Simulation-Based Curriculum Development: Lessons Learnt in Global Health Education

Abstract Background: Simulation based medical education (SBME) allows learners to acquire clinical skills without exposing patients to unnecessary risk. This is especially applicable to Emergency Medicine training programs where residents are expected to demonstrate proficiency in the management of time critical, low frequency, and highly-morbidity conditions. This study aims to describe the process through which a SBME curriculum was created, in a limited simulation resource setting at a 4-year Emergency Medicine (EM) residency program at the American University of Beirut Medical Center. Methods: A case-based pilot simulation curriculum was developed following Kern’s 6 step approach to curriculum design. The curricular objectives were identified through an anonymous survey of the program’s residents and faculty. Curriculum outcomes were assessed, and the curriculum was revised to address curricular barriers. Evaluations of the revised curriculum were collected during the simulation sessions and through a whole revised curriculum evaluation at the end of the first year of its implementation. Results: 14/20 residents (70%) and 8/8 faculty (100%) completed the needs assessment from which objectives for the pilot curriculum were developed and implemented through 6 2-hour sessions over a 1-year period. Objectives were not met and identified barriers included cost, scheduling, resources, and limited faculty time. The revised curriculum addressed these barriers and 24 40-minute sessions were successfully conducted during the following year. The sessions took place 3 at a time, in 2-hour slots, using the same scenario to meet the objectives of the different learners’ levels. 91/91 evaluations were collected from participants with overall positive results. The main differences between the pilot and the revised curricula included: a better understanding of the simulation center resources and faculty’s capabilities. Conclusion: Simulation-based education is feasible even with limited-resources. However, understanding the resources available, and advocating for protected educator time are essential to implementing a successful EM simulation curriculum.

Download Full-text

Simulation-Based Curriculum Development: Lessons Learnt in Global Health Education

10.21203/rs.3.rs-42344/v2 ◽

2020 ◽

Author(s):

Rasha Sawaya ◽

Sandra Mrad ◽

Eva Rajha ◽

Rana Saleh ◽

Julie Rice

Keyword(s):

Emergency Medicine ◽

Curriculum Design ◽

Clinical Skills ◽

Medical Center ◽

Curriculum Evaluation ◽

Low Frequency ◽

American University ◽

Global Health Education ◽

Resource Setting ◽

Simulation Based

Abstract Abstract: Background: Simulation based medical education (SBME) allows learners to acquire clinical skills without exposing patients to unnecessary risk. This is especially applicable to Emergency Medicine training programs where residents are expected to demonstrate proficiency in the management of time critical, low frequency, and highly-morbidity conditions. This study aims to describe the process through which a SBME curriculum was created, in a limited simulation resource setting at a 4-year Emergency Medicine (EM) residency program at the American University of Beirut Medical Center. Methods : A case-based pilot simulation curriculum was developed following Kern’s 6 step approach to curriculum design. The curricular objectives were identified through an anonymous survey of the program’s residents and faculty. Curriculum outcomes were assessed, and the curriculum was revised to address curricular barriers. Evaluations of the revised curriculum were collected during the simulation sessions and through a whole revised curriculum evaluation at the end of the first year of its implementation. Results : 14/20 residents (70%) and 8/8 faculty (100%) completed the needs assessment from which objectives for the pilot curriculum were developed and implemented through 6 2-hour sessions over a 1-year period. Objectives were not met and identified barriers included cost, scheduling, resources, and limited faculty time. The revised curriculum addressed these barriers and 24 40-minute sessions were successfully conducted during the following year. The sessions took place 3 at a time, in 2-hour slots, using the same scenario to meet the objectives of the different learners’ levels. 91/91 evaluations were collected from participants with overall positive results. The main differences between the pilot and the revised curricula included: a better understanding of the simulation center resources and faculty’s capabilities. Conclusion : Simulation-based education is feasible even with limited-resources. However, understanding the resources available, and advocating for protected educator time are essential to implementing a successful EM simulation curriculum.

Download Full-text

Simulation-based curriculum development: lessons learnt in Global Health education

BMC Medical Education ◽

10.1186/s12909-020-02430-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rasha D. Sawaya ◽

Sandra Mrad ◽

Eva Rajha ◽

Rana Saleh ◽

Julie Rice

Keyword(s):

Emergency Medicine ◽

Curriculum Design ◽

Clinical Skills ◽

Medical Center ◽

Curriculum Evaluation ◽

Low Frequency ◽

American University ◽

Global Health Education ◽

Resource Setting ◽

Simulation Based

Abstract Background Simulation based medical education (SBME) allows learners to acquire clinical skills without exposing patients to unnecessary risk. This is especially applicable to Emergency Medicine training programs where residents are expected to demonstrate proficiency in the management of time critical, low frequency, and highly-morbidity conditions. This study aims to describe the process through which a SBME curriculum was created, in a limited simulation resource setting at a 4-year Emergency Medicine (EM) residency program at the American University of Beirut Medical Center. Methods A case-based pilot simulation curriculum was developed following Kern’s 6 step approach to curriculum design. The curricular objectives were identified through an anonymous survey of the program’s residents and faculty. Curriculum outcomes were assessed, and the curriculum was revised to address curricular barriers. Evaluations of the revised curriculum were collected during the simulation sessions and through a whole revised curriculum evaluation at the end of the first year of its implementation. Results 14/20 residents (70%) and 8/8 faculty (100%) completed the needs assessment from which objectives for the pilot curriculum were developed and implemented through 6 2-h sessions over a 1-year period. Objectives were not met and identified barriers included cost, scheduling, resources, and limited faculty time. The revised curriculum addressed these barriers and 24 40-min sessions were successfully conducted during the following year. The sessions took place 3 at a time, in 2-h slots, using the same scenario to meet the objectives of the different learners’ levels. 91/91 evaluations were collected from participants with overall positive results. The main differences between the pilot and the revised curricula included: a better understanding of the simulation center resources and faculty’s capabilities. Conclusion Simulation-based education is feasible even with limited-resources. However, understanding the resources available, and advocating for protected educator time are essential to implementing a successful EM simulation curriculum.

Download Full-text

Stakeholder perceptions about the establishment of medical simulation-based learning at a university in a low resource setting: A qualitative study in Uganda

10.21203/rs.3.rs-27026/v3 ◽

2020 ◽

Author(s):

Josephine Nambi Najjuma ◽

Francis Bajunirwe ◽

Margaret Twine ◽

Tamara Namata ◽

Catherine Kyakwera ◽

...

Keyword(s):

Nursing Students ◽

Clinical Teaching ◽

Clinical Skills ◽

Prior Experience ◽

Real Life ◽

Qualitative Assessment ◽

Medical Simulation ◽

University Administrators ◽

Resource Setting ◽

Simulation Based

Abstract Background: Simulation based learning (SBL) is a technique where teachers recreate “real life” clinical experiences for health care teams for purposes of gaining clinical skills in a safe environment. There is evidence that SBL is superior to the traditional clinical teaching methods for acquisition of clinical skills. Although it is well established in resource rich settings, there is limited experience in resource limited settings and there is uncertainty regarding how SBL will be perceived among the stakeholders in medical education. As part of the steps leading to implementation of a SBL program at a university in Uganda, we sought to describe the perceptions of various stakeholders regarding the introduction of SBL methodology into learning at a medical school in Uganda. Methods: We conducted a formative qualitative assessment using key informant interviews (KIIs) among faculty members and university administrators and focus group discussions (FGDs) among medical and nursing students at Mbarara University of Science and Technology. Data were collected till saturation point and were transcribed and analyzed manually using open and axial coding approaches to develop themes. Results: We conducted 7 KIIs and 3 FGDs. Overall, findings were categorized into five broad themes: 1. Motivation to adopt simulation-based learning 2. Prior experience and understanding of simulation-based education 3. Outcomes arising from introduction of medical simulation 4. Drawbacks to establishment of medical simulation; and 5. Potential remedies to the drawbacks. Overall, our data show there was significant buy-in from the institution for SBL, stakeholders were optimistic about the prospects of having a new method of teaching, which they perceived as modern to complement the traditional methods. There was significant knowledge but very limited prior experience of medical simulation. Also, there was some concern regarding how students and faculty would embrace training on lifeless objects, the human resources needed and sustainability of simulation-based learning in the absence of external funding. Conclusion: Stakeholders perceive SBL positively and are likely to embrace the learning methods. Concerns about human resource needs and sustainability need to be addressed to ensure acceptability.

