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Development of National Approach to Simulation based Education
Phase 1 Development University of Dundee/NES Partnership 2007-2011
Phase 2 Capacity buidlingIncorporated into NES Across Directorates
2011-2014
Phase 3 Collaboration Medical Directorate
2014 CSG Multiprofessional Group2017 NES Medical Simulation Collaborative
Evidence of Effectiveness of Simulation
• Professional Behaviours• SBE shortened learning curves(Ahlberg 2007, Larsen 2009)• Enhanced proficiency and decreased performance time
(Kneebone 2003)• Investigation of Performance Shaping Behaviour (Howard et al
2003 use of new airways and fatigue)
• Professional Practice • Wayne et al (2008) enhanced compliance to treatment guidelines
ie cardiac arrest
• Patient Outcome • Barsuk et al (2009) Dec complications of procedures• Duncan et al 2009 Pleural aspiration • Barsuk et al (2014) Abdominal paracentesis• Draycott (2006) Perinatal outcome enhanced
For Further Information Contact:
Clinical Skills Managed Educational Network
Core principles of:
• Functioning with explicit management arrangements
• Embedding systems of accountability
• Agreeing expected outcomes
• Utilising an evidence base
• Committing to Research and Development
• Having a multi-professional and multidisciplinary staff engagement focus
• Engaging in a system of dissemination
• Generating better value for money
adapted from MCN NHS HDL 69 (2002)
Clinical Skills Simulation Framework for Excellence
Managed Educational
Network
Partnership working and Networking
Educational resources
Research and development
Quality assurance and
Standards Delivery of Skills Education
Faculty development
• CSMEN Research and Development Conferences • PhD funding to explore the use and impact of a mobile clinical skills
and simulation facility in remote and rural Scotland using a realistapproach.
• Collaborative ProjectsCollaborative developmental projects have been undertaken underthe CSMEN umbrella with RHEAL, Optometry and Pharmacy.
• Research and Development Projects26 projects funded. A transparent peer reviewed applicationprocess utilised.
CSMEN Research and Development Work stream
CSMEN R and D Conferences
• Improving Quality of Medical Education Research C Rees (2011-12)
• Advances in simulation based Education Research N Maran (2012-13)
• Human Factors in Simulation based education Research V Swanson (2103-14)
Agreed high level outcomes for simulation
based education at Tier 1
AOME
domains
Describe range of appropriate learning
activities that can use simulation
( e.g. procedural skills, communication
skills, drills etc)
1.1.5, 2.1.1
2.1.5, 2.2.1
Recognise the spectrum of simulation
modalities
(e.g. VR, part task, emulators, manikins,
and simulated patients )
Recognise impact simulation based learning
(SBL) can have on learner, team and system
(e.g. knowledge, skills, drills and
performance)
1.3.2
2.3.10
Identify the range of opportunities for
faculty development in simulation based
learning
( e.g. range of courses, programmes
masterclasses, degrees)
2.2.3
Recognise SBL in context of curriculum
outcomes
(e.g. Tomorrows Doctors, Foundation and
specialty competency based curricula,
NMC, )
1.3.2
Demonstrate awareness of mapping where
simulation can enhance curriculum delivery
(e.g. Blue print vs curriculum )
1.2.5
Agreed high level outcomes for
simulation based education Tier 2
AOME
Domains
Identify appropriate learning outcomes
for simulation based learning event
( e.g. use of SMART, Blooms taxonomy )
1.1.4
1.1.3
Demonstrate the appropriate
underpinning educational theory
( e.g. behaviourism, experiential learning
reflective practice, social cognitive
theory, activity theory )
1.1.2,
4.1.1
4.2.1
Design a SBL event taking account stage
and expertise of learner
(E.g Dreyfus and Dreyfus, Benner
Challenge point framework, Perry )
1.1.1
1.1.3
Design a SBL event utilising principles of
deliberate practice and prevention of
skill decay
( e.g. Ericsson, paced education )
1.1.1
Design a SBL event using principles of
constructive alignment
(e.g Biggs)
1.2.5
4.1.1
Delivery of SBL Activity
(E.g. Immersion using STEPS or 4 stage,
reflective immersion,
use of faculty confederate Simulated
patients and or simulators)
2.1.1
Debrief and reflect on the SBL event
(use of relevant models, e.g. agenda led-
outcomes based, description-analysis-
application, learning conversation)
2.1.4,
2.1.6
2.2.6,
2.2.7
Establish a safe learning environment for
the SBL event
( e.g. Confidentiality, consent, ground
rules, time out )
2.1.2,
2.2.2,
2.3.4
Evaluate SBL event using appropriate
framework
( eg Realistic evaluation, Kirkpatrick
levels, DASH Student version )
1.1.6,
1.2.7
Agreed high level outcomes for simulation based
education Tier 3
AOME
Domains
Design, deliver and evaluate Interprofessional SBL
event
2.3.1
Evaluate role as SBL educator
(e.g. for portfolio evidence, appraisal)
2.2.9
4.2.2
Demonstrate use of simulation for assessment
(e.g. constructive alignment, immersion and
assessment; use of Millar’s triangle; Tools such as
OSCE and OSCE variants, OSATS, Behavioural
marker systems, WSE tool)
3.1.1-6
Demonstrate skills with video debrief of SBL event
(e.g. book-marking, learning aligned selection,
signposting, use of teaching moments)
2.2.6,
2.3.8
Identify and contribute research opportunities for
simulation based education
(e.g. Multicentre trials, publications,)
4.1.4,
4.2.3,
4.3.5
Develop integrated curricular programme for SBL
(e.g. integrated, progressive development of
knowledge, skills, drills and performance )
1.3.1
Participate in learning from meta-debriefing (E.g.
