interior health/ubc faculty of medicine simulation …...the sims make me feel more confident in my...

Interior Health/UBC Faculty of Medicine

Simulation Program

2017-18 Annual Report

2017-18 Simulation Program Annual Report of 36

Table of Contents

Executive Summary .................................................................................4

Vision & Mission Statement ....................................................................5

Staff ...........................................................................................................6

Donors .......................................................................................................8

Metrics .......................................................................................................9

Utilization – Fixed Centres .................................................................................................................... 9

Evaluation Data – Fixed Centres ............................................................................................................. 10

Attendance – Rural Sites ........................................................................................................................ 11

Evaluation Data – Rural Sites ................................................................................................................. 12

Simulation Educational Courses ..........................................................13

Research .................................................................................................15

Notable Achievements ...........................................................................16

Publication - two part series on Simulation ............................................................................................... 16

Simulation Fellowship ............................................................................................................................ 16

Emergency Nursing Association of BC Conference (ENABC) ..................................................................... 17

Simulated Ultrasound Machine ............................................................................................................... 17

Professional Development ....................................................................18

Simulation Learning Strategies ............................................................................................................... 18

Royal College of Canada Simulation Summit ........................................................................................... 18

Preventative Maintenance (PM) Course ................................................................................................... 18

Gateway Debriefing Skills Workshop ....................................................................................................... 19

Education ................................................................................................23

UBC Faculty of Medicine – Southern Medical Program .......................................................................... 23

Transition into Clinical Education (TICE) ............................................................................................. 23

UBC Faculty of Medicine – Family Medicine ........................................................................................... 24

Canadian Residency Simulation Tournament (CReST) ................................................................... 24

UBC FoM Family Practice (FP) Residency Programs ...................................................................... 24


Kelowna Emergency Medicine Residency Program ................................................................................ 25

The UBC Emergency Medicine Interior Site ........................................................................................ 25

Emergency Department (ED) in situ .................................................................................................... 25

Interior Health ......................................................................................................................................... 26

Safe Consumption Site ....................................................................................................................... 26

The BC Society of Respiratory Therapists (BCSRT) ........................................................................... 26

Mock Code Pinks ................................................................................................................................ 27

Five Alive Blue and White ................................................................................................................... 27

Just in Time ........................................................................................................................................ 27

IH Rural Mobile Simulation Program ....................................................................................................... 29

Collaboration Provincially .....................................................................30

Mobile Medical Unit (MMU) .................................................................................................................... 30

Simulation Trauma Update Course (STRUC) ......................................................................................... 30

Provincial Initiatives ..............................................................................31

The British Columbia Simulation Network (BCSN) .................................................................................. 31

Clinical Simulation Management System ................................................................................................ 31

Capital Equipment Purchase Contract .................................................................................................... 31

Collaboration with Schools ...................................................................32

UBC Okanagan School of Nursing ......................................................................................................... 32

British Columbia Institute of Technology (BCIT) Emergency Nursing...................................................... 32

University of Northern BC(UNBC) Rural Emergency Nursing Course ..................................................... 32

Thompson River’s University (TRU) Respiratory Therapy (RT) Program ................................................ 32

Selkirk College Nursing Program ............................................................................................................ 33

School District #23 .................................................................................................................................. 33

Justice Institute of British Columbia (JIBC) ............................................................................................. 33

Moulage ...................................................................................................35

Upcoming in 2018-19 .............................................................................36


Executive Summary

Interior Health, the University of British Columbia (UBC) Faculty of Medicine (FoM), and

University of British Columbia Okanagan School of Nursing have formed a partnership to

work collaboratively in order to provide simulation education activities for

undergraduate, postgraduate, practicing clinicians and physicians across UBC and

Interior Health (IH).

Fiscal Year 2017-18 saw tremendous growth with the simulation programs across all

sites in Interior Health. We endeavored to undertake research in our rural emergency

sites, a simulation fellowship at Kelowna General Hospital, publications, hosting of

provincial conferences, collaboration with various schools from inter-professional to

specialty training, undergrad and postgrad curriculum based simulation, as well as

various mock codes exercises on patient floors. We opened the third simulation site in

Interior Health which will serve the west and east Kootenay’s. The Rae Fawcett

Simulation Centre in Kamloops has been operational for three years; they saw a 157

percent increase in utilization from 2016 to 2017. This year also marks five years for the

Pritchard Simulation Centre. We’ve come a long way from training mostly practicing

nurses in Cardiac Arrest Management to now offering courses that include simulation for

advanced life support, resuscitation, clinical competency, specialty training, as well as

undergrad and postgrad training.

