CSMEN R and D Conference The Past

A Summary of R and D Funded Projects

Friday March 17th 2017

• Clinical excellence

• Patient safety

• Mutuality

Policies Services Education

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

CLINICAL SKILLS

Managed Educational Network

Excellent skills for excellent care

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