Download Full-text

Stakeholder perceptions about the establishment of medical simulation-based learning at a university in a low resource setting: a qualitative study in Uganda

BMC Medical Education ◽

10.1186/s12909-020-02301-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Josephine Nambi Najjuma ◽

Francis Bajunirwe ◽

Margaret Twine ◽

Tamara Namata ◽

Catherine Kalimba Kyakwera ◽

...

Keyword(s):

Nursing Students ◽

Clinical Teaching ◽

Clinical Skills ◽

Prior Experience ◽

Real Life ◽

Qualitative Assessment ◽

Medical Simulation ◽

University Administrators ◽

Resource Setting ◽

Simulation Based

Abstract Background Simulation based learning (SBL) is a technique where teachers recreate “real life” clinical experiences for health care teams for purposes of gaining clinical skills in a safe environment. There is evidence that SBL is superior to the traditional clinical teaching methods for acquisition of clinical skills. Although it is well established in resource rich settings, there is limited experience in resource limited settings and there is uncertainty regarding how SBL will be perceived among the stakeholders in medical education. As part of the steps leading to implementation of a SBL program at a university in Uganda, we sought to describe the perceptions of various stakeholders regarding the introduction of SBL methodology into learning at a medical school in Uganda. Methods We conducted a formative qualitative assessment using key informant interviews (KIIs) among faculty members and university administrators and focus group discussions (FGDs) among medical and nursing students at Mbarara University of Science and Technology. Data were collected till saturation point and were transcribed and analyzed manually using open and axial coding approaches to develop themes. Results We conducted seven KIIs and three FGDs. Overall, findings were categorized into five broad themes: 1. Motivation to adopt simulation-based learning 2. Prior experience and understanding of simulation-based education 3. Outcomes arising from introduction of medical simulation 4. Drawbacks to establishment of medical simulation; and 5. Potential remedies to the drawbacks. Overall, our data show there was significant buy-in from the institution for SBL, stakeholders were optimistic about the prospects of having a new method of teaching, which they perceived as modern to complement the traditional methods. There was significant knowledge but very limited prior experience of medical simulation. Also, there was some concern regarding how students and faculty would embrace training on lifeless objects, the human resources needed and sustainability of simulation-based learning in the absence of external funding. Conclusion Stakeholders perceive SBL positively and are likely to embrace the learning methods. Concerns about human resource needs and sustainability need to be addressed to ensure acceptability.

Download Full-text

An Innovative Clinical Skills “Boot Camp” for Dental Medicine Residents

Journal of Medical Education and Curricular Development ◽

10.1177/2382120517710018 ◽

2017 ◽

Vol 4 ◽

pp. 238212051771001 ◽

Cited By ~ 3

Author(s):

Jenny Castillo ◽

Jared Kutzin ◽

Kathleen Agoglia ◽

Patricia Janicke ◽

Zachary Milligan ◽

...

