scholarly journals Combining in-situ simulation and live HEMS mission facilitator observation: a flexible learning concept

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Per P. Bredmose ◽  
Jostein Hagemo ◽  
Doris Østergaard ◽  
Stephen Sollid
Keyword(s):  
Simulation Training ◽  
Clinical Skills ◽  
Training Session ◽  
Numerical Data ◽  
Continuous Medical Education ◽  
Structured Interviews ◽  
Immediate Feedback ◽  
In Situ Simulation ◽  
One Year

Abstract Background Continuous medical education is essential in Helicopter Emergency Medical Services (HEMS). In-situ simulation training makes it possible to train in a familiar environment. The use of a dedicated facilitator is essential; however, when an in-situ simulation training session is interrupted by a live mission, the efforts invested in the training are left unfulfilled. This study aims to evaluate if HEMS mission observation and debriefing by the simulation facilitator is a feasible alternative to mission-interrupted simulation training, and how this alternative to simulation training is perceived by both facilitators and HEMS crew members. Methods Facilitator observation during live missions and post-mission debriefing was offered as an alternative to mission-interrupted simulation training over a one-year period at three HEMS bases. Immediate feedback was requested from crews and facilitators after each observed live mission on a predefined questionnaire. At the end of the study period, semi-structured interviews were performed with a sample of HEMS crew members and facilitators to further explore the experience with the concept. Numerical data about the sessions were recorded continuously. Results A total of 78 training sessions were attempted, with 46 (59%) of the simulations conducted as planned. Of the remaining, 23 (29%) were not started because the crew had other duties (fatigued crew or crew called for a mission where observation was inappropriate/impossible), and 9 (12%) training sessions were converted to observed live missions. In total, 43 (55%), 16 (21%) and 19 (24%) attempts to facilitate simulation training were undertaken on the three bases, respectively. The facilitators considered mission observation more challenging than simulation. The interviews identified local know-how, clinical skills, and excellent communication skills as important prerequisites for the facilitators to conduct live mission observation successfully. Participating crews and facilitators found simulation both valuable and needed. Being observed was initially perceived as unpleasant but later regarded as a helpful way of learning. Conclusion Live mission observation and debriefing seems a feasible and well-received alternative to an in-situ simulation program in HEMS to maximise invested resources and maintain the learning outcome. Furthermore, additional training of simulation facilitators to handle the context of live mission observation may further improve the learning output.

scholarly journals National implementation of in situ simulation training in Helicopter Emergency Medical Services: A multicenter study

2020 ◽  
Author(s):  
Per P. Bredmose ◽  
Jo Røislien ◽  
Doris Østergaard ◽  
Stephen Sollid
Keyword(s):  
Simulation Training ◽  
Emergency Services ◽  
Successful Implementation ◽  
In Situ Simulation ◽  
National Implementation ◽  
Simulation Based ◽  
Key Factor ◽  
One Year ◽  
Implementation Factors

Abstract IntroductionMedical simulation is used in helicopter emergency services as a tool for training the crew. Using in situ simulation we aimed to evaluate the degree of implementation, factors for successful simulation and the crew’s attitude towards this form for training.MethodsA one year prospective study on simulation at all Norwegian helicopter emergency services bases and one search and rescue base. Local facilitators were educated and conducted simulations at their own discretion.ResultsAll bases participated, but the number of simulations attempted at each base varied from 1 to 46. Busier bases had a significantly higher number of aborted simulations. Regardless of base and number of attempted simulations, participating crews scored self-evaluated satisfaction with this form of training highly. The number of local facilitators and their travel distance to work seemed to make no difference to the number of attempted simulations.DiscussionOur study reveals large differences in the number of attempted simulations between bases. Our findings suggest that the local facilitator is a key factor for successful implementation of simulation based training in helicopter emergency services.

scholarly journals Challenges to the implementation of in situ simulation at HEMS bases: a qualitative study of facilitators’ expectations and strategies

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Per P. Bredmose ◽  
Doris Østergaard ◽  
Stephen Sollid
Keyword(s):  
Qualitative Study ◽  
Simulation Training ◽  
Successful Implementation ◽  
Management Support ◽  
In Situ Simulation ◽  
National Implementation ◽  
Simulation Based ◽  
Before And After ◽  
One Year

