Heather is a fourth year resident asked to create and facilitate a simulation scenario for junior residents. She has always been interested in simulation based learning, but struggles with finding the time to create high-fidelity scenarios featuring important learning points. Heather wonders if there is a collection of simulation scenarios that she can use as educational tools.
Emergency Medicine training programs often use simulation scenarios as important teaching tools. However, due to time constraints, it can be difficult to create high-fidelity and high-yield situations. This Feature Educational Innovation (FEI), titled “Archives of Scholarship in Simulation and Educational Techniques (ASSET)” was originally posted by the CAEP EWG FEI Team on August 17, 2016 and answers the question: “Can we provide trainees and educators with an online repository of simulation scenarios?” A PDF version is available here. A CAEP Cast is available here.
Summary of the Innovation
The authors write simulation scenarios (technical reports) in multidisciplinary teams, with learners from all levels, and publish the scholarly product in a peer-reviewed journal that is indexed with PubMed Central. ASSET is their channel in the “The Cureus Journal of Medical Science”. ASSET gathers the work under one roof, and provides a home for their Community of Practice (CoP).1 By involving learners, they facilitate achievement of the CanMEDS roles.2 The innovation also makes simulation scenarios globally accessible while at the same time encouraging scholarly activity.
This online simulation repository can be found here.
Rationale of ASSET
Simulation is a commonly used and valuable vehicle for delivering health professionals education (HPE). While educators based in academic centres generally have access to simulation facilities and sophisticated teaching equipment, they may lack the protected academic time to write scenarios. Educators in rural settings are similarly challenged, particularly in distributed provinces like Newfoundland and Labrador (NL). Memorial University’s mission states that students must receive the same quality of education wherever in the province they are learning,3 but in reality some are far away from the simulation laboratory. Rural preceptors with punishing clinical schedules may have even less protected time than their urban counterparts. The challenge, then, is two-fold: finding resources to provide open and accessible simulation-augmented HPE, while enabling, encouraging and recognizing scholarly activity.
The innovation potentially mitigates both issues.
Composition of ASSET
The authors write simulation scenarios in teams composed of undergraduates from across disciplines, residents, medical education researchers and clinical faculty. They publish then scenarios in a peer-reviewed journal. Each team member has a role to play, thereby fulfilling a CanMEDS role like leader, communicator or medical expert. Writing simulation scenarios allows students to actively learn patient management alongside contextual matters that affect patient care. For instance to write a scenario involving pregnancy and privacy in the emergency department,4 learners must diagnose and manage a potential ectopic pregnancy while maintaining patient privacy and confidentiality in the face of her anxiously hovering parent. Writing is itself a necessary skill for learners; the process of writing simulation scenarios reinforces the stepwise learning that simulation teaches.5 This enables first and second year medical learners to consider complex simulated scenarios ahead of the actual ones they will encounter later.
The teams are inter-disciplinary. The collaborative educational laboratory gathers kinesiology, music and engineering students to work alongside learners from allied health professions. While not everybody can contribute medical knowledge, each learner has a valuable role. For example, an engineering student learns project management and leadership when she or he is tasked with bringing a publication to fruition. A human kinetics student familiar with literature on human skills acquisition and development contributes applicable theory from that domain, and a music student contributes experience with deliberate practice. All these contributions help build a robust scholarly work that is worthy of publication.
The setting for the innovation is the nascent inter-disciplinary laboratory, a natural home for a CoP. Necessary resources are few beyond human. Online connectivity helps to extend the CoP beyond the laboratory’s bricks-and-mortar confines. On reflection, the authors felt that students must be empowered as project managers and given academic rewards in order to feel comfortable placing demands on busy medical faculty.
Future Directions of ASSET
In order to encourage involvement and activity, the authors have launched an inaugural Simulation by Design competition. This competition is primarily meant to promote the development of an online repository of simulation cases that can be freely shared across professions and geographical locations. The simulation cases are published as Technical Reports, all of which are subject to rigorous peer-review and publishing processes; as such they will be indexed in PubMed Central and distributed around the globe. Additionally, by using the Scholarly Impact Quotient (SIQ), a crowdsourcing feature that is unique to Cureus, to score the Technical Reports and choose the winner, the authors continuously build their CoP.
How do you obtain simulation scenarios for your training program?
What strategies do you use to create high-fidelity simulation scenarios?
More about CAEP FEI
This post was originally authored for the Canadian Association of Emergency Physicians (CAEP) Feature Educational Innovations project sponsored by the CAEP Academic Section’s Education Working Group and edited by Drs. Teresa Chan and Julien Poitras. CAEP members receive FEI each month in the CAEP Communiqué. CanadiEM will be reposting some of these summaries, along with a case/contextualizing concept to highlight some recent medical education literature that is relevant to our nation’s teachers.