With the increased use of simulation training in medical school, residency, and hospitals

alike, we endeavor to meet the growing needs of all learners. The IH/UBC FoM

Simulation Program management and staff will continue to work collaboratively with our

partners to provide education and training that supports high quality and safe care for

our patients.


Vision & Mission Statement

Vision

To support excellence in healthcare delivery through the use of simulation based

education.

Mission

To facilitate simulation-based education that:

promotes inter-professional engagement and collaboration; and

supports highly competent providers to achieve excellence in health care

delivery


Staff

Pritchard Simulation Centre JoAnne Slinn, RN, MN, ENC (C)

Regional Knowledge Coordinator JoAnne is a Registered Nurse, with a background in emergency nursing and the Regional Knowledge Coordinator (RKC) or educator at the Pritchard Simulation Centre, located at KGH/UBC Clinical Academic Campus. JoAnne recently completed her Masters of Nursing and has CNA certification in emergency nursing. JoAnne started her role as the RKC in 2015.

Chris Olivier Simulation Technician Chris Olivier is the Simulation Technician for the Pritchard Simulation Centre, Rae Fawcett Simulation Centre, the KB Simulation Program and the UBC Okanagan School of Nursing. Chris has shown keen interest in simulation as has been integral in designing simulation centre’s across our region, building simulated ultrasound machines while creating new and innovated modalities to meet the needs of our simulation community.

Rae Fawcett Simulation Centre

Chelsea Holmes, RN, BSN, ENC (C) Regional Knowledge Coordinator

Chelsea Holmes is a Registered Nurse, with a background in emergency nursing and the Regional Knowledge Coordinator (RKC) or educator at the Rae Fawcett Simulation Centre at Royal Inland Hospital in Kamloops, B.C. Chelsea has been facilitating with the IH Rural Mobile Simulation Program since 2013 and started her role as the RKC in 2016.

Kootenay Boundary (KB) Simulation Program

Helen Clugston, RN, BSN Regional Knowledge Coordinator Helen Clugston is a Registered Nurse with a background in emergency, pediatrics and rural nursing. She is the Regional Knowledge Coordinator (RKC) or educator at the KB Simulation Program at Kootenay Boundary Regional Hospital in Trail, B.C. Helen has been facilitating with the IH Rural Mobile Simulation Program since 2013 and started her role as the RKC in 2016. Helen is passionate about supporting others to be the best that they can be through creative, supportive and realistic learning opportunities using simulation technologies.

https://bcsimulation.ca/index.php/sim-programs/fawcett


Staff

IH Simulation Program

Dr. Tara Gill, MD, CCFP-EM Medical Director, IH Rural Mobile Simulation Program Dr. Gill is an emergency physician and rotation lead for the integrated community clerkship (ICC) program in Trail. Dr. Gill provides leadership and instruction in simulation education, training and research to improve the quality of healthcare and improve patient safety outcomes.

Shelly Koochin Simulation Coordinator Shelly brought her 15 years of project management experience to develop and grow the simulation program in Interior Health. Shelly provided her vision and expertise to assist in building staff, resources and simulation centres across the Health Authority, in order to create more opportunity and access for this specialized education.

Ben Rhebergen Director, Strategic Initiatives-Acute & Medical School Ben oversees the Simulation Program across Interior Health to ensure that staff are supported in order to provide the best possible simulation education activities.

Lisa Wyness Director of Administration, Faculty of Medicine, Southern Medical Program (SMP) Lisa works with the staff and faculty across the SMP sites in Kelowna, Vernon, Kamloops and Trail as well as the Faculty of Medicine (FoM) distributed sites to ensure the successful delivery of the FoM Doctor of Medicine (MD) Undergraduate Program in the Interior.


Donors

The University of British Columbia (UBC) Faculty of Medicine (FoM) has been

very fortunate to receive donations from Lois and Colin Pritchard. Without the

Pritchard’s generous donations towards the first simulation centre built in

Kelowna and the purchase of high fidelity human patient simulators, we would

not be where we are today! Thank you.

Pritchard Simulation Centre2011 Lois and Colin Pritchard for UBC FoM SimMan3G (Laerdal)

Harvey Simulator (Laerdal) Infrastructure

2015 Lois and Colin Pritchard for UBC FoM SonoSite EDGE Ultrasound System (2)

2018 Lois and Colin Pritchard for UBC FoM SuperTory Neonate (Gaumard)

Rae Fawcett generously donated towards high fidelity human patient

simulators in Kamloops where simulation also serves Interior Health

clinicians, UBC faculty, students and residents. Thank you.

