Navigation Links
Rhode Island Hospital simulation center examines benefits and applications of medical simulation

PROVIDENCE, RI Emergency medicine physicians and simulation experts from Rhode Island Hospital discuss the benefits of advanced medical simulation in five manuscripts appearing in the November 2008 issue of Academic Emergency Medicine (now available online). The articles describe how simulation centers, along with new portable simulation technology, offer unique training opportunities for dynamic, complex and unanticipated medical situations in acute care fields. At the same time, the authors show how to guide team training and create new tools to measure teamwork effectiveness.

New advances are taking standard simulation techniques and manikin technologies currently used in simulation centers to a portable platform. In the first article, "Educational and Research Implications of Portable Human Patient Simulation in Acute Care Medicine," the researchers describe the adaptation of simulation techniques and manikin technologies for portable function. These new programs can relieve some limitations of traditional simulation, with an emphasis on the effects on acute care and disaster training. For example, mobile portable simulation allows on-site training in highly specialized clinical practice such as critical care transport medicine. Progressive simulations, i.e., longer-duration events that follow a simulated patient through sequential care environments, are also highlighted. These create an opportunity to study healthcare systems integration, continuity of care and transitions as well as the medical care delivered at each point of care. Lead author Leo Kobayashi, MD, notes, "Areas of education and research in acute care medicine are expanded by portable simulation's introduction of new topics, fresh perspectives and innovative methods."

The second article focuses on team performance in emergency medicine − "Defining Team Performance: Methodology, Metrics and Opportunities for Emergency Medicine." Rhode Island Hospital physicians Marc Shapiro, MD, and Gregory Jay, MD, PhD, led a consensus panel which identifies that "teamwork is a complex construct requiring metrics broad enough to capture the cycles of performance and yet sensitive and precise enough to assess a single behavior. No single measure can capture overall individual or team performance; it is helpful to measure both team process and outcomes to avoid the pitfalls in relying on 'one single inadequate criterion.'"

With this in mind, the panel reviews existing team performance metrics in health care, proposes a scientific methodology for simulation-based training (SBT) (including development of simulation scenarios and evaluation tools), and focuses on leadership as a target for SBT team training. Four core principles are proposed for effective team training and assessment:

  1. Team-based competencies must be established in advance for effective training and assessment.
  2. Carefully crafted simulation scenarios must be offered for guided teamwork practice.
  3. Team performance, strengths and weaknesses must be objectively diagnosed.
  4. Feedback must be linked to learning outcomes to develop effective debriefing protocols following a simulation exercise.

In a third article, "Advanced Medical Simulation Applications for Emergency Medicine Microsystems Evaluation and Training," a consensus panel led by Kobayashi and Frank Overly, MD, examines the role of simulation-based exercises in the assessment and improvement of small-scale clinical systems (microsystems) in emergency medicine. The panel suggests that focusing simulation on these microsystems creates distinct benefits: it introduces the possibility of working on higher-order, acute care functions while also enhancing system capabilities to respond to situations that are highly dynamic, unanticipated, incompletely specified, or otherwise problematic. Kobayashi comments, "Quality by design is made possible through use of simulation methods that create an engineered window on the system."

RIH simulation experts were also instrumental in developing two other manuscripts for the consensus conference. Shapiro contributed substantially to "Toward a Definition of Teamwork in Emergency Medicine," while Kobayashi served on the panel that generated "Defining Systems Expertise: Effective Simulation at the Organizational Level--Implications for Patient Safety, Disaster Surge Capacity, and Facilitating the Systems Interface." David G. Lindquist, MD, Mary L. Salisbury, RN, MSN, and Andrew Sucov, MD, are among the additional physicians and staff from the simulation center at Rhode Island Hospital involved in developing the recently published articles.

Led by emergency medicine physicians from Rhode Island Hospital and the Warren Alpert Medical School of Brown University, the region's first simulation center opened in 2002. Since then, the center's staff have served as leaders in simulation-based training for Lifespan and its affiliates, the Alpert Medical School, other health care providers in the community, and at national and international venues.


Contact: Nancy Cawley

Related biology news :

1. Rhode Island Hospital study finds link between obesity, type 2 diabetes and neurodegeneration
2. UC Riverside scientist to explore how vegetation affects urban heat islands
3. Study of islands reveals surprising extinction results
4. Sky islands: metaphor or misnomer?
5. Smithsonian coral biodiversity survey of Panamas Pearl Islands
6. Rare North Island brown kiwi hatches at the Smithsonians National Zoo
7. Rats on islands disrupt ecosystems from land to sea, researchers find
8. First wind turbines on Galapagos Islands will halve diesel imports, reduce risk of future oil spills
9. Island monkeys do not recognize big cat calls
10. Ancient whale fall from Californias Ao Nuevo Island one of youngest, most complete known
11. Ancient whale fall from Californias Año Nuevo Island one of youngest, most complete known
Post Your Comments:
(Date:11/11/2015)... MedNet Solutions , an innovative SaaS-based eClinical technology company that ... announce that it will be a Sponsor of the ... held November 17-19 in Hamburg , Germany.  ... iMedNet , MedNet,s easy-to-use, proven and affordable eClinical ... able to deliver time and cost savings of up to ...
(Date:11/9/2015)... 09, 2015 ... the "Global Law Enforcement Biometrics Market ... --> ) has announced the ... Biometrics Market 2015-2019" report to their ... ( ) has announced the addition ...
(Date:11/2/2015)... Calif. , Nov. 2, 2015  SRI International ... million to provide preclinical development services to the National ... contract, SRI will provide scientific expertise, modern testing and ... variety of preclinical pharmacology and toxicology studies to evaluate ... --> The PREVENT Cancer Drug Development Program ...
Breaking Biology News(10 mins):
(Date:11/30/2015)... , Nov. 30, 2015  Northwest Biotherapeutics (NASDAQ: ... DCVax® personalized immune therapies for solid tumor cancers, announced ... additional independent director, and the Company welcomes Neil ... in a recent anonymous internet report on NW Bio.  ... Linda Powers stated, "We agree with ...
(Date:11/27/2015)... , Nov. 27, 2015 /PRNewswire/--  Mallinckrodt plc ... announced today that it has closed the sale of ... to Guerbet (GBT- NYSE Euronext) in a transaction valued ... four manufacturing facilities and a total of approximately 1,000 ... the St. Louis area. This ...
(Date:11/26/2015)... CHESHAM , England , November 26, ... Lightpoint Medical, an innovative medical device company specializing in ... Euro grant from the European Commission as part of the ... enabling the company to carry out a large-scale clinical trial ... -->      (Logo: , ...
(Date:11/25/2015)... Studies reveal the differences in species of ... way for more effective treatment for one of the most ... --> --> Gum disease is ... yet relatively little was understood about the bacteria associated with ... by researchers from the WALTHAM Centre for Pet Nutrition together ...
Breaking Biology Technology: