Healthcare Simulation Standards of Best PracticeTM Professional Integrity

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has placed great demands on many hospitals to maximize their capacity to care for affected patients. The requirement to reassign space has created challenges for obstetric services. We describe the nature of that challenge for an obstetric service in New York City. This experience raised an ethical challenge: whether it would be consistent with professional integrity to respond to a public health emergency with a plan for obstetric services that would create an increased risk of rare maternal mortality. We answered this question using the conceptual tools of professional ethics in obstetrics, especially the professional virtue of integrity. A public health emergency requires frameshifting from an individual-patient perspective to a population-based perspective. We show that an individual-patient-based, beneficence-based deliberative clinical judgment is not an adequate basis for organizational policy in response to a public health emergency. Instead, physicians, especially those in leadership positions, must frameshift to population-based clinical ethical judgment that focuses on reduction of mortality as much as possible in the entire population of patients served by a healthcare organization.

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SP safety, autonomy and healthcare simulation practice in the COVID-19 era

BMJ Simulation and Technology Enhanced Learning ◽

10.1136/bmjstel-2020-000835 ◽

2021 ◽

pp. bmjstel-2020-000835 ◽

Cited By ~ 2

Author(s):

Lou Clark ◽

Anne Woll ◽

Tamara L Owens ◽

Deltonia Shropshire ◽

Bob Kiser ◽

...

Keyword(s):

Ethical Leadership ◽

Skills Training ◽

Simulated Patients ◽

Human Beings ◽

Healthcare Simulation ◽

Key Terms ◽

Simulation Practice

This letter expands upon the three tenets of the Healthcare Simulation Manifesto—comprehensive safety, collaborative advocacy, and ethical leadership. To do this, we will discuss two key terms: ‘essential’ and ‘autonomy’ in relation to safety for standardized/simulated patients (SPs). In this time of crisis, simulationists must move the boundary of skills training previously accepted as safe for human beings, and leverage technology to ensure the highest level of safety achievable for our SPs.

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Erosion of Professional Integrity

Implant Dentistry ◽

10.1097/id.0b013e31827c2bba ◽

2013 ◽

Vol 22 (1) ◽

pp. 1 ◽

Cited By ~ 2

Author(s):

Morton L. Perel

Keyword(s):

Professional Integrity

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The 2017 Academic Emergency Medicine Consensus Conference: Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcomes

Academic Emergency Medicine ◽

10.1111/acem.13302 ◽

2017 ◽

Vol 25 (2) ◽

pp. 109-115 ◽

Cited By ~ 2

Author(s):

William F. Bond ◽

Joshua Hui ◽

Rosemarie Fernandez

Keyword(s):

Emergency Medicine ◽

System Change ◽

Consensus Conference ◽

Healthcare Simulation ◽

Simulation Systems

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Working memory is limited: improving knowledge transfer by optimising simulation through cognitive load theory

BMJ Simulation and Technology Enhanced Learning ◽

10.1136/bmjstel-2015-000098 ◽

2016 ◽

Vol 2 (4) ◽

pp. 131-138 ◽

Cited By ~ 8

Author(s):

Michael Meguerdichian ◽

Katie Walker ◽

Komal Bajaj

Keyword(s):

Working Memory ◽

Knowledge Transfer ◽

Cognitive Load ◽

Curriculum Design ◽

Cognitive Load Theory ◽

Scenario Development ◽

Load Theory ◽

Healthcare Simulation ◽

Simulation Scenario ◽

Complex Knowledge

This analysis explores how to optimise knowledge transfer in healthcare simulation by applying cognitive load theory to curriculum design and delivery for both novice and expert learners. This is particularly relevant for interprofessional learning which is team-based, as each participant comes to the simulation experience with different levels of expertise. Healthcare simulation can offer opportunities to create complex and dynamic experiences that replicate real clinical situations. Understanding Cognitive Load Theory can foster the acquisition of complex knowledge, skills and abilities required to deliver excellence in patient care without overwhelming a learner's ability to handle new materials due to working memory limitations. The 2 aspects of working memory that will be explored in this paper are intrinsic load and extrinsic load. These will be addressed in terms of the learner's level of expertise and how to consider these elements to enhance the learning environment in simulation scenario development and delivery. By applying the concepts of Cognitive Load Theory, this paper offers educators a method to tailor their curricula to navigate working memory and optimise the opportunity for knowledge transfer.

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