Research and Innovations

Healthcare simulation online COVID-19 Response in 2020 & Beyond

Preparing the future healthcare workforce is critical as the world experiences the COVID-19 pandemic. Simulation education must pivot to online delivery and expand to meet clinical training needs resulting from limited face-to-face learning for the foreseeable future.

In rapid COVID-19 response, the University of Minnesota M Simulation team has mobilized to deliver healthcare simulation education online. This ongoing series will share what we have implemented and tested including:

  • practical knowledge
  • skills
  • training methods

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Interprofessional Online Simulation in COVID-19 Response

Navigating Leadership in COVID-19 Response: Working remotely in healthcare simulation teams

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Presenters:

  • Lou Clark, PhD, MFA - Executive Director - M Simulation
  • Bob Kiser, CHSE, CEC - Associate Director, Simulation and Integrative Learning, University of Illinois College of Medicine
  • Mojca Remskar Konia, MD, PhD, MACM, Medical Director – M Simulation
  • Christine Park, MD, FSSH - Director, Simulation and Integrative Learning, University of Illinois College of Medicine
  • Anne Woll, MS, Education Director - M Simulation

Session Objectives:

  • Identify your leadership contributions to healthcare simulation teams working online
  • Describe successes and challenges of leading online healthcare simulation teams
  • Learn effective strategies for leading online healthcare simulation teams

Description:
This webinar brings together the leadership teams from M Simulation from the University of Minnesota and from Simulation and Integrative Learning (SAIL) at University of Illinois at Chicago to share their successes, challenges, and stories related to leadership during the COVID-19 pandemic. Rather than a “how-to” session, the two teams will ask each other, in a Q & A format, questions that explore what leadership means in this unprecedented time. The approach, by design, is not to assert that the panelists have all of the answers but to spark a dialogue that includes the audience.

Topics covered will include:

  • What has been most surprising
  • Regional differences in leading through this response (e.g. Minnesota vs. Chicago)
  • Opportunities for role expansion for individual team members
  • Considering the dual role of clinicians as sim team leaders and front-line workers
  • Self-care strategies for leaders and teams
  • Return to work strategies – where to go from here

Previous Healthcare Simulation Online Sessions

Glo Germ, Central Lines & Vents

Glo Germ, Central Lines & Vents

Glo Germ, Central Lines & Vents:
Simulation provides direct support for front line clinicians in COVID-19 response

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Presenters:
  • Mojca Remskar Konia, MD, PhD, MACM, Medical Director - M Simulation
  • Jon Chaika, NREMT, Simulation Education Specialist - M Simulation
  • Eugene Floersch, BS, CHSE, CHSOS - Simulation Specialist – M Simulation
  • Nicholas Newman, Office & Administrative Services Supervisor – M Simulation
  • Lou Clark, PhD, MFA, Executive Director - M Simulation
Session Objectives:
  • Learn to effectively use Glo Germ for experiments to study COVID-19 spread
  • Gain knowledge to uptrain clinical staff - central and arterial line training, including our home, inexpensive recipe for central line
  • Examine NIPPV ventilators with emphasis on what our team learned about SimMan "respiratory physiology
Description:
During late March and April 2020 the M Simulation team partnered with faculty from UMN School of Medicine to provide direct support for clinicians during the COVID-19 pandemic. Our help was actively pursued by several of the most affected clinical departments, intensive care units, and hospital administration constituting the COVID-19 command center. The simulation support allowed for the study of: infection spread and protective devices, clinical environment for latent factors that could lead to patient harm, and repurposing of non-invasive positive pressure ventilators into invasive ventilators. Our work resulted in new clinical personal protective equipment which is now available, adjustment to clinical protocols, and training of 501 healthcare providers

Learners included:
  • 36 physicians
  • 165 nurse anesthetists
  • 300 nurses
Join M Simulation team members, Dr. Konia and Dr. Clark as they describe successes and challenges from implementing these projects.

