Your SlideShare is downloading. ×
0
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Dubrowski 1 SSE
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Dubrowski 1 SSE

255

Published on

Published in: Education
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
255
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
5
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Teaching the Trainers in Simulation Based Education: Barriers and Solutions Dubrowski A., MiliardDerbew, Byrne N., Pittini R., Satterthwaite L., and Tajirian T. <br /> Roger Kneebone <br />Alison Barnet <br />Fernando Bello<br /> <br />Supported by DelPHE<br />
  • 2. Ethiopia<br /> Maternal mortality ratio in 2005 (lifetime risk of maternal death) was 1 in 27<br /> 720 of every 100,000 births result in maternal death.<br />Canada<br />Maternal mortality ratio in 2005 (lifetime risk of maternal death) was 1 in 11,000, and 7 of every 100,000 births result in maternal death.<br />
  • 3. Ethiopia<br /> Maternal mortality ratio in 2005 (lifetime risk of maternal death) was 1 in 27<br />720 of every 100,000 births result in maternal death.<br />Canada<br />Maternal mortality ratio in 2005 (lifetime risk of maternal death) was 1 in 11,000, and 7 of every 100,000 births result in maternal death.<br />
  • 4. The World Health Organization (WHO) estimates that the majority of fatalities and disabilities could be prevented if deliveries were to take place at well-equipped health centres, with adequately trained staff.<br />Guilbert JJ. The World Health Report 2006: working together for health. Educ Health (Abingdon). 2006;19(3):385-7.<br />
  • 5. The goal of a partnership between Addis Ababa University, University of Toronto, and Imperial College London is to develop a sustainable plan for training cohorts of educators capable of developing and evaluating training programs in technical skills related to surgery [trauma], gynecology &amp; obstetrics (OBGYN), nursing and midwifery using simulation.<br />
  • 6. simulation<br /> Replication of a task or an event for the purpose of training or evaluation<br />
  • 7. November 2006<br />Medical Education, 2009<br />
  • 8. t=2.81, p=.012<br />t=3.42, p=.003<br />25<br />14<br />20<br />12<br />10<br />15<br />8<br />Checklists<br />GRS<br />10<br />6<br />Post-test<br />4<br />Pre-test<br />5<br />2<br />0<br />0<br />
  • 9. Pre-training<br />Post-training<br />
  • 10. In November 2008 a group of individuals representing the three partners conducted an extensive environmental scan and stakeholders analysis in order to set an agenda for the upcoming 3-year funding period. <br />
  • 11. Three primary objectives during this meeting were:<br />To identify current use of simulation resources in the Surgical Simulation Laboratory (SSL, The Black Lion hospital, Faculty of Medicine, Addis Ababa University),<br />to identify potential areas for faculty development (Train the Trainer) programs to enable optimal use of the SSL, and<br />to develop a plan for Train the Trainer program and its implementation.<br />
  • 12. Methods: <br />The group met with four groups of stakeholders:<br />Trainees from medicine, surgery, OBGYN, nursing and midwifery – current and potential users of the SSL,<br />faculty members from medicine, surgery, OBGYN, nursing and midwifery – current and potential users of the SSL,<br />university governance,<br />external stakeholders: CINS, and British Council.<br />The group also visited the site and participated in a training session in the facility.<br />
  • 13. Results: <br />The undergraduate medical program and surgical residency utilize the SSL extensively by:<br />Following the Essentials of Surgical Skills (ESS),<br />providing self-guided learning opportunities to students,<br />providing special skills training (e.g., laparoscopic skills)<br />encouraging other departments including OBGYN, nursing and midwifery to become involved in skills training courses.<br />
  • 14. Results: <br />Four significant areas for future development were identified: <br />Development and implementation of reliable and valid learner assessments, <br />Implementation of learner-centered educational approaches,<br />implementation of more realistic forms of simulation training,<br />shift towards inter and multi professional simulated training.<br />
  • 15. Conclusion:<br />
The collective expertise within the partnership group will be applied to the development of Train the Trainer program aimed to expand on skills necessary to plan, implement and assess simulation-based courses offered to the medical students, surgical residents, OBGYN residents, nurses and midwifes. <br />