Rae Fawcett Simulation Centre 2015 Rae Fawcett for Interior Health SimMan3G & SimJunior

2015 Rae Fawcett for Interior Health Victoria Birthing Simulator (Gaumard)

2015 Rae Fawcett for Interior Health SonoSite EDGE Ultrasound System

2018 Rae Fawcett for Interior Health SuperTory Neonate (Gaumard)

The various Foundations donated towards a high fidelity human patient

simulator that serves the rural hospital sites across Interior Health. Thank

you.

IH Rural Mobile Simulation Program 2016 For Interior Health:

KGH Foundation RIH Foundation KLH Foundation PRH Foundation EKH Foundation VJH Foundation

SimMan3G (Laerdal)


Metrics Uti l izat ion – F ixed Cent res

Simulation education has increased across all sites and professions in Interior

Health and UBC FoM. This graph displays the utilization (hours) that we saw

when the Pritchard Simulation Centre opened in 2013, the growth in 2016 with

the addition of the Rae Fawcett Simulation Centre and finally the growth in 2017

that included the addition of the Kootenay Boundary Simulation Program.

Utilization Data for Fixed Sites

312.02

676.23 689.65

855.25

980

54.5

337.25

868

68

312.02

677.23 776.35

1194.5

1916

0

500

1000

1500

2000

2500

2013 2014 2015 2016 2017

Pritchard Simulation CentreRae Fawcett Simulation CentreKootenay Boundary Simulation ProgramTotal Utilization


Metrics

Eva lua t ion Data – F i xed Cent res

Questions

Global Average (/5)

The outlined learning objectives were met 4.75

This session content enhanced my knowledge 4.82

I was able to incorporate theory into hands-on practice 4.73

I feel more confident in patient management 4.52

This simulation encouraged me to think critically 4.71

I believe this session will help me improve patient outcomes 4.68

The debrief was valuable 4.67

I would like to continue to use this technology in future education 4.78

The facilitator(s) maintained an engaging context for learning 4.84

The facilitator(s) fostered a safe learning environment 4.85

Open Ended Questions – comments taken from a few participants

List two (2) strong strengths of the simulation session Able to pause and discuss during the sim, getting practice on a pediatric patient. I like the pictures on screen to show

what the patient looks like. Practice of different roles during different scenarios without consequence of real death. Debrief was valuable with take

away points. Communication and being able to learn in a safe environment. It’s great to put theory into practice in a safe environment. I learn best with hands on experience.

List two (2) things you'd like to see done differently Maybe a bit more time with peds review prior to sim. Or a hysterical mom in the sim. I would like a younger child as well as the older child, just to feel more confident with pediatrics as a whole. Also, a

pregnant trauma. I appreciated the small group. It was great learning from each other. Time to actually do whole procedure such as complete prep and admin of octeplex. Time to re-practice what we

learned, i.e. octeplex mixing.

Any other comments?

Great learning experience and helped to solidify some take away points. The sims make me feel more confident in my knowledge. Enjoyed the discussion and learning with each scenario. Non-threatening environment - fostered better learning. This course was done well, small group made the greatest difference (large group would have been difficult.

Good Story

Family Medicine residents in Kelowna have been participating in simulation sessions since the start of our residency. These sessions have been very helpful in dealing with critical care situations on the wards, thus making us much more confident in managing unexpected situations during our first few months of residency. At one of the simulation sessions, we reviewed the management of accidental hypothermia’s. A few days later, a patient presented to the emergency room with a cardiac arrest related to an accidental hypothermia. Due to the knowledge acquired in the simulation session, we were able to optimize the rewarming of our patient and activate our ECMO team early in the resuscitation. “Simulation based learning which included reviewing the most recent guidelines on accidental hypothermia definitely improved the care provided in this situation”. Family Medicine Resident, UBC FoM Kelowna site


Metrics

At tendance – Rura l S i tes

In 2017-18, facilitators travelled to 20 rural hospital sites, sometimes visiting a site twice in

the year. 241 participants attended sessions throughout the region in the spring and fall.

NB: Facilitators do not travel in summer or winter.

Map of rural sites visited in 2017

These educational sessions are attended by an inter-professional group of clinicians that

vary from site to site. We usually see the highest attendance in nursing, followed by

physicians and paramedics.

