Comprehensive Healthcare Simulation

National networks such as the Canadian Pediatric Simulation Network (CPSN) were developed to share experiences and resources, promote curriculum standardization at the national level, and collaborate on pediatric education and research projects [1]. 2015 marks the seventh anniversary of the International Pediatric Simulation Symposia and Workshops (IPSSW), a conference that has marched around the world in various international venues, providing opportunities to collaborate and cross-fertilize across borders and to promote excellence in simulation education delivery and research [2].

Fundamentals of Simulation for Pediatrics

Pediatric Simulation Modalities, Technologies and Environments

Pediatric Simulation for Professional Development

Pediatric Simulation Specialties

Pediatric Simulation Program Development

The Future of Pediatric Simulation

Anne Ades, MD Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Grant, MD, FRCPC Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Fundamentals of Simulation for Pediatrics

Cognitive Load and Stress in Simulation

Studies on the effects of stress in simulation-based education (SBE) lack uniformity in the measurement of stress [8]. Effects of stress on memory The effects of stress on memory are considered in the section above.

Table 1.1 Strategies for managing stress and cognitive load in simulation

Essentials of Scenario Building for Simulation- Based Education

Other additions may be added to the scenario design process depending on the student's level and desired learning objectives. This allows the facilitator to control how quickly the scenario runs and reacts to the actions of the participants.

Essentials of Debriefing and Feedback

Specific examples of this include: (1) the use of the intra-simulation debriefing during PALS training for pediatric residents [25], (2) the use of the three-phase model of de-briefing during neonatal resuscitation simulation training [32] , and (3) using the G.A.S. The simulated parents can use learners' initial reactions during the opening of the debriefing to guide their comments.

Table 3.1 Comparison of debriefing and feedback

Simulation-Based Team Training

These roles must be assigned, but are often taken based on the team member's profession. The written summary to help summarize the simulation scenarios has also been included in the most recent iterations of the course [35].

Fig. 4.1 Team photo. (Photograph courtesy of KidSIM Pediatric Simu- Simu-lation Program)

The Role of Simulation in Improving Patient Safety

Multiple institutions—see INSPIRE network [60] Alberta Children's Hospital, Calgary, AB, Canada Assessment/skills development—inclusion of a patient safety scenario (handover, line confusion, etc.) in annual pediatric nursing update and pediatric resident academic curriculum. Assessment/skill development-incorporation of patient safety cases (handover issues, medical errors, etc.) into pediatric academic curriculum teams, for example, lack of shared mental model leading to medication dosing errors. For example, the Systems Engineering Initiative for Patient Safety (SEIPS) model describes patient safety in terms of the interactions, relationships, and impacts of various system components, including the individuals who are part of the system [12] (see Fig. 5.1). .

Simulation is a natural partner for ongoing patient safety activities at the individual, team and system level of organizations. Systems-level simulation is increasingly being used to identify and mitigate patient safety risks. The Growing Role of Simulation Education in Achieving Patient Safety: Translating Deliberate Practice and Reporting to Save Lives.

Table 5.1 Applications of simulation for patient safety LevelInstitutionApplication Provider for example, active errors leading to complications (technical, psychomo- tor, cognitive)Multiple institutions—see INSPIRE network [60]Skills development—bench-t

Systems Integration, Human Factors, and Simulation

Possible causes may be ergonomic (e.g. the contents of the bottle are displayed in a microscopic font) or cognitive (e.g. it is difficult, especially under stress, to calculate correctly and tenfold calculation errors are common; epinephrine is a scary drug to have. make a mistake). Identification of LSTs in simulation enables system-level solutions before patient harm occurs, as demonstrated in the pediatric emergency department [11], the obstetrics department [12], and with ECMO (Extracorporeal Membrane Oxygenation) simulations [13]. Simulation can be incorporated into the planning phase, in the application of lessons learned, and then processes can be tested and retested iteratively using simulation.

The origins of Lean can be traced back to the Toyota Production System developed in the 1950s. Each element in the 6S tool can help teams explore problems, both in real patient care and in simulation, from a systems perspective. Six Sigma was developed by Motorola in the 1980s and became central to General Electric's business strategy in the 1990s [16].

Fig. 6.1 Systems integration: a schematic representation depicting the independence, overlap, and dependence of different systems elements (task, tool, user, environment, and processes) related to the overall system

Health care is a complex adaptive system; components of the system learn and adapt their behavior or responses, contributing to increasing complexity; the results of these interactions can be unpredictable. Health care systems exhibit complex behavior resulting from the complexity of the large number of procedural, biological and sociotechnical rules - whether they are understood and articulated or not - that drive the system and influence the interdependent interactions between components [18]. Example 1: Application of a systems approach for identifying patient safety risks in a proton therapy unit.

Image courtesy of Dr. Kimberly Stone and Jennifer Reid of the Pediatric Emergency Medicine Simulation Program at Seattle Children's Hospital 2014c) Fig. Image courtesy of Dr. Kimberly Stone and Jennifer Reid of the Pediatric Emergency Medicine Simulation Program at Seattle Children's Hospital 2014c). Image courtesy of Dr. Kimberly Stone and Jennifer Reid of the Pediatric Emergency Medicine Simulation Program at Seattle Children's Hospital 2014c).

Fig. 6.3 Pediatric simulator in a proton therapy bed. (Image courtesy of Dr. Ellen S Deutsch, Center for Simulation, Advanced Education and Innovation, the Children’s Hospital of Philadelphia)

Assessment in Pediatric Simulation

It is important to note that validity is a characteristic of the data and not a characteristic of the instrument. Determining this requires some judgment on the part of the assessor, which may be subject to bias. Shortcomings of BARS include a tendency to overestimate the learner's level of mastery by faculty (permissibility bias), halo effect, and poor discriminative capacity [44].

