IPSS Webinar - EXPRESS
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The document describes a multicenter trial called EXPRESS that examined the impact of using a scripted debriefing method compared to a non-scripted method after pediatric resuscitation simulations. The trial involved over 200 participants across 14 sites in North America. Results showed no significant differences in learning outcomes between the scripted and non-scripted debriefing groups. Limitations included only using one simulation scenario and questions around how to best measure the impact of debriefing. The researchers used learnings from the trial to develop new debriefing tools and guidance that were incorporated into PALS instructor training.
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IPSS Webinar - EXPRESS
- 1. Assessing Simulation in Pediatrics: Improving Resuscitation Education Examining Pediatric Resuscitation Education using Simulation and Scripting (EXPRESS): A Multicenter Trial Adam Cheng, Elizabeth Hunt, Aaron Donoghue, Kristen Nelson, Walter Eppich, Vinay Nadkarni for the EXPRESS Investigators
- 2. • Research Grant Support – American Heart Association – EXPRESS project – Laerdal Foundation for Acute Medicine – Heart and Stroke Foundation of Canada – Canadian Institute for Health Research • Intellectual – Pediatric Subcommittee, American Heart Association – Contributing Editor, 2011 PALS Instructor Manual Assessing Simulation in Pediatrics: Improving Resuscitation Education Disclosure
- 3. • Trend: – More simulation in standardized resuscitation courses (PALS, ACLS) • Issue: – Thousands of instructors across North America – Instructor debriefing skills are variable Assessing Simulation in Pediatrics: Improving Resuscitation Education Background
- 4. • Proposed Solution: Debriefing Script – Sound debriefing principles – Framework – Specific wording and phrases – Promotes reflective learning Assessing Simulation in Pediatrics: Improving Resuscitation Education Debriefing Script
- 5. Multicenter Study • Prospective, RCT • Factorial design • Subjects: – Novice Instructors – Interprofessional pediatric healthcare teams Assessing Simulation in Pediatrics: Improving Resuscitation Education EXPRESS Study Low Realism (LoR) High Realism (HiR) Non-Scripted Debriefing (nS) nS - LoR nS - HiR Scripted Debriefing (S) S - LoR S - HiR
- 6. Assessing Simulation in Pediatrics: Improving Resuscitation Education EXPRESS Study Institution Investigator(s) BC Children’s Hospital Adam Cheng Children’s Hospital of Philadelphia Vinay Nadkarni, Aaron Donoghue, Akira Nishisaki Johns Hopkins Betsy Hunt, Kristen Nelson Children’s Medical Center Dallas Judy Leflore, Jeffrey Hopkins Cincinnati Children’s Mike Moyer, Mary Patterson Children’s Memorial Hospital Walter Eppich, Mark Adler Children’s Hospital Boston Marisa Brett-Fleegler, Monica Kleinman, Liana Kappus Children’s Hospital at Dartmouth Matthew Braga AI Dupont Susanne Kost, Glen Stryjewski Walter Reed / National Naval Steve Min, John Podraza, Joe Lopreiato Pittsburgh Children’s Melinda Fiedor-Hamilton Stollery Children’s Hospital Jonathan Duff Center for Medical Simulation Robert Simon, Jenny Rudolph Seattle Children’s Hospital Kimberly Stone, Jennifer Reid Oregon Health Sciences JoDee Anderson
- 7. • Task-based guidance • Performed Well vs. Needs Work • Debriefing Theory: Advocacy Inquiry Assessing Simulation in Pediatrics: Improving Resuscitation Education EXPRESS Script
- 8. Assessing Simulation in Pediatrics: Improving Resuscitation Education Debriefing Script
- 9. Assessing Simulation in Pediatrics: Improving Resuscitation Education EXPRESS – Study Design Interprofessional TeamInterprofessional Team Outcome Measures - Knowledge - Behavioural Performance - Cognitive Performance Outcome Measures - Knowledge - Behavioural Performance - Cognitive Performance Simulation Scenario - PRESimulation Scenario - PRE Simulation Scenario - POSTSimulation Scenario - POSTSimulation Scenario - POSTSimulation Scenario - POST Non-Scripted DebriefingNon-Scripted DebriefingScripted DebriefingScripted Debriefing Simulation Scenario - PRESimulation Scenario - PRE n=200n=187
- 10. Assessing Simulation in Pediatrics: Improving Resuscitation Education Review Team Cognitive Performance Tool (CPT) Behavioural Assessment Tool (BAT) Debriefing Assessment for Simulation in Healthcare (DASH) Stephanie Sudikoff Frank Overly Marino Festa Takanari Ikeyama John Podraza Glenn Stryjewski Aaron Donoghue Matthew Braga Kathleen Ventre Jonathan Duff Douglas Leonard Kristine Boyle Laura Corbin Mike Moyer JoDee Anderson Jeffrey Hopkins Walter Eppich Vinay Nadkarni Akira Nishisaki Elizabeth Hunt Kristen Nelson Monica Kleinman Marisa Brett-Fleegler Adam Cheng
- 11. Assessing Simulation in Pediatrics: Improving Resuscitation Education Research Portal
- 12. Assessing Simulation in Pediatrics: Improving Resuscitation Education Research Portal