Percent of Attendance by Discipline

RN 43%

MD 33%

Paramedic 14%

LPN 4%

Attendance RNMDParamedicLPNAdminMedical Student - Year 1Medical StudentNPLab TechnicianMedical Student - Year 3MLANP StudentResidentRN Student


Metrics

Eva lua t ion Data – Rura l S i tes

Questions Global Average (/5) The outlined learning objectives were met 4.72

This program content enhanced my knowledge 4.78

My knowledge in assessment of patients improved 4.48

I was able to incorporate theory into hands-on practice 4.65

I developed a better understanding of the medications, equipment, and supplies used in practice 4.60

I believe this session will help me improve patient outcomes 4.76

The presentations offered balanced views 4.78

This session was free from bias (e.g., conflict of interest, promotional content, product

endorsement)

4.89

The facilitator(s) maintained an engaging context for learning 4.87

The facilitator(s) guided discussions that led me to reflect on my practice 4.83

The facilitator(s) fostered a safe learning environment 4.89

Open Ended Questions – comments taken from a few participants

Reflecting on today's session, I am motivated to integrate into/change my practice in the following ways Review machines more often. Consider options earlier in treatment. Protocols available in other departments such as DKA. Stronger communication on arrival at ER Identifying team lead. Waiting to report, until team gathered / appropriate time. Use of emergent equipment & medications, as well as using & implementing algorithms. Be a little more vocal/assertive in my role as RN. Use the closed-loop more effectively.

List two (2) strengths of the simulation session Feel like a part of the team and getting to know physicians better. Brought up discussions about best treatment. Encouraged team communication. Lots of reflection on own practice. Involvement of paramedics to hear their views. Great, realistic scenarios with opportunity to practice management of acutely ill patients. Opportunity to debrief/reflect

on own performance and team work. Fantastic session! Thanks! Super hands on and high fidelity. Safe learning/ discussion for whole team. Great team environment. Identify gaps in equipment & stocked in ED trauma bay. I felt free to ask questions without judgement. Interventions and medications were properly explained to me.

Can you identify any barriers to incorporating what you learned today into your practice? (e.g., knowledge, attitude, behavioural, organizational) Knowing where equipment is - Better now that we have had sim session My own lack of knowledge of Peds chart The usual possible lack of staff (RNs and specialists). Transferring pts to higher levels of care. Lack of exposure, i.e. may be a long time before I am exposed to this again in the ER. Not seeing a lot of trauma cases in our emerg; Not too many staff to help during resuscitations. Not having enough exposure in day to day work.


Simulation Educational Courses

The Simulation Programs across the Health Authority offers educational

courses that include simulation. These courses are:

Advanced Trauma Life Support (ATLS)

Advanced Cardiac Life Support (ACLS)

Basic Life Support (BLS)

Pediatric Advanced Life Support (PALS)

Neonatal Resuscitation Program (NRP)

MOREob Skills Drills

Essentials of Critical Care Orientation (ECCO)

Emergency Practice, Interventions and Care Canada (EPICC)

Trauma Nursing Core Course (TNCC)

Mock codes

In situ – simulation on various units

Nursing clinical competency simulation sessions

Nursing specialty training

Physician specialty training

Respiratory Therapy simulation sessions

Outreach simulation training

Preventing Alcohol and Risk-related Trauma in Youth (PARTY)

UBC Faculty of Medicine under-grad and post-grad simulation training


Simulation Educational Courses

Outreach Simulation

Education

The Mobile Medical Unit (MMU)

and the IH Simulation Program

collaborated to carry out

emergency and disaster scenarios

at Elk Valley Hospital in Fernie.

Facilitator Training

Our simulation facilitators gather

together annually to share key

learning, discuss advancement in

simulation, and share best

practices. This session was held at

the Pritchard Simulation Centre in

Kelowna.

Student Orientation

Students from the Stswecem’c

Xgat’tem First Nations, interested

in pursuing a career in healthcare

are provided with an orientation at

the Rae Fawcett Simulation

Centre.


Research

Does s imulat ion enhance knowledge and appreciat ion of Inter ior

Heal th Pre-Pr inted Orders (PPO)?

Interior Health (IH) Simulation Program completed a research project in

2017. Research Question: Does simulation enhance knowledge and

appreciation of Interior Health Pre-Printed Orders (PPO)?

A severe adult asthma simulation scenario was designed based on the IH

Asthma: Severe Adult Emergency Department PPO.