Topics covered will include:
  • Leveraging simulation education resources to support front line clinicians
  • Innovating knowledge pertinent to clinical practice utilizing simulation education
  • Further elevating the healthcare simulation profession as a meaningful collaborator in clinical practice.

Simulation educators and faculty collaborate to deliver adapted online interprofessional education (IPE) simulation for health s

Simulation educators and faculty collaborate to deliver adapted online interprofessional education (IPE) simulation for health s

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Presenters

  • Lou Clark, PhD, MFA, Executive Director - M Simulation
  • Joseph Miller, BS, CHSE, SP Program Coordinator - M Simulation
  • Barbara Peterson, PhD, RN, CNS, Clinical Associate Professor, Population Health and Systems Cooperative - School of Nursing
  • Amy Pittenger, PharmD, MS, PhD, Department Head and Associate Professor – Department of Pharmaceutical Care and Health Systems
  • Anne Woll, MS, Education Director - M Simulation

Session Objectives

  • Identify process for transition of face to face IPE events to online format
  • Identify key management skills for effective delivery of interprofessional education (IPE) events via Zoom
  • Describe strategies used by simulation educators and faculty to mobilize successful delivery of online simulation

Description
On April 1 the M Simulation team partnered with faculty from UMN School of Nursing and College of Pharmacy to implement a fully online formative IPE session using Zoom. The event featured multiple large group didactic and small group breakout sessions with 23 students. A faculty member from each program performed a simulated mental health interview including assessment and treatment plan with an SP, which was followed by a debrief session. Learners included:

  • 10 Psych Mental Health students in the Doctor of Nursing Program
  • 13 PharmD students

M Simulation team members, Dr. Peterson, and Dr. Pittenger describe successes and challenges from their educational planning and event implementation. Topics covered:

  • applying best practices for IPE in an online format
  • selecting best pedagogies to meet IPE learning objectives in online format
  • adapting a face to face IPE session to a fully online format in a resource constrained environment
  • utilizing breakout rooms to promote small group interprofessional discussion
  • outcomes, as demonstrated by program evaluation data (2019 face to face vs. 2020 online)

Zooming with SPs in COVID-19 Response Presentation Video

Zooming with SPs in COVID-19 Response Presentation Video

Using Zoom to train Standardized Patients (SPs) and implement formative Objective Structured Clinical Examination (OSCEs) with health science students

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Presenters:
Lou Clark, PhD, MFA, incoming Executive Director, M Simulation
Anne Woll, MS, Education Director, M Simulation
Joseph Miller, BS, CHSE, SP Program Coordinator, M Simulation

Session Objectives:

  • Learn skills to effectively train SPs online in Zoom
  • Understand logistics needed to implement formative OSCEs in Zoom
  • Gain tips for meaningful debriefing with faculty and students in Zoom

Description:
On March 20 the M Simulation team rolled out fully online formative OSCEs using Zoom. Two events were planned, deployed, and debriefed:

  • a small OSCE for 15 graduate nursing students
  • a large scale OSCE for 104 veterinary medicine students

Join M Simulation team members as they share details and logistics from the SP training sessions and event implementation. Topics covered will include:

  • managing breakout rooms
  • tips for facilitating orientation and debrief sessions with students and faculty
  • suggestions for coaching SPs on how to deliver physical exam findings in a narrative style

Leading the field: snapshots of innovations in simulations and clinical skills education

The Interprofessional Education and Resource Center (IERC) and AHC Simulation Center’s team of simulation professionals collaborates with faculty across the health sciences (and beyond) to develop innovative and effective simulation strategies to address emerging needs, including:

Identifying common curriculum across professions to improve health care training

Identifying common curriculum across professions to improve health care training

Because we work across the health professions, our staff has a unique vantage point to address common clinical challenges. Learners across the Academic Health Center (AHC) need to practice having difficult conversations so that they can be prepared to communicate effectively with their patients on topics ranging from domestic violence to medical errors to end-of-life issues. Our staff makes interprofessional connections so that faculty across schools can work together to improve practitioner preparation for challenging conversations. 

