Dubrowski final 1

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Dubrowski final 1

  1. 1. Research in simulation based health professions education: Building houses or making bricks? Adam Dubrowski, PhD Learning and Research Institutes Wilson Centre Department of Paediatrics, UofT
  2. 2. Chaos in the Brickyard
  3. 3. Applying the Scientific Method and underpinning research methodology to generate evidence that will be used to build simulation based education programs. General Aim
  4. 4. •  Models of Medical Education •  Introduction to Simulation •  Working Model •  Components of Simulation –  Simulators –  Educators –  Organization •  Future Directions Outline
  5. 5. Apprenticeship Model Trainer Trainee PatientCare Shift in responsibility Ashley, 2000
  6. 6. Apprenticeship Model Trainer Trainee PatientCare Gap Ashley, 2000
  7. 7. Apprenticeship Model Trainer Trainee PatientCare More people die in a given year as a result of medical errors ( 44,000) than from motor vehicle accidents (43,458), breast cancer (42,297), or AIDS (16,516). "To Err is Human, Building a Safety Health System" (2000).
  8. 8. Apprenticeship Model Trainer Trainee PatientCare Simulation
  9. 9. Simulation Based Education Learn faster Remember longer Be safer
  10. 10. The replication of a task or an event for the purpose of education and/or assessment. Simulation Based Education
  11. 11. Simulation Based Education Working model
  12. 12. Dubrowski, A., Brydges, R., Satterthwaite, L., Xeroulis, G., Classe, R. American Journal of Surgery. in press. Busy Environment: Multitasking Simulation Based Education
  13. 13. Technical Performance Communication Environment Clinical Knowledge Attentional capacity threshold Additional Learning Simulation Based Education
  14. 14. Simulation Based Education Technical Performance Communication Environment Clinical Knowledge Additional Learning Attentional capacity threshold
  15. 15. Simulation Based Education Technical Performance Communication Environment Clinical Knowledge Additional Learning Attentional capacity threshold
  16. 16. Simulation Based Education Technical Performance Communication Environment Clinical Knowledge Additional Learning Attentional capacity threshold
  17. 17. Simulation Based Education Technical Performance Communication Environment Clinical Knowledge Additional Learning Attentional capacity threshold
  18. 18. Simulation Based Education Evidence
  19. 19. Kurahashi et al. Surgery. 2010 Study 1: Does it work? Can simulation based training help in pre-training?
  20. 20. Practice Skills Test Written Test 1 week rest Study 1: Does it work?
  21. 21. Skills Test: Expert Opinion 0 5 10 15 20 25 Written Test: Score 0 5 10 15 20 25 Trained Novice Novice Trained Novice Novice Study 1: Does it work?
  22. 22. simulation performanceimproves Study 1: Does it work?
  23. 23. learningenables Study 1: Does it work? simulation
  24. 24. Simulation Based Education How to use it?
  25. 25. Simulation Based Education Components Simulators Educators Organization
  26. 26. Simulators Information Flow Framework Brydges et al., Am J Surg. 2007, Sidhu et al., J Vasc Surg. 2007
  27. 27. Study 2: Realism Brydges et al., Am J Surg. 2007, Sidhu et al., J Vasc Surg. 2007 High fidelity Animal model Low fidelity
  28. 28. Study 2: Realism Brydges et al., Am J Surg. 2007, Sidhu et al., J Vasc Surg. 2007 ExpertOpinion 0 5 10 15 20 25 Senior 0 5 10 15 20 25 Novice Synthetic Cadaver ExpertOpinion Pre-training baseline Synthetic Cadaver
  29. 29. Study 2: Realism simulation appropriate modelsrequires
  30. 30. Study 3: Educators Errors in learning Xeroulis et al., Surgery. 2007
  31. 31. Study 3: Educators Xeroulis et al., Surgery. 2007 ExpertOpinion 0 5 10 15 20 25 Post-training Retention 1 month Pre-training baseline Errors allowed Errors not allowed Independent learning
  32. 32. Study 3: Educators simulation educated educatorsrequires
  33. 33. Organization Moulton et al., Ann Surg. 2007 Optimal schedules
  34. 34. Study 4: Organization Moulton et al., Ann Surg. 2007 1 2 3 4 1 hour block 1 month 1 2 3 4 1 hour block 1 week rest 1 month distributed practice massed practice 1 2 3 41 2 3 41 2 3 41 2 3 41 2 3 4 R R Transfer
  35. 35. Study 4: Organization Moulton et al., Ann Surg. 2007 distributed massed ExpertOpinion 30 20 10 0 Pre-test Microsurgical drill Post-test Rat Transfer
  36. 36. Study 4: Organization simulation effective curricularequires
  37. 37. Summary of Results simulation appropriate modelsrequires simulation educated educatorsrequires simulation effective curricularequires
  38. 38. Implications Trainer Trainee PatientCare Medical Education = Evidence Based Education
  39. 39. Future
  40. 40. Technology Future Directions
  41. 41. Mechanisms Future Directions
  42. 42. Conclusions Cell
Society


  43. 43. End adam.dubrowski@sickkids.ca http://www.slideshare.net/adam.dubrowski/dubrowski-bricks

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