Results showed substantial improvements in comfort levels in using the PPO,

increased knowledge of the PPO, and improved confidence in the assessment

and management of a severe adult asthma patient.

IH Simulation Program Research Poster

C l ic k i mage abo ve t o see fu l l -page p os te r

https://www.interiorhealth.ca/sites/Partners/Simulation/Documents/ResearchPoster.pdf


Notable Achievements Pub l i ca t ion - two par t se r ies on S imu la t ion

Dr. Kevin Clark, Dr. Jared Baylis and JoAnne Slinn published a two-part series on Simulation showcased on a FOAM (Free Open Access Medical education) blog that is quite well-known in the simulation world.

Par t I : Qua l i t y Improvem ent Th r ough S imu la t i on

Par t I I : ED I n -S i t u S im u la t i on f o r Ke lowna Genera l Hosp i t a l

Simu lat ion Fe l low sh ip

Dr. Jared Baylis, Kelowna Emergency Resident, participated in the first

simulation fellowship at Kelowna General Hospital entitled “Leadership Training

in Simulation for Health Education”.

This fellowship was through the Centre of

Excellence for Simulation Education Innovation

(CESEI). However, hands on simulation

experience mostly occurred at the Pritchard

Simulation Centre in Kelowna. Dr. Baylis led

simulation sessions with emergency medicine

and family practice residents, medical students,

and staff in the emergency department.

Research and fe l lowship act iv i t ies

Dr. Baylis presented research and fellowship activities such as:

Simulation Curriculum Evaluation and Development in a Postgraduate

Emergency Medicine Program (Published in BMJ STEL)

Using a common template: a national consensus process among Emergency

Medicine educators

Two articles on EMSimCases.com, as noted above, and Learner-Consultant

Communication Cases published on emsimcases.com:

https://emsimcases.com/2018/04/24/learner-consultant-communication/

https://emsimcases.com/2018/01/23/in-situ-simulation-part-1-quality-improvement-through-simulation/

https://emsimcases.com/2018/02/06/in-situ-simulation-part-2-ed-in-situ-simulation-for-qi-at-kelowna-general-hospital/

https://emsimcases.com/2018/04/24/learner-consultant-communication/


Notable Achievements

Emergency Nurs ing Assoc ia t ion o f BC Confe rence (ENAB C)

The RFSC in Kamloops

hosted the Emergency

Nursing Association of

BC Conference (ENABC)

in September 2017. Pre-

conference sessions

were held for Advanced

Cardiac Life Support

(ACLS) and adult and

pediatric simulation.

Concurrent pediatric

trauma simulation

sessions were held

throughout the day.

Simu lated U l t rasound Mach ine

A simulated ultrasound

machine was built by

SIM Tech, Chris Olivier.

Specific case scenario

ultrasound videos can

be loaded into the

system and programed

to RFID tags situated

on the simulator. When

the RFID is scanned

with the probe, it

launches the video to

simulate an

ultrasound.


Professional Development

“Attending simulation conferences provides an opportunity to learn, train and knowledge share with others that are passionate about improving patient safety and quality of care. Staff return