- 13. Assessing Simulation in Pediatrics: Improving Resuscitation Education Research Portal Functionality LMS Res Portal Security Custom admin access Y Y Study Design Custom study design – arm / group / subject hierarchy Automated or custom assignment of subject codes N N Y Y Assessment Tools Custom tool creation Match assessment tools to videos Y Y Y Y Video Management Upload of video from multiple sites with different A/V systems Custom assignment of video to team OR individuals based on study arm View review and data entry online from multiple sites Y N N Y Y Y Data Management Download custom spreadsheets according to study arm or outcome measure N Y
- 14. Assessing Simulation in Pediatrics: Improving Resuscitation Education Results
- 15. Assessing Simulation in Pediatrics: Improving Resuscitation Education Validation of Assessment Tools
- 16. Assessing Simulation in Pediatrics: Improving Resuscitation Education EXPRESS Results
- 17. Why weren’t our results more significant? Scripted Debriefing: •One scenario – Difficulty? Enough exposure? •Length of debriefing Realism •High emotional, conceptual and environmental realism •Enough exposure? Assessing Simulation in Pediatrics: Improving Resuscitation Education Limitations
- 18. Assessing Simulation in Pediatrics: Improving Resuscitation Education Research Process
- 19. AHA Pediatric Subcommittee identified: •Existing PALS instructor material were inadequate •More debriefing instruction and guidance was required •Standardized method of debriefing needed to be introduced Assessing Simulation in Pediatrics: Improving Resuscitation Education PALS Instructor Training
- 20. • Online debriefing module • GAS Model – Gather – Analyze – Summarize Assessing Simulation in Pediatrics: Improving Resuscitation Education Structured and Supported Debriefing
- 21. Assessing Simulation in Pediatrics: Improving Resuscitation Education Challenge
- 22. Assessing Simulation in Pediatrics: Improving Resuscitation Education What worked… and What Didn’t EXPRESS Debriefing Script:
- 23. Assessing Simulation in Pediatrics: Improving Resuscitation Education New Debriefing Tool
- 24. Assessing Simulation in Pediatrics: Improving Resuscitation Education New Debriefing Tool
- 25. Assessing Simulation in Pediatrics: Improving Resuscitation Education New Debriefing Tool
- 26. Assessing Simulation in Pediatrics: Improving Resuscitation Education New Debriefing Tool
- 27. Assessing Simulation in Pediatrics: Improving Resuscitation Education Pilot Testing
- 28. • Structured and Supported Debriefing • Instructor Course • Instructor Manual – New debriefing chapter – Scenario Cards • Front : Scenario • Back : Debriefing Tool Assessing Simulation in Pediatrics: Improving Resuscitation Education 2011 PALS Instructor Training
- 29. Assessing Simulation in Pediatrics: Improving Resuscitation Education PALS Scenario Cards
- 30. Assessing Simulation in Pediatrics: Improving Resuscitation Education ACLS Scenario Cards
- 31. Assessing Simulation in Pediatrics: Improving Resuscitation Education PALS Debriefing
- 32. • Scripted debriefing helps to improve learning outcomes • Knowledge acquired from simulation-based research can be disseminated via collaboration with established associations • Future Directions – Research : instructor and learner feedback, compliance, usability, learner outcomes, patient outcomes – Use of debriefing tool in non-PALS context Effective knowledge translation = Greater Impact Assessing Simulation in Pediatrics: Improving Resuscitation Education Take Home Messages
- 33. Assessing Simulation in Pediatrics: Improving Resuscitation Education INSPIRE Network
- 34. • Attend meetings / webinars • Research – Single site studies – Multicenter studies • Primary or site investigator • Video reviewer • Consultant Assessing Simulation in Pediatrics: Improving Resuscitation Education INSPIRE Network • Distribution List: – Nicola Robertson – nicola.robertson@albertahealthservices.ca • Research: – Adam Cheng ch enger@me.com – Marc Auerbach dr.auerbach@gmail.com
Hinweis der Redaktion
- AHA research grant to address these – with our own goal of having the script in the 2011 instructor materials
- Primary : To evaluate the effectiveness of a scripted debriefing tool when used by novice instructors versus non-scripted debriefing after simulation-based learning for PALS educational outcomes Secondary : Evaluate the effectiveness of high fidelity simulation versus low fidelity simulation for PALS educational outcomes Novice Instructors As such we are utilizing a factorial design in order to assess the independent and potentially combined effect of these two interventions (script vs. no script and high vs. low fidelity mannequin) on the outcomes described. We also will test whether novice instructors performing a scripted debriefing rated higher than those facilitating a non-scripted debriefing as assessed by a debriefing assessment tool.