Strategically integrating simulation into limited class time

Strategically integrating simulation into limited class time

Our staff collaborates with faculty across professions to develop simulation strategies that allow for clinical skills to be taught and assessed at multiple points in their curricula. An ongoing challenge is to ensure that learners at every level can participate in meaningful simulations within their limited available course time. We address this by ensuring the efficient utilization of resources. The School of Nursing has large numbers of learners at all levels who participate in simulations multiple times over the course of their educational programs. We ensure efficiency by pairing their students for team-based simulations, which require half the resources and time, and allow for faculty to include important concepts related to teamwork in their scenarios.

Using hybrid simulations for teaching and assessment

Using hybrid simulations for teaching and assessment

Our staff implements creative solutions to maximize realism and enable learners to practice a broader spectrum of skills. By combining real people with simulators or task trainers, we transform teaching and practice. In collaboration with faculty we conduct hybrid simulations for learners in the University of Minnesota’s Nurse-Midwifery program. Their learners participate in simulated scenarios with standardized patients wearing birth simulators, allowing them to practice managing the stages of labor and delivery while also providing patient support and practicing communication. Hybrid simulations provide learners the opportunity to improve and demonstrate both affective skills and psychomotor skills in patient care.

Meeting changing accreditation standards

Meeting changing accreditation standards

Our staff works collaboratively with faculty to design simulations that address rapidly changing accreditation standards. Through the implementation of a six-station objective structured clinical exam (OSCE) for OB-GYN residents, we are helping faculty meet new requirements to document performance in different competency areas, including patient care, medical knowledge, communication skills, and systems-based practice. Our simulations also address other accreditation requirements, including interprofessional education and collaborative practice.

Training standardized patients to facilitate physical exam instruction as patient educators

Training standardized patients to facilitate physical exam instruction as patient educators

Our staff provides training to a subset of standardized patients to prepare them to facilitate instruction in physical examination, clinical interviewing, and small group learning. These specially trained laypeople - known as patient educators (PEs) - fill the dual role of patient and educator as they facilitate workshops with health science learners at the University of Minnesota. In workshops with the patient educators, medical students practice their exam skills and the patient educators facilitate team-learning on the utility of each exam maneuver in assessing patient health. Clinical faculty oversee and provide support to patient educators, but no longer need to facilitate each small group, which allows them to use their expertise more strategically. This model also helps learners better understand how patients themselves are a critical component of the health care team.

Utilizing standardized patient methodology to enhance educational programs of non-medical professions

Utilizing standardized patient methodology to enhance educational programs of non-medical professions

In collaboration with faculty, we prepare members of the standardized patient (SP) pool to portray individuals other than patients. The University of Minnesota Law School utilizes SPs as standardized clients in a unique curriculum designed to teach law students how to interview and counsel clients. We prepare SPs to be effective standardized clients by drawing on key parallels in practice between medicine and law. Both standardized patients and standardized clients need to be prepared to work with learners who need to gather information, make decisions, and provide counseling and support. The successes we have had collaborating with the Law School since 2008 demonstrate that standardized patient methodology is useful across a wide range of professions.

Developing simulations that can be conducted anywhere

Developing simulations that can be conducted anywhere

In situ simulation – simulation that takes place within actual health care settings –allows us to support team-based learning in highly realistic environments. Our staff works to make it easy and cost-effective to conduct simulations in a wide range of environments and locations. In collaboration with School of Dentistry faculty, we conduct in situ simulations in University of Minnesota dental clinics, utilizing both standardized patients and patient simulators. Using B-Line Medical’s SimCapture® Ultraportable, we are able to record simulation video, audio, and data during off-site simulations. These recordings are immediately available for debriefing and review. We also serve other regional areas across the state, including our campuses in Duluth and Rochester, by developing standardized patients outside the Twin Cities.