with enthusiasm ready to share and implement what they’ve learned”. Shelly Koochin

~~~

Simu lat ion Learn ing St ra teg ies

The Simulation Learning Strategies or Train the Trainer course for simulation

educators has been hosted in Interior Health three times, the last being at

Kootenay Boundary Regional Hospital (KBRH) in Trail, where Dr. Andrew Sellars

and JoAnne Slinn were able to co-facilitate with Dr. Chris Chin who leads the

two-day interactive course. The course will provide learners with knowledge of

simulation based strategies, identify elements of effective team work,

incorporate learning objectives, debriefing skills and how to apply them.

Roya l Col lege o f Canada S imula t ion Summi t

The RKCs participated in inter-disciplinary seminars that included debriefing

skills using the Promoting Excellence and Reflective Learning in Simulation

(PEARLS) technique; strategies for giving peer instructor feedback, teaching

technical skills in simulation, and co-debriefing with other facilitators. As well,

they obtained an understanding of the extent simulation is being used and a

variety of applications including renovations/facility design, task training, team

training, implementation of protocols, staff flow, and improving quality and

patient safety

Preven ta t i ve Ma in tenance (PM) Course

UBC FoM SMP sent Sim Tech, Chris Olivier to a PM course at the Laerdal

headquarters in New York. This certification provided more familiarity with

software/firmware, programming, diagnostic testing, disassembly/reassembly

etc. As we have a partnership between UBC FoM, Interior Health and UBC

Okanagan School of Nursing, having an experienced technician with these skills

improves the longevity of the Laerdal simulators which in turn provides cost

savings for all sites.



Gateway Debr ie f ing Sk i l l s Workshop

This workshop introduced healthcare education facilitators to the

foundational practices of the Debriefing with Good Judgment© method from

Harvard University Center for Medical Simulation. All of the RKCs and the

Medical Director attended this very valuable learning workshop.

The poster below was brought back from the Gateway Debriefing Skills

Workshop and adapted for our sites. The poster is used to convey

unconditional positive regard for the participants and to set the stage for a

safe and positive learning environment. It is also a reminder for the

facilitators that we do believe it and should be fostered.

Basic Assumptions Poster



Simulation Brief Handout (devised from the Strategies to Debriefing Course) –

Page 1

The Simulation Brief is a quick guide that is used to assist simulation

facilitators to pre-brief, outline objectives for the simulation and debrief using

the G-A-S frame-work.

Simulation Brief Handout (page 1)


P Professional Development

Simulation Brief Handout (devised from the Strategies to Debriefing Course)

Simulation Brief Handout (page 2)



Crisis Resource Management

Crisis Resource Management (CRM) refers to the non-technical skills required for effective teamwork in a crisis situation. CRM training improves performance and reduces errors (settings include the emergency department, trauma teams and rapid response teams).

This handout is used in simulation education and hangs in all the simulation centres throughout Interior Health.

Crisis Resource Management Handout


Education UBC Faculty of Medicine – Southern Medical Program

(Years 1- 4 Medical Students)

Transi t ion into Cl in ical Educat ion (TICE)

This session takes place in the last two weeks of Year 2 medical training. It

supports the transition from classroom-learning to hands-on learning.

Through simulation the students develop the knowledge, skills, and attitudes

to become clinical clerks. The TICE simulation sessions were designed

provincially with J. Slinn, the RKC playing a large role to assist in supply

lists and curriculum development for simulation.

Year 3 Southern Medica l Program (SMP)

SMP introduced simulation into their curriculum in the specialties below with

one or all sessions running in the simulation centres. The sessions were

developed and revised in

collaboration with the simulation

program across all three sites for:

o Anesthesia

o Cardiology

o Emergency

o Internal Medicine

o Neurosurgical

o Orthopedics

o Pediatrics

o Surgical

o Trauma


Education

UBC Faculty of Medicine – Family Medicine

Canadian Res idency Simula t ion Tournament (CReST )

The UBC Faculty of Medicine

Department, Family Medicine

residents, held a provincial

simulation competition at the

Pritchard Simulation Centre

(PSC) in Kelowna in November

2017. CReST brought Family

Medicine Residents together

from St. Paul’s, Lions Gate and

Kelowna General Hospital’s.

Residents teamed up and ran

through critical care cases using

the high fidelity adult and pediatric mannequins. Judges looked at

assessment, diagnosis, management, disposition, and

leadership/teamwork to decide on the winning teams. See v ideo

UBC FoM Fami ly Pract ice (FP) Residency Programs

The FP Residency Program in the Interior came together in Kelowna for their

annual Bootcamp. The residents rotated through three concurrent stations

using adult and pediatric simulators and airway management task trainers.

Other sessions occurring for FP residents included: Kamloops residents attend monthly simulation sessions;

Peer-Led simulation sessions occur monthly in Kelowna and Trail;

Penticton residents travel to the PSC in Kelowna four times a year for

