Download - 2012.07.02 the story from the asset centre
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ASSET Centre UCC Galway July 2012
John McAdoo Medical Director ASSET Centre University College Cork
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Introduction
We are what we repeatedly do
Excellence is not an act, but a habit
Aristotle
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Ether Dome 1846
Photo from the Mass General Site
Halstedian Training
Apprentice Model
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21st Century Competency Based Healthcare Training and Assessment
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Simulation Training UCC Why Now?
• Progressive decrease in traditional clinical learning opportunities for health professionals
(Explicit patient covenant, legislation such as EU Working Time Directive, Health Service Reconfiguration)
• Worldwide move from time-based to competence-based training in healthcare
• Legislation which requires implementation of mandatory professional competence schemes
• Current or future mandatory recertification/revalidation of health professionals
• Routine Disclosure of Trainee Participation and Its Effect on Patient Willingness and Consent Rates
Ref Christopher R. Porta et al Arch Surg. 2012;147(1):57-62
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Simulation Training UCC Why Now?
• Medical "inflation" - increase in the rate of development of new techniques, procedures, devices with evidence of (or licensed to) improve patient care.
• The bodies responsible for licensing medical devices will require evidence of valid reliable forms of assessment of the use by individual practitioners.
• The FDA recommends validation and human factors testing in a simulated environment as part of any pre-market approval application. (FDA draft guidance January 2012)
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Simulation Training UCC Why Now?
• Expectations as outlined in the Buttimer Report
Provide for the necessary infrastructural and ICT investments and virtual laboratories at an early stage (Buttimer Report, Ireland)
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International Simulation Training
• Simulation based training has already been mandated by the Accreditation Council for Graduate Medical Education (ACGME) (Beall, 1999)
• Australia as part of a $1.5 billion investment in healthcare education
• $46M will be allocated in 2010-11 to support SLE capital establishment $48M will be allocated to revenue costs
• The program will have an annual allocation of $20m Ref Mark Cormack: Head of Health Workforce Australia, Health Workforce Australia website
March 2011
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Medical Simulation UK
• Simulation offers an important route to safer care for patients and must be more fully integrated into the health service.
• This framework clearly states that healthcare professionals, as part of a managed learning process and where appropriate, should learn skills in a simulation environment and using other technologies before undertaking them in supervised clinical practice.
Liam Donaldson 2008 CMO UK
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Team Training
• Patient care depends on high functioning teams.
• We must ensure that technological approaches are used to support teams training together.
• Simulation in particular allows teams to practise safely and reduces the risk of complications for patients.
(A Framework for Technology Enhanced Learning DoH UK) Dame Sally Davies CMO UK
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TE Simulation the Evidence
• Technology-enhanced simulation training in health professions education is consistently associated with large effects for outcomes of knowledge, skills, and behaviours and moderate effects for patient related outcomes.
Ref Technology-Enhanced Simulation for Health Professions Education A Systematic Review and Meta-
analysis Cook et al JAMA, September 7, 2011—Vol 306, No. 9
• SBME with DP is superior to traditional clinical medical education in achieving specific clinical skill acquisition goals
Ref Does Simulation-based medical education with deliberate practice yields better results than traditional
clinical education:? A meta-analytic comparative review of the evidence.
McGaghie WC, et al Acad Med. 2011 Jun;86(6):706-11
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ASSET Centre Hub and Spoke
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Objectives of ASSET Centre
• A capacity resource to UCC • Team Training and Human Factors CRM Courses • High fidelity skills training • Standard courses eg ACLS etc • Medium fidelity and clinical skills training • Opportunities for deliberate skills practice • Assessment • CPD – Self Directed Learning • Research • Critical event management • Multidisciplinary and inter-professional/disciplinary training and
education • Proficiency-based progression • Train the Trainer Courses
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Research
• Formative Assessment
• Summative Assessment
• High Stakes Assessment
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Fifth Year Medical Students Feedback
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Interns Feedback
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Postgraduate Structured Feedback
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Questions?