Keyword(s):

Emergency Medicine ◽

Clinical Skills ◽

Clinical Skill ◽

Medical Knowledge ◽

Boot Camp ◽

School Curriculum ◽

Dental School ◽

Knowledge And Skills ◽

Inpatient Hospital ◽

Simulation Based

During a 1-year hospital-based residency, dental residents are required to rotate through many departments including surgery, medicine, and emergency medicine. It became apparent that there was a gap between clinical skills knowledge taught in dental school curriculum and skills required for hospital-based patient care. In response, a simulation-based intensive clinical skill “boot camp” was created. The boot camp provided an intensive, interactive 3-day session for the dental residents. During the 3 days, residents were introduced to medical knowledge and skills that were necessary for their inpatient hospital rotations but were lacking in traditional dental school curriculum. Effectiveness of the boot camp was assessed in terms of knowledge base and comfort through presession and postsession surveys. According to resident feedback, this intensive introduction for the dental residents improved their readiness for their inpatient hospital-based residency.

Download Full-text

Stakeholder Perceptions About the Establishment of Medical Simulation-Based Learning at a University in a Low Resource Setting: A Qualitative Study in Uganda

10.21203/rs.3.rs-27026/v1 ◽

2020 ◽

Author(s):

Josephine Nambi Najjuma ◽

Francis Bajunirwe ◽

Margaret Twine ◽

Tamara Namata ◽

Catherine Kyakwera ◽

...

Keyword(s):

Medical Education ◽

Nursing Students ◽

Clinical Teaching ◽

Clinical Skills ◽

Prior Experience ◽

Real Life ◽

Qualitative Assessment ◽

Medical Simulation ◽

Resource Setting ◽

Simulation Based

Abstract Background: Simulation based learning (SBL) is a technique where teachers recreate real life clinical experiences for health care teams for purposes of gaining clinical skills in a safe environment. There is evidence that SBL is superior to the traditional clinical teaching methods for acquisition of clinical skills. Although it is well established in resource rich settings, there is limited experience in resource limited settings and there is uncertainty regarding how SBL will be perceived among the stakeholders in medical education. As part of the steps leading to implementation of a SBL program at a university in Uganda, we sought to describe the perceptions of various stakeholders regarding the introduction of SBL methodology into learning at a medical school in Uganda.Methods: We conducted a formative qualitative assessment using key informant interviews (KIIs) among faculty members and university administrators and focus group discussions (FGDs) among medical and nursing students at Mbarara University of Science and Technology. Data were collected till saturation point and were transcribed and analyzed manually using a thematic approach.Results: We conducted 7 KIIs and 3 FGDs. Overall, findings were categorized into four broad themes: 1. Current challenges of medical education 2. Prior experience and understanding of medical simulation 3. Opportunities arising from introduction of medical simulation; and 4. Drawbacks to establishment of medical simulation. Overall, our data show there was significant buy-in from the institution for SBL, stakeholders were upbeat about the prospects of having a new method of teaching, which they perceived as modern to complement the traditional methods. There was significant knowledge but very limited prior experience of medical simulation. Also, there was some concern regarding how students and faculty would embrace training on lifeless objects, the human resources needed and sustainability of simulation-based learning in the absence of external funding.Conclusion: Stakeholders perceive SBL positively and are likely to embrace the learning methods. Concerns about human resource needs and sustainability need to be addressed to ensure acceptability.

Download Full-text

Stakeholder perceptions about the establishment of medical simulation-based learning at a university in a low resource setting: A qualitative study in Uganda

10.21203/rs.3.rs-27026/v2 ◽

2020 ◽

Author(s):

Josephine Nambi Najjuma ◽

Francis Bajunirwe ◽

Margaret Twine ◽

Tamara Namata ◽

Catherine Kyakwera ◽

...

