SBE in rehabilitation. A scoping review methodology was used to search the published and grey literature in relevant databases, reports, position papers, and abstracts from relevant conference proceedings and networks. Two authors reviewed the list of abstracts against inclusion criteria which were use of simulation, pre- or post-licensure education, and involvement of rehabilitation professionals or students. Included articles were retrieved for full review, data extraction and analysis using Alkin’s Evaluation Theory Tree. Subsequent qualitative content analysis revealed that only 3 types of simulations are being used in rehabilitation education but SBE may have a role beyond that of developing and assessing procedural skills. Although research has examined the effectiveness of SBE in rehabilitation education, its potential to influence processes that address broader curricular goals have yet to be examined in detail. A program evaluation framework is suggested for program developers and researchers to consider as a more holistic approach to addressing educational research gaps in rehabilitation. P-51 Partnering for Success - Open Doors 2012

Mullins-Richards, Paula (Memorial University of NL, St. John's, NL, CAN)

Simulation is not simply mannequins. A multidisciplinary approach to include high fidelity simulators, standardized patients, surgical skills, low fidelity simulation and distributive education tools can create a unique environment to attract multiple partners. We all can research templates from any good business school, academic texts or the internet to provide the required contents and processes to create a first rate strategic and business plan for our centres. It is most important to ensure you have identified the stakeholders, forged lasting partnerships both within and outside your institution prior to the preparation of both sets of plans. Memorial University of NL new Clinical Learning Center will open its doors in 2012 and you bet we are excited! During our presentation you will learn of how our dream of a 15,000 sq ft facility is now our reality - and all of the unique twists and turns along the way. This is a presentation about sharing facilities and resources which are not limited to capital equipment, materials and human resources. Partnering for Success will also explore unique opportunities for funding that would not normally be open.


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POSTER PRESENTATIONS – SALLE DE BAL P-52 Making It Real: 3-D Simulation Immersion in Radiation Therapy

Cherryman, Fiona (The Michener Institute, Toronto, ON, CAN); Niblett, Brad (The Michener Institute, Toronto, ON, CAN); Bandali, Karim (The Michener Institute, Toronto, ON, CAN)

Simulation offers bridging opportunities to immerse students safely into clinical scenarios without impacting quality patient care. Radiation Therapists are practitioners who interact equally with patients and technology to deliver specialized oncology care. The Virtual Environment Radiotherapy Training System (VERT) facilitates student learning in an immersive environment through interactions with virtual patients and radiation therapy equipment. The Michener Institute is the first VERT installation site in North America. Students create individualized patient treatment plans using a true clinical system and import them directly into VERT. Although Michener is in the early stages of embedding VERT into the curriculum, initial qualitative data gathered through focus groups has been positive. Preliminary feedback shows faculty incorporated VERT and its enhanced visualization tools for abstract concepts successfully especially for experiential and visual learners. During initial curriculum development, faculty selected and expanded clinical cases into the VERT platform to illustrate key concepts and competencies. Students indicated a preference for this hands-on learning approach over traditional book learning. We anticipate increasing the utilization of the VERT platform throughout the curriculum providing students an interactive risk-free environment to examine clinical concepts, anatomical specifics and achieve competencies. Further research is required to assess impact on student learning with the aim to improve skill acquisition and theory retention and thereby increase setup accuracy and reproducibility ultimately leading to improved patient safety and outcomes.


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POSTER PRESENTATIONS – SALLE DE BAL P-53 This poster will be featured in the Poster Flash Points session on Thursday, November 3 at 16:40 hrs Simulation in the Canadian Context: Perceptions of Program Directors and University Administrators

LeBlanc, Vicki (Wilson Centre- University of Toronto, Toronto, ON, CAN); Brydges, Ryan (Wilson Centre- University of Toronto, Toronto, ON, CAN); McNaughton, Nancy (Standardized Patient Program - University of Toronto, Toronto, ON, CAN); Piquette, Dominique (Wilson Centre- University of Toronto, Toronto, ON, CAN); Sharma, Bharat (Department of Surgery - University of Toronto, Toronto, ON, CAN); Bould, Dylan (University of Ottawa, Ottawa, ON, CAN)

Objective: Within the context of the FMEC: PG Project, the goal of this study was to explore the practical realities of postgraduate simulation-based education in Canada. Methods: Seventeen simulation program directors and university administrators were interviewed about their conceptualization of the central tenets of simulation, and how they integrate simulation in the Canadian postgraduate system. Transcripts of semi-structured interviews were analyzed using an iterative inductive thematic approach. Results: Simulation is perceived as an important and necessary component of postgraduate training, to target skills and behaviours difficult to acquire through traditional training, and to reduce risks to patients. However, for the theoretical advantages of simulation to be fully realized, interviewees called for improvements: 1) Investment in faculty development to improve the uptake and effective use of simulation. 2) Integration of simulation more thoughtfully into existing curricula, and across specialties & modalities. 3) Evolution of research beyond description towards justification and clarification of how to optimally use simulation. There was broad agreement that simulation is ideal for training in an interprofessional context. However, postgraduate simulation-based interprofessional education (IPE) is resource intensive and logistically challenging, with education competing with service commitments. For theoretical advantages of IPE simulation to be realized, interviewees argued for stakeholders to prioritize this form of teaching. Conclusion: Within Canada, further developments in faculty development, integration, research, and simulation for IPE are advocated to optimize the effectiveness of simulationbased education.