simulation;

Nelson residents travel to Trail for simulation sessions;

Advanced Cardiac Life Support (ACLS) Renewal courses are held in

Kelowna and Trail; and

Kelowna and Trail residents attend monthly ED in situ sessions at their

respective sites.

https://youtu.be/xrStJ8X35hc


Education

Kelowna Emergency Medicine Residency Program

The UBC Emergency Medic ine Inter ior S i te

This is a 5-year training program satisfying the Royal College requirements

for Emergency Medicine. It is based in Kelowna, B.C. with approximately 3

months per year in Vancouver from PGY-2 to PGY-4 inclusive. There are two

residents per year, totaling eight residents for the 2017-18 year.

The residents participate in high fidelity simulation sessions once a month in

the Pritchard Simulation Centre. The sessions are run by emergency

physician facilitators and cover a wide variety of topics including trauma,

shock, toxicology, and pediatrics.

Emergency Department (ED) in s i tu

These sessions occur in the ED in situ, meaning the environment the staff

normally practices in. The aim is to have once monthly sessions, followed by

EM Grand Rounds. The objective is to have the interdisciplinary team come

together to learn and grow as a team. Staff have found these sessions

valuable in improving patient management and teamwork.

One session involved a neonate

with a heart defect where the team

integrated the Tele PICU cart into

the case and performed a live call

to British Columbia Children’s

Hospital (BCCH) to test the system.

Lots of systems-issues were

identified including timely access to

an infant warmer.


Education

Interior Heal th

Safe Consumpt ion Si te

Sessions that are held in Kelowna and

Kamloops are supported by the RKCs

who co-facilitate and provide

simulators and equipment. Training

has included safe injection and

management of overdose and

anaphylaxis. Through this training,

gaps were identified with regard to

calling an ambulance which led to the

creation of a guide to better navigate

BCEHS dispatch.

Matern i ty MoreOB

Training sessions occur at the

RFSC in Kamloops with the

MoreOB core team to prep for

skills drills.

Victoria®, the birthing simulator, was newly purchased in 2017 with donated funds from Rae Fawcett!

The BC Society of Respiratory Therapists (BCSRT)

An educational roadshow at RIH, with RTs from across the province is held

annually. Simulation was showcased during the conference using both the

adult simulator and airway task trainers allowing participants to practice both

basic and advanced airway management techniques.

https://www.moreob.com/


Ambulatory Care

Education

Interior Heal th

Mock Code Pinks

Mock code pinks or simulated pediatric emergency exercises, are held at

KBRH in Trail, aimed to be held monthly in various departments. The RFSC

in Kamloops hold these sessions on the Pediatric floor post the Pediatric

Advanced Life Support (PALS) course to help solidify the learning.

Five Al ive Blue and White

Scenario training is occurring in situ (on the clinical floors) at KBRH in Trail.

These are short scenarios focusing on initial staff interventions prior to code

team arrival (i.e., Basic Life Support and de-escalation). These sessions

assist staff to apply training learned in course work to real time/real

environment.

Just in T ime

Scenarios are being held in the Intensive Care Unit at KBRH in Trail. These

scenarios look at identifying the sickest patient on the floor and their worst

possible scenario, which is then simulated with staff.

All programs are now branching out to various

in s i tu areas of the hospital including:

Ambulatory Care

Day Care

Emergency

Maternity

Medical

Operating Room

Pediatrics

Post Anesthetic Recovery (PAR)

Psychiatry

Surgical


Education

Travel

Physician/Nurse teams continue to travel to 28 rural and regional hospital sites

across the Health Authority to carry out simulated critical care scenarios based

on site’s needs assessments.

Below is a map of the rural hospital sites across Interior Health.

Interior Health Emergency Services site map


Education

IH Rural Mobile Simulation Program

In 2017-18 we expanded the program to include three of the regional hospitals across Interior Health: Penticton Vernon Cranbrook

In 2017 more human patient simulators were purchased and are now stationed

at the fixed sites in Kelowna,

Kamloops, and Trail which

provides increased

opportunity for rural and

regional hospital’s across

each region.

With the high-fidelity human

patient simulators,

we are able to create close to

real life experiences

in sites’ own emergency or

trauma room, utilizing their

supplies, equipment, and

staff while building or

enhancing relationships

within their inter-

professional teams.

Sites identify their own learning needs and goals which direct the choice of

cases or scenarios. These sessions are followed up with post session

summaries which identify main learning points that can be shared with all

staff at the site.


Collaboration Provincially

Our team assists in the coordination and facilitation of:

Mobile Medical Uni t (MMU)

The IH Rural Mobile Simulation

Program and the MMU team up

to provide education in the RV

or in situ in the

emergency/trauma room. This

collaboration could consist of

low fidelity Midwifery birthing

techniques/skills to a mass

casualty that could involve

police, first responders, Search

and Rescue and hospital

personnel using high fidelity