- Primary : To evaluate the effectiveness of a scripted debriefing tool when used by novice instructors versus non-scripted debriefing after simulation-based learning for PALS educational outcomes Secondary : Evaluate the effectiveness of high fidelity simulation versus low fidelity simulation for PALS educational outcomes Novice Instructors As such we are utilizing a factorial design in order to assess the independent and potentially combined effect of these two interventions (script vs. no script and high vs. low fidelity mannequin) on the outcomes described. We also will test whether novice instructors performing a scripted debriefing rated higher than those facilitating a non-scripted debriefing as assessed by a debriefing assessment tool.
- 3 pages Outline Medical Management Crisis Resource Management
- Primary : To evaluate the effectiveness of a scripted debriefing tool when used by novice instructors versus non-scripted debriefing after simulation-based learning for PALS educational outcomes Secondary : Evaluate the effectiveness of high fidelity simulation versus low fidelity simulation for PALS educational outcomes Novice Instructors As such we are utilizing a factorial design in order to assess the independent and potentially combined effect of these two interventions (script vs. no script and high vs. low fidelity mannequin) on the outcomes described. We also will test whether novice instructors performing a scripted debriefing rated higher than those facilitating a non-scripted debriefing as assessed by a debriefing assessment tool.
- 3 pages Outline Medical Management Crisis Resource Management
- Three full-day courses were designed to meet the distinct learning objectives of pediatric residents in years 1 through 3 respectively. We chose a blended approach to address various learning styles and emphasized core knowledge with didactic teaching, technical competence with skill stations, and clinical application with simulation scenarios. All scenarios were reviewed and pilot tested as part of the existing pediatric emergency medicine simulation-based curriculum at BCCH
- Three full-day courses were designed to meet the distinct learning objectives of pediatric residents in years 1 through 3 respectively. We chose a blended approach to address various learning styles and emphasized core knowledge with didactic teaching, technical competence with skill stations, and clinical application with simulation scenarios. All scenarios were reviewed and pilot tested as part of the existing pediatric emergency medicine simulation-based curriculum at BCCH
- Three full-day courses were designed to meet the distinct learning objectives of pediatric residents in years 1 through 3 respectively. We chose a blended approach to address various learning styles and emphasized core knowledge with didactic teaching, technical competence with skill stations, and clinical application with simulation scenarios. All scenarios were reviewed and pilot tested as part of the existing pediatric emergency medicine simulation-based curriculum at BCCH
- Three full-day courses were designed to meet the distinct learning objectives of pediatric residents in years 1 through 3 respectively. We chose a blended approach to address various learning styles and emphasized core knowledge with didactic teaching, technical competence with skill stations, and clinical application with simulation scenarios. All scenarios were reviewed and pilot tested as part of the existing pediatric emergency medicine simulation-based curriculum at BCCH
- No difference in demographics between groups
- How could this be effectively done with an instructor network of thousands?
- Three full-day courses were designed to meet the distinct learning objectives of pediatric residents in years 1 through 3 respectively. We chose a blended approach to address various learning styles and emphasized core knowledge with didactic teaching, technical competence with skill stations, and clinical application with simulation scenarios. All scenarios were reviewed and pilot tested as part of the existing pediatric emergency medicine simulation-based curriculum at BCCH
- How could this be effectively done with an instructor network of thousands?
- How could this be effectively done with an instructor network of thousands?
- Gather Participants provide their perspective Team leader Team member Facilitator asks probing questions to encourage discussion Analyze Facilitator promotes student reflection and analysis Facilitator reviews record of events (objective) Participants and facilitator report observations (good and bad) Participants and facilitator understand basis of actions Performance gaps are closed through discussion and reflection Summarize Participants review lessons learned Facilitator elicits what learners will do differently
- The final year 3 course emphasized crisis resource management (CRM) principles. These were highlighted with carefully scripted scenarios and included one scenario with a blindfolded leader to illustrate the importance of closed-loop communication and situational awareness.
- Learning objectives matched to the action column in the tool
- The final year 3 course emphasized crisis resource management (CRM) principles. These were highlighted with carefully scripted scenarios and included one scenario with a blindfolded leader to illustrate the importance of closed-loop communication and situational awareness.
- The final year 3 course emphasized crisis resource management (CRM) principles. These were highlighted with carefully scripted scenarios and included one scenario with a blindfolded leader to illustrate the importance of closed-loop communication and situational awareness.
- Disseminated through the entire AHA instructor network and Heart and Stroke Canada Debriefing Tool has been implemented into ACLS course material as well
- Disseminated through the entire AHA instructor network and Heart and Stroke Canada Debriefing Tool has been implemented into ACLS course material as well
- Disseminated through the entire AHA instructor network and Heart and Stroke Canada Debriefing Tool has been implemented into ACLS course material as well
- Disseminated through the entire AHA instructor network and Heart and Stroke Canada Debriefing Tool has been implemented into ACLS course material as well