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ABSTRACTS

POSTER PRESENTATIONS – SALLE DE BAL P-54 This poster will be featured in the Poster Flash Points session on Thursday, November 3 at 16:40 hrs Simulation for Family Centered Care: Improving Caregiver Skills, Self-Efficacy and Quality of Life using a Practice-Until-Perfect Simulation Intervention for Seizure Management in the Home Environment

Sigalet, Elaine (KidSIM-Aspire Pediatric Simulation Research Program, Alberta Children's Hospital, University of CalgaryKIDSIM Program Alberta Children's hospital, Calgary, AB, CAN); Chatfield, Jenn (KidSIM-Aspire Pediatric Simulation Research Program, Alberta Children's Hospital, University of CalgaryKIDSIM Program Alberta Children's hospital, Calgary, AB, CAN); Grant, Vince (KidSIM-Aspire Pediatric Simulation Research Program, Alberta Children's Hospital, University of CalgaryKIDSIM Program Alberta Children's hospital, Calgary, AB, CAN); Koot, Deanna (KidSIM-Aspire Pediatric Simulation Research Program, Alberta Children's Hospital, University of CalgaryKIDSIM Program Alberta Children's hospital, Calgary, AB, CAN); Robinson, Traci (KidSIM-Aspire Pediatric Simulation Research Program, Alberta Children's Hospital, University of CalgaryKIDSIM Program Alberta Children's hospital, Calgary, AB, CAN); Cheng, Adam (Alberta Children's Hospital, KidSIM-ASPIRE Simulation Program, Calgary, AB, CAN)

This study examines the impact of utilizing a novel Family Centered Care focused high fidelity simulation intervention to deliver seizure management teaching on caregiver performance, perceptions of self-efficacy, and quality of life. This intervention will engage practice until perfect ideology congruent with the principles of family centered care doctrine, providing an opportunity for caregivers to practice managing seizures until they verbalize comfort with skills and knowledge. We hypothesize that participants in the intervention group will demonstrate improved performance with emergent seizure management, report greater confidence, and enhanced quality of life compared to participants in the control group who receive traditional discharge education. An experimental two-group pretest/posttest randomized controlled research study will be used to compare participant responses to both types of curriculum. We will recruit primary caregivers of children with underlying seizure disorders being cared for at the Alberta Children's Hospital. We anticipate a sample size of 98 subjects to support a two-tailed alpha of 0.05, beta of 0.20, resultant power of 80%, predicting a moderate effect size of ≥ 0.40. The effect size is based on health professional research. This study is a work in progress. Preliminary results are expected January 2012. To date, simulation-based education has focused primarily on health professionals as learners. Our study aims to assess the impact of a simulation-based intervention in caregivers. We anticipate that our practice-until-perfect simulation-based intervention will demonstrate improved caregiver performance, self-efficacy and quality of life, and thus pave the wave for caregiver-based simulation interventions in other contexts as well.


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CONFLICT OF INTEREST Last Cheng

First Adam

Fried Harder

Gerald B. Nicole

Kolozsvari

Nicoleta

Kurashima

Yo

LeBlanc

Vicki

Marquis Piquette

François Dominique

Riesen Sigalet

Eleanor Elaine

Declaration Research grants from Laerdal Foundation of Acute Medicine and the Heart & Stroke Foundation Speaker honorarium form Olympus Endoscopy Adjunct faculty member with a simulation manufacturer (METI) adjunct faculty member with a simulation manufacturer (METI) SAGES Research Grant. The Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation receives an unrestricted educational grant from Covidien. Salary support from the McGill Surgeon Scientist program Steinberg-Bernstein Centre for Minimally Invasive Surgery receives an unrestricted educational grant from COVIDIEN. The FMEC PG Project was funded by Health Canada and managed by the AFMC, the CFPC, le CMQ & the Royal College. The authors acknowledge the support of the University of British Columbia, University of Toronto & McGill University. Local PI for two GSK studies Funded by the Network of Excellence in Simulation for Clinical Teaching and Learning Grants from NSERC, AVAYA and Virtual 3D Crafting Grant from the Alberta Children's Hospital Foundation through the division of Family Centered Care.

Authors not listed above do not have any relationships with commercial entities to disclose.


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FLOOR PLAN Marriott Château Champlain


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FLOOR PLAN Arnold and Blema Steinberg Medical Simulation Centre Location:

3575 Parc Ave, Suite 5640 (Lower Level of “Les Galeries Du Parc” LaCité shopping mall)

We are located at the southeast corner of Parc Avenue and Prince Arthur in the “Les Galeries Du Parc” LaCité shopping mall. Upon entering the main entrance of the mall, take the stairs down to the food court level and proceed to the right. The Medical Simulation Centre is located diagonally across from Le Metro grocery store. If you have trouble locating the Centre, please call 514-398-8978. If you are coming by car you can park in the garage located at Les Galeries du Parc. There are two entrances to the parking garage, both on the east side of Parc Avenue, one located just north of Milton, the other located just north of Prince Arthur near the McGill New Residence. You can then take the elevator to the shopping mall level and follow the signs to the Medical Simulation Centre. We are located across from the Metro grocery store.


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FLOOR PLAN McGill Residence – New Residence Hall 3625, ave Parc, Niveau C, Salle de bal Particpants should meet at the Arnold and Blema Steinberg Medical Simulation Centre to pick up registration materials. A guide will bring you to the New Residence Hall at McGill University.


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Health Sciences Simulation Centre

2012 SIMULATION SUMMIT NOVEMBER 17 – 18, 2012 OTTAWA, ONTARIO Ottawa Convention Centre Westin Ottawa


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