DASH, OSAD, peer review debriefing)
2.3.7,
2.3.11
Provide leadership for SBE educators
(e.g. organisations such as universities NHS
organisations, societies and associations)
5.1.3
Recognise need to link to statutory and regulatory
bodies (e.g. GMC, NMC, HPC)
5.1.4
Manage resources effectively and efficiently ( e.g.
use of simplest possible simulator, procurement of
consumables, development of patient banks )
5.2.1
CSMEN R and D Projects
Skills Development Role of laparoscopic simulation in surgical skills acquisition: a feasibility studyVariation in training of SPs across Scottish medical schools. What is best practice?Enhancing Skills MaintenanceDevelopment, implementation & evaluation of online video in clinical skills education to UG student nursesEvaluating the effectiveness of podcasts in UG practical procedure training.Significant Event Analysis: a reflective tool for UG medical students.Peer teaching of clinical skills by undergraduate studentsPreparation for PracticeAs easy as ABC? How can newly-qualified doctors be better prepared in acute care?Standards of safe clinical practice in the elderly - identifying the components for a core clinical skills bundleHighland Surgical Bootcamp: using self-regulated learning microanalysis to determine if sequential simulations can accelerate non-technical and technical skills acquisition in new-start surgical trainees.Non Technical SkillsCritical Incident training: does inter-disciplinary training enhance critical decision making and team performance
Cleland J., Walker K., Gale M., Nicol LG., Simulation based education: understanding the socio-cultural complexity of a surgical training boot camp Med Educ 2016, 50 (8) 829-41
McGuire A, McEwan T, Ker JS, Stafford DA. Pharmacy support in developing prescribing skills. Clinical Teacher 2015; 12(6) 408-12 doi:10.1111/tct. 12324
Mok M, Ker JS. Developing clinical skills bundles. Clinical Teacher 2015; 12(6) 403-7doi:10.1111/tct. 12332
Joseph, S., Diack, L., Haxton, J. and Garton, F., 2012. Interprofessional education in practice. The Clinical Teacher, 9(1), pp. 27-31
Tallentire V Smith SE Skinner J Cameron H., Understanding the behaviour of newly qualified doctors in acute care contexts Med Educ 2011 45(10) 995-1005
CSMEN R and D Peer Reviewed Publications
Clerihew L., Rowney D., Ker J., Simulation in paediatric training Arch Diseases in Childhood Pract Ed (2016) 101(1) 8-14
Gordon L., Rees C., Ker J., Cleland J., Dimensions, discourses and differences: conceptualization healthcare leadership and followership Medical Education (2015) 49(12) 1248-62
Ker J., Cachia P., Beasant B., A national approach for the use of simulation to educate and train the NHS workforce- The first National Clinical Skills Strategy Scottish Medical Journal (2015) 60(4)220-2
Skinner J, Hardie L, Baker A, Beasant B, Ker J, O’Neill A, Morse J. Trochars no more.2014; Medical Teacher 37 No 6 585-588
Dennis A, Cleland JA, Johnston P, Ker JS, Lough M, Rees CE. Identifying multiple stakeholders’ views of medical education research priorities: A national survey. Medical Education 2014; 48 (11) 1078-91
Jarvis I, Ker J., Ensuring standards for the extended role of optometry The Clinical Teacher 2014:11 (3):184-7.
De Mello, G, Fraser F, Nicholl, P, Ker, J, Green G, Laird C. Mental health care training for practitioners in remote and rural areas. The Clinical Teacher 2013: 10:384-388
Johnstone T., Tang B., Alijani A., Tai I., Steele R., Ker J., Nabi G., Laparoscopic surgical skills are significantly improved by the use of portable laparoscopic simulator: results of a randomized controlled trial World Journal of Surgery 2013 37(5) 957-64
Ker J. Review: The challenges of developing and evaluating complex care scenarios using simulation in nurse education Journal of Research in Nursing 2012: vol17 (4) 346-347.
Hogg G, Stewart F, Ker J Over the counter clinical skills: enhancing the profile of the pharmacists role through safe acquisition of clinical skills. The Clinical Teacher 2011; 8:109-113.
Ker J, Stevenson J Education through simulation News Laerdal 2009; Issue 10; 1-2
• 18 final reports which are on the website
• Three awards have funded MDs.
• Three awards have funded Masters Projects
• AMEE prize winner
• RPS award
CSMEN Research and Development Impact