Internal consistency should only be used to support an argument if we believe that there must be consistency given the nature of the construct being assessed. These are not mutually exclusive and feedback mechanisms using several of the above approaches can be used. Measuring multidisciplinary health care team performance in a ward: a validation study of the Team Performance Assessment Tool (TFAT).

Fig. 7.1 The spectrum of assessment: formative versus summative

Pediatric Simulation Modalities, Technologies and Environments

Standardized Patients

Recruitment of standardized and simulated patients Recruitment can be one of the most challenging aspects of securing SPs. It is important to cast the right individual to portray patient and family roles so that the realism of the case is not affected. Regardless of how SPs are recruited, it is important to consider the ethnicity, gender and age of the individual in relation to the learning objectives of the case.

This can help standardize the case and allow standardized patients to ask questions and learn from each other. Incorporating simulated patients and simulated family members into high-resolution simulation scenarios can add an additional layer of complexity to the case and can increase the authenticity and usefulness of the educational experience [9]. Both standardized patients and simulated patients can also provide specific insight into the nuances of a learner's communication style, such as body language, tone, and eye contact [17].

Screen-Based Simulation, Virtual Reality, and Haptic Simulators

With SBS, however, most of the simulation can be done at the learner's own discretion and time. Keep in mind that all of the advantages listed above depend on programming; Proper data collection inside. Scenarios that require rapid and sequential actions on a patient can be very difficult to navigate if a complex set of menus and options is the SBS interface used.

At a minimum, an SME is required who provides a clinical perspective on VP fidelity and realism and interoperability. Determine the content of the case and choose a flow pattern: The content of the case should be appropriate for the level of the target learner. Construct validity testing of the Simbionix GI Mentor II virtual reality colonoscopy simulator metrics: module matters.

Fig. 9.1 Screenshot of a virtual patient encounter in a two-dimensional manner patient simulator

Mannequin-Based Simulators and Task Trainers

Figures 10.2 and 10.3 illustrate an example of the choice of simulation modalities based on educational objectives. Neonatal trainers are available for practicing umbilical catheterization of the venous and arterial lines (Fig. 10.12). A variety of LP PTTs for infants and children are available for practicing the LP technique (Figs. 10.15 and 10.16).

Pediatric models have soft and flexible body tissue resistance, which adds to the realism of the procedure. The model reproduces the arm of an 8-year-old child that can attach to the right shoulder of the mannequin away from the body for easy accessibility (Fig. 10.20). Soft and flexible material allows practical simulation of real examination procedures, such as lifting the eyelid to obtain better visualization of the eye (Fig. 10.25).

Fig. 10.2 Choosing a 3D training program best used to train knowledge of endotracheal intubation

Task and Procedural Skills Training

With the addition of high-resolution electronic components, airway trainers can mimic the functional and anatomical characteristics of the airway, and these features can be activated remotely in real time and change the difficulty of the task. A comprehensive review of the use of simulators in the field of otolaryngology has shown that dozens of training aids are available or under development in this field. Some trainers allow for connection to a drainage tube so that this part of the procedure can be practiced.

One of the oldest models, the skeleton, is ubiquitous in the training of healthcare professionals. Increasing the amount of time spent in the simulation setting is one of the most important aspects of procedural training. Use of tissue models for vascular access training: Phase I of the Procedural Patient Safety Initiative.

Table 11.1 Procedures required by selected accrediting organizations for Pediatric certification

In Situ Simulation

The physical and cognitive demands on the simulation educator team are different for in situ simulation than for simulations conducted within a center. For the richest experience, the new unit should be patiently ready before the in situ session. In situ offers the unique ability to explore complex systems and interrelationships, at all levels of the healthcare delivery process.

Integrated in-situ simulation using diverted faculty educational time to minimize costs: a feasibility study. High-reliability emergency response teams in the hospital: improving quality and safety using in situ simulation training. In situ simulation: detection of safety threats and teamwork training in a high-risk emergency department.

Fig. 12.2 Example of an in situ stretcher modified for carrying a mannequin, simulation equip-ment and supplies, which can be wheeled through the hospital for in situ simulation

Pediatric Simulation for Professional Development

Simulation Along the Pediatric Healthcare Education Continuum

A consideration of the research needs and future pedagogical directions of simulation-based education (SBE) across the healthcare education continuum. However, the study revealed that there is a lack of pediatric focused simulation-based curricula. As is evident from the breadth of literature discussed above, simulation-based programs have already found widespread acceptance in the undergraduate nursing and medicine contexts.

The application of simulation-based educational methodologies to pediatric postgraduate training has been widespread and, accordingly, has produced a robust literature [ 32 ]. A pre- and post-survey study of a web-based course and simulation of ultrasound-guided nerve blocks for pediatric emergency medicine. Self-perceived impact of simulation-based training in the management of real-life obstetric emergencies.

Table 13.1 A comparison of different approaches to graduate medical simulation

Simulation Curriculum Development, Competency-Based Education, and

Based on the results of the needs analysis, the target group and the level(s) of expertise, the critical requirements to be included in the training initiative should be identified. Based on social learning theory, all individuals may not need to participate in the simulation in order to learn. If formal requirements are not predefined, the design team must specify the competencies that will be included in the training.

The first step in the design phase is to write a goal statement against which the success of the training initiative will be measured. In the design phase of the curriculum development process, learning objectives for the subject are defined, while in the development phase, specific ones. Assessment should include assessment of student performance, as described below.