  • 16. Planned activities: <br />Year 1: “This is how we do it”<br />March 2009: Train the Trainer workshop<br />March 2009: Independent research studies indentifying institutional facilitators for the progress and the effectiveness of the program (Drs. MaisamFazel).<br />
  • 17. Planned activities: <br />Year 2: “Now it is your turn”<br />A selected group will be asked to re-develop the workshop (objectives  simulation  evaluation)<br />Tangible outcome: Train the Trainer Guidebook <br />2-day module in advanced assessment in evaluation and new simulation approaches (contextualized simulation).<br />
  • 18. Planned activities: <br />Year 3: “Sustainability”<br />Evaluation of the program. <br />Exporting the program to other schools in Ethiopia and Sub-Saharan Africa.<br />
  • 19. In March 2009 a group of individuals from Toronto lead a 3 day hands on Train the Trainer course on simulation-based program development and performance assessment. <br />
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27. Summary: <br />The course was graduated by 12 clinicians and 2 administrators. <br />UTAASC was formed.<br />
  • 28. Inactivity<br />External factors<br />Lack of follow up from us<br />Internal factors<br />Top down rather than bottom up process<br />
  • 29. Next steps (November 2009): <br />Distribution of a source book<br />Development of a guide book<br />Environmental re-scan and stakeholder re-analysis<br />Assign specific roles<br />
  • 30. Next steps (November 2009): <br />Distribution of a source book<br />
  • 31.
  • 32.
  • 33. Next steps (November 2009): <br />Development of a Guide book<br />Basic Technical Skills [e.g. Suturing, IV Catheterization]<br />Perineal Tear Repair<br />Instrumental Delivery<br />C-section<br />Abortion Care<br />
  • 34. Next steps (November 2009): <br />Environmental re-scan and stakeholder re-analysis<br />
  • 35.
  • 36. Infrastructure: <br />Skill lab<br />inanimate and animal models<br />instructional videos <br />Faculty:<br />Interest of the faculty and leadership in the lab<br />Strong support from department members to have the curriculum designed<br />Strong interest by faculty and department head<br />Interdepartmental cooperation<br />Students:<br />Interested students<br />Expanding post graduate program<br />
  • 37. Infrastructure:<br />Financial constraint/Budget<br />Single and small skills lab<br />Limited resources and times<br />Accessibility to all staff 24/7<br /> <br />Faculty and staff:<br />Management<br />Limited and untrained staff<br />Less advertised even within faculty<br />Poor linkage <br />Incentives for faculty members<br /> <br />Program:<br />Absence of well-structured program<br />Under-developed curriculum<br />Infrastructure: <br />Skill lab<br />inanimate and animal models<br />instructional videos <br />Faculty:<br />Interest of the faculty and leadership in the lab<br />Dedicated staff<br />Strong support from department members to have the curriculum designed<br />Strong interest by faculty and department head<br />Interdepartmental cooperation<br />Young surgeons who have good energy<br />Students:<br />Interested students<br />Expanding post graduate program<br />
  • 38. Infrastructure: <br />Skill lab<br />inanimate and animal models<br />instructional videos <br />Faculty:<br />Interest of the faculty and leadership in the lab<br />Dedicated staff<br />Strong support from department members to have the curriculum designed<br />Strong interest by faculty and department head<br />Interdepartmental cooperation<br />Young surgeons who have good energy<br />Students:<br />Interested students<br />Expanding post graduate program<br />Infrastructure:<br />Financial constraint/Budget<br />Single and small skills lab<br />Limited resources<br />Accessibility to all staff 24/7<br />Lack of time<br /> <br />Faculty and staff:<br />Management, committed support staff<br />Limited and untrained staff<br />Less advertised even within faculty<br />Administration<br />Poor linkage (duplication)<br />Incentives for faculty members<br /> <br />Program:<br />Absence of well-structured program<br />Less developed curriculum<br />Collaboration with other skills labs<br />Partner with external institution like U of T, Imperial Collage<br />Favorable policy and commitment<br />Huge inter/intra networking<br />Expanding and diversity of graduate studies<br />Support from grants [e.g., DelPHE]<br />Support from CNIS<br />