simulators.

Simulation Trauma Update Course (STRUC)

The objective of this course is to provide

a simulation based one day update

highlighting skills and knowledge

required for the resuscitation of complex

trauma patients through simulated

exercises. Crisis Resource Management

(CRM) principles of leadership, clear

closed loop communication, teamwork,

resource utilization, situational

awareness and problem solving will be

emphasized, as well as medical

knowledge regarding resuscitation

strategies in various clinical scenarios.

Physicians, RTs, and RNs are involved in

this valuable training.


Provincial Initiatives The Brit ish Columbia Simulation Network (BCSN)

The BCSN acts as a provincial community of practice aiding British Columbia-

based simulation centres with a forum in which to discuss and advance ideas in

the intersection of healthcare, simulation, and technology. This network meets to

create provincial standardization with respect to clinical tools, debriefing, data

collection, rental guidelines/cost

matrix, equipment pricing etc.

Modules have been created for Safe Patient Handover as well as principles of Crisis Resource Management.

Check out the sites!

Clinical Simulation Management System

With funding from UBC Faculty of Medicine, a management system was created

which can be used by all provincial simulation centres to input and track activity

and evaluation data. Out of this work a Lexicon for B.C. Simulation Centres

was also created to standardize data collection and reporting.

Capital Equipment Purchase Contrac t

Interior Health undertook a Request for Proposal (RFP) that created a Capital

Equipment Purchase Contract for the B.C. Health Authorities. This contract, from

one particular vendor, has held pricing for an adult & pediatric simulator from

April 2016 - April 2019. Sites have seen significant cost savings with this venture.

Website https://bcsimulation.ca

@BCSimNet

BC Simulation Network (closed group)

https://bcsimulation.ca/about/



https://bcsimulation.ca/

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Collaboration with Schools UBC Okanagan School of Nursing

Year 3 nursing students practice

maternity and pediatric scenarios in

the Pritchard Simulation Centre.

This collaboration involves sharing

of resources, space, and simulation

equipment which benefits all users of

the Pritchard Simulation Centre.

Brit ish Columbia Insti tute of Technology (BCIT) Emergency Nursing

Groups consist of 5-6 students who are doing their placement at Kelowna

General Hospital. They rotate through four unique simulation sessions that

were developed by the RKC and BCIT instructor that include: ACLS, physical

assessment & basic interventions, pediatrics, and trauma.

University of Northern BC(UNBC) Rural Emergency Nursing Course

One section of the rural nursing certificate program through UNBC, has

integrated simulation into their end-of-term three day workshop. This

workshop is intended to cover the practical aspect of emergency nursing that

is not able to be touched on without hands-on learning. It is geared towards

the needs of the students, covering topics such as emergency patient

assessment, triage, trauma, cardiovascular and respiratory emergencies .

Thompson River’s University (TRU) Respiratory Therapy (RT) Program

Groups consist of 10 students who are doing their placement at Kelowna

General Hospital. Each group rotates through three unique simulation

sessions that include ACLS, initial responder, and pediatrics.


Collaboration with Schools

Selkirk College Nursing Program

Nursing students attend ED in situ, Mock Codes and Five Alive simulation training sessions at KBRH in Trail.

School Distr ict #23

Prevent Alcohol and Risk-related Trauma in Youth (PARTY)

Over 120 local high school

students attend the PARTY

program in Kelowna and

Kamloops.

A team of emergency

department staff and emergency

responders lead a trauma

simulation where participants

“walk-in” to a simulated

emergency department trauma

resuscitation.

Justice Insti tute of Bri t ish Columbia (JIBC)

The JIBC holds an inter-

professional day in Kelowna

involving emergency responders,

community members and hospital

staff. Paramedic students are

able to practice life-saving skills

during simulated emergencies.

Our RKCs are invited to be part of

an expert panel discussion and

assist in facilitating with this very

interactive day.


Great Learning

Chest Tube Insertion

Emergency residents practice chest tube insertions on task trainers at the Pritchard Simulation Centre.

Pediatric Trauma

A team of physicians, nurses

and respiratory therapists come

together for the Simulation

Trauma Update Course

(STRUC). One scenario involved

using our pediatric mannequin to

simulate a child that was

involved in a MVA.

Emergency Department

in situ - KGH

Clinicians come together

monthly at Kelowna General

Hospital (KGH) to practice

emergency/trauma scenarios in

the emergency room (in situ).

Following the simulation, an

email is disseminated to

participant’s that includes a case

summary, take home points and

action items.


Moulage


Upcoming in 2018-19

MoreOB Training

National Emergency Nurses Association (NENA) – April 19, 2018

CAEP Conference – May 26-30, 2018

Nelson Research Conference – June 1, 2018

National Forum on Simulation for Quality and Safety – June 12, 2018

Many more upcoming sessions are planned for 2018-19

New Neonate simulator for 2018-19 sessions