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  • Thank trainers in advance for their participation and remind them that we need them to help champion the study in their clinical area
  • This session will focus on teaching simulation based mastery learning. A separate presentation will provide training for the JIT sessions.
  • Concept-Providers achieve skill mastery during orientation.JIT refreshers to polish skills before clinical performance*worth the effort to improve safety and performance New paradigm for quality! = distributed practice(PALS, NRP, Airway Courses are one time and retention throughout recert time is poor)*Primary outcome = LP success rates
  • Session format6 elementsIntroductionOrientation to simulatorSkills assessmentMastery checklist completionCoached training (bulk of session)Mastery performance (completion of session)
  • 5. Coached training
  • What is poise- (patient outcomes in simulation education)+Network studying medical education interventions and impact on patient care+Commitment to robust educational research and disseminating best educaiton practice+Multidisciplinary and multicenter network--still growing
  • Masterytrainthetrainer

    1. 1. Train-the-trainer: mastery session<br />Improving infant LP skills through simulation-based mastery learning and just-in-time refreshersPOISE 2010-2011<br />
    2. 2. HYPOTHESIS<br />Participation in simulation-based mastery learning with just-in-time refreshers will lead to improved infant LP success rates<br />
    3. 3. 1. <br />Online Survey & Audiovisual Training<br />3. <br />JIT:<br />Just-in-time Refresher<br />Session<br />4. <br />JIT:<br />Just-in-time Refresher<br />Session<br />4. <br />Clinical Lumbar Puncture<br />5. <br />Clinical Lumbar Puncture<br />2. <br />Mastery Learning Session<br />
    4. 4. What is mastery training?<br />Extreme form of competency based education<br />Clearly described checklist of component steps<br />Pre-defined target level of performance (mastery)<br />ALL participants achieve mastery <br />Duration and content of session tailored to specific needs<br />
    5. 5. Mastery Learning Session<br />1. Introduction<br />6. Mastery Performance<br />3. <br />Skills Assessment<br />4. <br />Mastery Checklist<br />5. <br />Coached Training<br />2. Orientation<br />
    6. 6. 1. Introduction<br />Introduce yourself to the intern.<br />Read aloud:<br />You are here to learn and practice your infant LP skills using this simulator.<br />By the end of this session you will master all of the critical steps to perform this procedure.<br />
    7. 7. 2. Simulator Orientation<br />Iliac crests- point to spot represented by ridge in plastic<br />
    8. 8. 2. Simulator Orientation<br />Umblicus- point to spot where umbilicus would be<br />
    9. 9. 2. Simulator Orientation<br />Read aloud<br />When you insert a needle into the proper interspace you will get fluid back in the same way you would on a real patient.<br />I will serve as both your holder and teacher for this exercise. <br />Do you have any questions for me before we begin?<br />
    10. 10. Skills assessment<br />Read introduction aloud<br />Show me what you know about this procedure.<br /> Treat this simulator as if it is a real baby and start from the beginning of the procedure as you would in real life.<br />Don’t worry if you have never done this before- I just want to get a sense of what you already know to help tailor this session to your needs.<br />
    11. 11. During this initial attempt encourage the learner to try their best to perform independently<br />Let mistakes happen<br />Help to identify the specific learning needs <br />Lead to effective learning<br />Will guide the coached component of training<br />
    12. 12. Use the mastery checklist to mark any steps <br />Not done<br />Where errors were made<br />The intern required help<br />The checklist will provide a guide to tailor the subsequent training to the providers needs<br />
    13. 13.
    14. 14.
    15. 15. Global rating<br /><ul><li> The scale measures level of independence
    16. 16. “Proficient” indicates ability to perform independently
    17. 17. “Expert” level is not expected</li></li></ul><li> Coached Deliberate Practice<br />Repetitive deliberate practice<br />Hands-on practice, kinesthetic learning<br />Practice-Feedback-Correction-Practice --> independence/mastery<br />Customized to learner needs<br />Time varies to achieve mastery of skill <br />ALL participants achieve mastery<br />
    18. 18. Read aloud:<br />Now that you have independently tried this procedure are there any areas that you felt were challenging? <br />Address these areas with the learner first<br />In a step-by-step fashion coach the learner on any steps from the mastery checklist where they asked for help, an error occurred or that you identified as deficient.<br />For each step describe or demonstrate the intern’s error and work with them until they can perform the step independently. <br />
    19. 19. ✓<br />✓<br />✓<br />
    20. 20. Error: Wrong angle on needle insertion (aimed toward feet)<br />Needle inserted correctly and independently<br />
    21. 21. Mastery Performance<br />The session will end once you and the learner feel that ALL STEPS can be performed without help. <br />If the learner does not achieved mastery mark the deficient step(s) and describe the reasons for stopping training<br />
    22. 22. How to set up the simulator<br />Fill bottle with water up to fill-line<br />Insert bottle in pressure bag<br />Inflate bag until pop-off valve hits 150mmHg<br />
    23. 23. POISE aims to improve patient outcomes through the development and dissemination of robust educational interventions<br />