  • 39. Infrastructure: <br />Skill lab<br />inanimate and animal models<br />instructional videos <br />Faculty:<br />Interest of the faculty and leadership in the lab<br />Dedicated staff<br />Strong support from department members to have the curriculum designed<br />Strong interest by faculty and department head<br />Interdepartmental cooperation<br />Young surgeons who have good energy<br />Students:<br />Interested students<br />Expanding post graduate program<br />Infrastructure:<br />Financial constraint/Budget<br />Single and small skills lab<br />Limited resources<br />Accessibility to all staff 24/7<br />Lack of time<br /> <br />Faculty and staff:<br />Management, committed support staff<br />Limited and untrained staff<br />Less advertised even within faculty<br />Administration<br />Poor linkage (duplication)<br />Incentives for faculty members<br /> <br />Program:<br />Absence of well-structured program<br />Less developed curriculum<br />Collaboration with other skills labs<br />Partner with external institution like U of T, Imperial Collage<br />Favorable policy and commitment<br />Huge inter/intra networking<br />Expanding and diversity of graduate studies<br />Support from grants [e.g., DelPHE]<br />Support from CNIS<br />Budget<br />Competition within and between faculties<br />Brain drain<br />IT facilities and Internet access <br />Lack of incentives<br />Lack of adequate monitoring<br />
  • 40. Infrastructure: <br />Skill lab<br />inanimate and animal models<br />instructional videos <br />Faculty:<br />Interest of the faculty and leadership in the lab<br />Dedicated staff<br />Strong support from department members to have the curriculum designed<br />Strong interest by faculty and department head<br />Interdepartmental cooperation<br />Young surgeons who have good energy<br />Students:<br />Interested students<br />Expanding post graduate program<br />Infrastructure:<br />Financial constraint/Budget<br />Single and small skills lab<br />Limited resources<br />Accessibility to all staff 24/7<br />Lack of time<br /> <br />Faculty and staff:<br />Management, committed support staff<br />Limited and untrained staff<br />Less advertised even within faculty<br />Administration<br />Poor linkage (duplication)<br />Incentives for faculty members<br /> <br />Program:<br />Absence of well-structured program<br />Less developed curriculum<br />Collaboration with other skills labs<br />Partner with external institution like U of T, Imperial Collage<br />Favorable policy and commitment<br />Huge inter/intra networking<br />Expanding and diversity of graduate studies<br />Support from grants [e.g., DelPHE]<br />Support from CNIS<br />Budget<br />Competition within and between faculties<br />Brain drain<br />IT facilities and Internet access <br />Lack of incentives<br />Lack of adequate monitoring<br />
  • 41. Next steps (November 2009): <br />Assign specific roles<br />Program: UTAASC – DelPHE<br />Director: Dr. FekadesilassieHenok<br />Patron: Dr. DawitDesalegn<br />
  • 42. Director: Dr. FekadesilassieHenok<br />Chair the UTAASC Curriculum Committee<br />Ensure that the UTAASC Curriculum has regularly scheduled meetings with an advanced agenda and recorded and approved minutes of each meeting.<br />Facilitate the individual course participants in completing course planning, implementation and evaluation.<br />Ensure that each course participant completes an evaluation.<br />Act as the key link between the DelPHE Team and the participants.<br />Report regularly with the DelPHE Team on course progress and accomplishments. <br />
  • 43. Patron: Dr. DawitDesalegn<br />Oversee the UTAASC Project in Addis<br />Report twice yearly to the DelPHE Team regarding project progress and accomplishments.<br />Meet regularly with the UTAASC Course Director to review project progress and accomplishments. <br />Provide counsel and direction, if requested, to the UTAASC Course Director.<br />Facilitate communication through Dr. MiliardDerbew between the British Council in Addis and the DelPHE Team.<br />
  • 44. Summary: <br />Inactivity<br />External factors<br /><ul><li>Lack of follow up from us</li></ul>Internal factors<br /><ul><li>Top down rather than bottom up process</li></li></ul><li>Summary: <br />Inactivity<br />External factors<br /><ul><li>Lack of follow up from us
  • 45. Source book distributed</li></li></ul><li>Summary: <br />Inactivity<br />Internal factors<br /><ul><li>Top down rather than bottom up process
  • 46. SWOT analysis
  • 47. Guide book in preparation
  • 48. Governance of the program established</li></li></ul><li>Significance: <br />With proper implementation, this program will create cohorts of local trainers proficient in using simulation for training of clinical skills.<br />This proficiency will lead to self-sustainable programs with Ethiopian and Sub Saharan appropriate content and methods.<br />

×