Keyword(s):

Nursing Students ◽

Clinical Teaching ◽

Clinical Skills ◽

Prior Experience ◽

Real Life ◽

Qualitative Assessment ◽

Medical Simulation ◽

University Administrators ◽

Resource Setting ◽

Simulation Based

Abstract Background: Simulation based learning (SBL) is a technique where teachers recreate “real life” clinical experiences for health care teams for purposes of gaining clinical skills in a safe environment. There is evidence that SBL is superior to the traditional clinical teaching methods for acquisition of clinical skills. Although it is well established in resource rich settings, there is limited experience in resource limited settings and there is uncertainty regarding how SBL will be perceived among the stakeholders in medical education. As part of the steps leading to implementation of a SBL program at a university in Uganda, we sought to describe the perceptions of various stakeholders regarding the introduction of SBL methodology into learning at a medical school in Uganda. Methods: We conducted a formative qualitative assessment using key informant interviews (KIIs) among faculty members and university administrators and focus group discussions (FGDs) among medical and nursing students at Mbarara University of Science and Technology. Data were collected till saturation point and were transcribed and analyzed manually using open and axial coding approaches to develop themes. Results: We conducted 7 KIIs and 3 FGDs. Overall, findings were categorized into five broad themes: 1. Motivation to adopt simulation based learning 2. Prior experience and understanding of medical simulation 3. Outcomes arising from introduction of medical simulation 4. Drawbacks to establishment of medical simulation; and 5. remedies to the drawbacks. Overall, our data show there was significant buy-in from the institution for SBL, stakeholders were optimistic about the prospects of having a new method of teaching, which they perceived as modern to complement the traditional methods. There was significant knowledge but very limited prior experience of medical simulation. Also, there was some concern regarding how students and faculty would embrace training on lifeless objects, the human resources needed and sustainability of simulation-based learning in the absence of external funding. Conclusion: Stakeholders perceive SBL positively and are likely to embrace the learning methods. Concerns about human resource needs and sustainability need to be addressed to ensure acceptability.

Download Full-text

Establishing an ECMO program in a developing country: challenges and lessons learned

Perfusion ◽

10.1177/0267659119834489 ◽

2019 ◽

Vol 34 (6) ◽

pp. 508-515 ◽

Cited By ~ 2

Author(s):

Jana Assy ◽

Hadi Skouri ◽

Lama Charafeddine ◽

Marianne Majdalani ◽

Khaled Younes ◽

...

Keyword(s):

Medical Center ◽

Pediatric Population ◽

Developed Countries ◽

Lessons Learned ◽

Full Time ◽

American University ◽

American University Of Beirut ◽

Resource Setting ◽

Low Resource Setting ◽

Preparation Phase

Aim: The ECMO (extracorporeal membrane oxygenation) Program at the American University of Beirut Medical Center was established in November 2015 as the first program serving adult and pediatric population in a low-resource setting. The aim of the study is to describe the challenges faced during the establishment of the program and factors leading to its success. Methods: The program establishment is described. The preparation phase, included the strategic, financial, and clinical planning by administration, nursing, and a multidisciplinary team of physicians. The training and education phase included all the involved nurses, perfusionists, and physicians. Concerns were heard from various stakeholders, and the challenges were analyzed and discussed. Results: The preparation committee chose the adequate equipment, responded to the concerns, defined roles and responsibilities through credentialing and privileging, wrote policies and protocols, and established a strategy to decide for the ECMO indication. Selected team of nurses, physicians, and perfusionists are identified and trained locally, and abroad. A full-time ECMO physician was recruited to launch the program. Twelve patients (6 adults, 3 children, and 3 neonates) were supported by ECMO, for cardiac and respiratory indications. Eleven patients were supported by veno-arterial ECMO, and 1 patient (a neonate) with veno-venous ECMO. Overall, 75% survived to decannulation and 41% survived to discharge. Conclusion: With limited human and financial resources, new ECMO centers need to carefully establish selection criteria that may differ from those used in developed countries. Indications should be discussed on a case by case basis, taking into account clinical, social, and financial issues. This experience might help other institutions in developing countries to build their own program despite financial and human limitations.

Download Full-text