Abstract Introduction Facilitators play an essential role in simulation-based training on helicopter emergency medical services (HEMS) bases. There is scant literature about the barriers to the implementation of simulation training in HEMS. The purpose of this explorative interview study was to identify factors that the local facilitators anticipated would challenge the smooth implementation of the program, and their strategies to overcome these before the national implementation of in situ simulation-based training locally, and subsequently, one year after the programme was initiated, to identify the actual challenges they had indeed experienced, and their solutions to overcome these. Methods A qualitative study with semi-structured group interviews of facilitators was undertaken before and after one year of simulation-based training on all HEMS bases and one Search and Rescue base. Systematic text condensation was used to extract facilitators’ expectations and experiences. Results Facilitators identified 17 themes in the pre-study-year interviews. Pedagogical, motivational and logistical issues were amongst the dominant themes. Other key themes included management support, dedicated time for the facilitators and ongoing development of the facilitator. In the post-study-year interviews, the same themes were identified. Despite anxiety about the perceptions of, and enthusiasm for, simulation training amongst the HEMS crews, our facilitators describe increasing levels of motivation over the study period. Conclusion Facilitators prognosticated the anticipated challenges to the successful implementation of simulation-based training on HEMS bases and suggested solutions for overcoming these challenges. After one year of simulation-based training, the facilitators reflected on the key factors for successful implementation.

scholarly journals Using in situ simulation to improve care of the acutely ill patient by enhancing interprofessional working: a qualitative proof of concept study in primary care in England

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028572
Author(s):  
Amy Halls ◽  
Mohan Kanagasundaram ◽  
Margaret Lau-Walker ◽  
Hilary Diack ◽  
Simon Bettles
Keyword(s):  
Primary Care ◽  
Training Session ◽  
Medical Emergency ◽  
Future Research ◽  
Proof Of Concept ◽  
In Situ Simulation ◽  
Concept Study ◽  
Interprofessional Working ◽  
General Practices

ObjectiveAcutely unwell patients in the primary care setting are uncommon, but their successful management requires involvement from staff (clinical and non-clinical) working as a cohesive team. Despite the advantages of interprofessional education being well documented, there is little research evidence of this within primary care. Enhancing interprofessional working could ultimately improve care of the acutely ill patient. This proof of concept study aimed to develop an in situ simulation of a medical emergency to use within primary care, and assess its acceptability and utility through participants’ reported experiences.SettingThree research-active General Practices in south east England. Nine staff members per practice consented to participate, representing clinical and non-clinical professions.MethodsThe intervention of an in situ simulation scenario of a cardiac arrest was developed by the research team. For the evaluation, staff participated in individual qualitative semistructured interviews following the in situ simulation: these focused on their experiences of participating, with particular attention on interdisciplinary training and potential future developments of the in situ simulation.ResultsThe in situ simulation was appropriate for use within the participating General Practices. Qualitative thematic analysis of the interviews identified four themes: (1) apprehension and (un)willing participation, (2) reflection on the simulation design, (3) experiences of the scenario and (4) training.ConclusionsThis study suggests in situ simulation can be an acceptable approach for interdisciplinary team training within primary care, being well-received by practices and staff. This contributes to a fuller understanding of how in situ simulation can benefit both workforce and patients. Future research is needed to further refine the in situ simulation training session.

scholarly journals Improving safety and reducing error in endoscopy: simulation training in human factors

2019 ◽  
Vol 10 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Srivathsan Ravindran ◽  
Siwan Thomas-Gibson ◽  
Sam Murray ◽  
Eleanor Wood
Keyword(s):  
Human Factors ◽  
Simulation Training ◽  
Working Environment ◽  
Advisory Group ◽  
In Situ Simulation ◽  
Simulation Based ◽  
The Uk ◽  
Endoscopy Simulation ◽  
Patient Safety Incidents

Patient safety incidents occur throughout healthcare and early reports have exposed how deficiencies in ‘human factors’ have contributed to mortality in endoscopy. Recognising this, in the UK, the Joint Advisory Group for Gastrointestinal Endoscopy have implemented a number of initiatives including the ‘Improving Safety and Reducing Error in Endoscopy’ (ISREE) strategy. Within this, simulation training in human factors and Endoscopic Non-Technical Skills (ENTS) is being developed. Across healthcare, simulation training has been shown to improve team skills and patient outcomes. Although the literature is sparse, integrated and in situ simulation modalities have shown promise in endoscopy. Outcomes demonstrate improved individual and team performance and development of skills that aid clinical practice. Additionally, the use of simulation training to detect latent errors in the working environment is of significant value in reducing error and preventing harm. Implementation of simulation training at local and regional levels can be successfully achieved with collaboration between organisational, educational and clinical leads. Nationally, simulation strategies are a key aspect of the ISREE strategy to improve ENTS training. These may include integration of simulation into current training or development of novel simulation-based curricula. However used, it is evident that simulation training is an important tool in developing safer endoscopy.

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