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Global Perspective for Integrating Simulation Across the Curriculum

Global Perspective for Integrating Simulation Across the Curriculum. Dr. Teresa Gore. SIM-One 2015 SIM EXPO Simulation and Integration Toronto, Canada December 14, 2015. Presenter. Teresa Gore, PhD, DNP, FNP-BC, NP-C, CHSE-A Associate Professor

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Global Perspective for Integrating Simulation Across the Curriculum

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  1. Global Perspective for Integrating Simulation Across the Curriculum Dr. Teresa Gore SIM-One 2015 SIM EXPO Simulation and Integration Toronto, Canada December 14, 2015

  2. Presenter • Teresa Gore, PhD, DNP, FNP-BC, NP-C, CHSE-A • Associate Professor • University of South Florida College of Nursing • INACSL President 2015-2017 • Disclosure: Elsevier Simulation Learning System (SLS) scenario development

  3. Overview • The body of evidence supporting the use of standards in Simulation education is growing.  • This presentation will introduce the standards and provide concrete examples for faculty to integrate the standards across nursing curriculum globally.

  4. What is Simulation • “A pedagogy using one or more typologies to promote, improve, or validate a participant’s progression from novice to expert” • “Technique not technology to replace or amplify real experiences” • “An educational technique that allows interactive and at times immersive activity by recreating all or part of a clinical experience without exposing patients to the associated risks” • A pedagogy using one or more typologies to promote, improve, or validate a participant’s progression from novice to expert - CASN

  5. Australia • Canada • China • Egypt • Europe • France • India • Mexico • Middle East • South America • Spain • Turkey • USA

  6. GNSH • Brazilian Association for Simulation in Healthcare • Association for Simulated Practice in Healthcare (ASPE) • Association for Standardized Patient Educators (ASPE) • Australian Society for Simulation in Healthcare (ASSH) • Canadian Network of Simulation in Healthcare (CNSH) • Nine Industry Providers • International Nursing Association for Clinical Simulation and Learning (INACSL) • International Pediatric Simulation Symposia (IPSS) • Japanese Society for Instructional Systems in Healthcare (JSISH) • London Deanery • Polish Society for Simulation in Healthcare (PSSH) • Royal College of Physicians and Surgeons of Canada (RCPSC) • Spanish Society for Simulation in Healthcare • Swiss Standardized Patient and Simulation Group • Society for Simulation in Healthcare (SSH) • Society in Europe for Simulation Applied to Medicine (SESAM)

  7. Global

  8. INACSL • Vision: INACSL is the global leader in transforming practice to impact patient safety through excellence in healthcare simulation. • Mission: Advancing the science of healthcare simulation

  9. Canadian Representation • Nicole Harder • University of Manitoba • VP of Finance • Assistant Editor Clinical Simulation in Nursing • Colette Foisy-Doll • Grant MacEwan University • Awards and Nominations Chairperson • Leslie Graham • Durham College • Standards Committee • Running for VP of International Collaborative

  10. INACSL Standards • INACSL Standards of Best Practice: SimulationSM • 2011 • 2013 • 2015 • 2016

  11. External Review • American Academy of Pediatric Dentistry • American Nursing Association • Association for Simulated Practice in Healthcare • Australian College of Nursing • Australian Society for Simulation in Healthcare • British Columbia Institute of Technology School of Health Sciences • International Council of Nurses • International Federation of Dental Anesthesiology Societies • International Simulation and Gaming Association • National League for Nursing • Royal College of Physicians and Surgeons of Canada • Sigma Theta Tau International • Simulation Task Force of QTAR • Scottish Centre for Simulation and Clinical Health Factors • Society for Simulation in Healthcare

  12. Standards 1. Terminology 2. Professional Integrity 3. Participant Objectives 4. Facilitation Methods 5. Facilitator 6. Debriefing 7. Evaluation • Sim-IPE • Simulation Design

  13. INACSL Standards of Best Practice: SimulationSM Terminology

  14. Consistent terminology provides guidance and clear communication and reflects shared values in simulation experiences, research, and publications. Knowledge and ideas are clearly communicated with consistent terminology to advance the science of simulation. Consistency

  15. INACSL Standards of Best Practice: SimulationSM Professional Integrity

  16. It is essential to provide clear expectations for the attitudes and behaviors of simulation participants. Professional integrity related to confidentiality of the performances, scenario content, and participant experience is required during and after any simulation. Confidentiality is expected in live, recorded, or virtual simulation experiences.

  17. Criterion 1. Protecting content of scenario and simulation • Criterion 2. Demonstrating professional and ethical behavior • Criterion 3. Receiving and providing constructive feedback

  18. INACSL Standards of Best Practice: SimulationSM Participant Objectives

  19. All simulation-based learning experiences begin with development of clearly written participant objectives, which are available prior to the experience. Criterion 1. Address domains of learning Criterion 2. Correspond to participant’s knowledge level and experience Criterion 3. Remain congruent with overall program outcomes

  20. Criterion 4. Incorporate evidence-based practice • Criterion 5. Include viewing of client holistically • Criterion 6. Be achievable within an appropriate timeframe

  21. Innovative Curriculum Overview • Typical 57

  22. INACSL Standards of Best Practice: SimulationSM Facilitation

  23. Multiple methods of facilitation are available, and use of a specific method is dependent on the learning needs of the participant(s) and the expected outcomes. • Criterion 1. Using facilitation methods congruent with simulation objectives • Criterion 2. Using facilitation methods congruent with expected outcomes

  24. Pre-briefing During Simulation Debriefing

  25. INACSL Standards of Best Practice: SimulationSM Facilitator

  26. A proficient facilitator is required to manage the complexity of all aspects of simulation. The facilitator has specific simulation education provided by formal coursework, continuing education offerings, and targeted work with an experienced mentor. • Criterion 1. Clearly communicates objectives and expected outcomes to participant(s) • Criterion 2. Creates a safe learning environment that supports and encourages active learning, repetitive practice, and reflection

  27. Criterion 3. Promotes and maintains fidelity • Criterion 4. Uses facilitation methods appropriate to participants’ level of learning and experience • Criterion 5. Assesses and evaluates the acquisition of knowledge, skills, attitudes, and behaviors • Criterion 6. Models professional integrity

  28. Criterion 7. Fosters participant learning by providing appropriate support throughout the simulation activity, from preparation through reflection • Criterion 8: Establishes and obtains evaluation data regarding the effectiveness of the facilitator and the simulation experience • Criterion 9. Provides constructive feedback and facilitates debriefing with participants

  29. INACSL Standards of Best Practice: SimulationSM Debriefing

  30. All simulation-based learning experiences should include a planned debriefing session aimed toward promoting reflective thinking. • Criterion 1. Facilitated by a person(s) competent in the process of debriefing • Criterion 2. Conducted in an environment that supports confidentiality, trust, open communication, self-analysis, and reflection

  31. Criterion 3. Facilitated by a person(s) Who observes the simulated experience • Criterion 4. Based on a structured framework for debriefing • Criterion 5. Congruent with the participants’ objectives and outcomes of the simulation-based learning experience

  32. Debriefing Methods How and why do you debrief? Plus – delta (can use delta sign) Structured and Supported Debriefing Module using Gather, Analyze, and Summarize (GAS) Debriefing for Meaningful Learning Debriefing Assessment for Simulation in Healthcare Debriefing Using Good Judgment PEARLS

  33. INACSL Standards of Best Practice: SimulationSM Evaluation

  34. In a simulation-based experience, formative assessment or summative evaluation can be used Criterion 1. Formative assessment Criterion 2. Summative evaluation Criterion 3. High-stakes evaluation

  35. Adamson, K. A., Kardong-Edgren, S., & Willhaus, J. (2012). An updated review of published simulation evaluation instruments. Clinical Simulation in Nursing, 9(9), 393-400. http://dx.doi.org/10.1016/j.ecns.2012.09.004 • Kardong-Edgren, S., Adamson, K. A., & Fitzgerald, C. (2010). A review of currently published evaluation instruments for human patient simulation. Clinical Simulation in Nursing, 6(1), e25-e35. doi:10.1016/j.ecns.2009.08.004

  36. Sample Evaluations • CLECS • CCSI

  37. INACSL Standards of Best Practice: SimulationSM Simulation-Enhanced interprofessional education (sim-IPE)

  38. Sim-IPE occurs when participants and facilitators from two or more professions are engaged in a simulation health care experience to achieve shared or linked objectives and outcomes. The Sim-IPE is designed for the individuals involved to “learn about, from and with each other to enable effective collaboration and improve health outcomes” (WHO, 2010, p.31) Criterion 1. Based on Theory Criterion 2. Follow Best Practices in Simulation-Based and IPE Criterion 3. Address Institutional and Local Issues Criterion 4. Include an Evaluation Plan

  39. INACSL Standards of Best Practice: SimulationSM Simulation Design

  40. Simulation-based experiences (SBEs) should be purposefully designed to meet identified objectives Criterion 1. Needs Assessment Criterion 2. Measurable Objectives Criterion 3. Format of Simulation Based Experiences Criterion 4. Clinical Scenario or Case Criterion 5: Fidelity

  41. Criterion 6: Facilitator/Facilitative Approach • Criterion 7: Briefing • Criterion 8: Debriefing and/or Feedback • Criterion 9: Evaluation • Criterion 10: Participant Preparation • Criterion 11: Pilot Testing of the SBE

  42. Simulation Design

  43. Simulation Design Effective Simulation-based Learning Design Aldridge, M (2012) Developing Healthcare Skills through Simulation. London, SAGE.

  44. Application • Arizona State Board of Nursing Advisory Opinion: Use of Simulation in Approved RN/LPN Programs • Incorporates a policy, general guidelines, requirements for simulation • Training requirements for facilitators • Canadian Association of Schools of Nursing (CASN)

  45. Simulation Guidelines • The NCSBN Simulation Guidelines are available at http://www.journalofnursingregulation.com/article/S2155-8256(15)30783-3/pdf • Commitment from the institution • Appropriate facilities • Educational and technological resources and equipment • Qualified faculty and personnel

  46. Resistance • Buy-in • Roger’s Diffusion of Innovation Theory • Diffusion of innovations is a theory that seeks to explain how, why, and at what rate new ideas and technology spread through cultures • Cost • Mindset • Skills lab versus simulation

  47. Simulation Fellowship • INACSL and CAE Healthcare • Fellowship based on the INACSL Standards of Best Practice: Simulation SM and the Essential of Simulation • Timeline • Webinar • Two-day immersive workshop • Webinar • Two-day immersive workshop • Mentorship online

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