- 1. Medical SimulationSee one do one teach onejust not on my Mum
Peter Brindley, MD FRCPC. Consultant Physician, Critical Care
MedicineAssistant Professor and Program Director, CCMMedical Lead
for Simulation, CH Vice-president, Canadian Resuscitation Institute
Division of Critical Care Medicine
2. On a serious note- 3. More education, right 4. More realistic
education 5. What Can Simulation Do?
- Teaching knowledge and procedures
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- Crisis Resource Management (CRM Training)
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- Leadership, communication, dealing with stress
6. What Can Simulation Do CTD
- Our door to delivery times are too slow
- Skills beyond knowledge are ignored
- CRM training is compulsory in other industries
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- Airline, nuclear power, military,
- Social justice imperative
- Building a safety-net around patient
7. A Modern Educational tool
- Hands-on (experiential learning)
- Modify to learning styles
- Reproducible, standardized
- Address the CanMeds objectives
- ? A licensing/competency tool
8. The Laerdal SimMan Intubatable/modifiable airway/surgical
airway/voice/pneumatic lungs /cardiovert/defibrillate/mimic
rhythms/produces urine/ 9. Urology 10. OB/Gyn 11. OB/Gyn 12. Task
Trainers CTD 13. Teaching beyond Knowledge
- Crisis Resource Management (CRM)
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- Dealing with stress/uncertainty
14. Examples please..
- Very senior 747 pilot begins taxiing
- Copilots know he has not been cleared
- Everyone too intimidated to say anything
- Two planes collide- hundreds die
15. The ABCs
16. The New ABCs
17.
- Be aware of how do you deal with stress
- Declare an emergency without looking panicked
- Realize when youre in charge and when not
- Realize when a decision is needed.
18. Leadership Skills
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- .We must do something, anything
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- Its not my problem, what can you do
19.
- Crisis Resource Management
20. Avoid vague suggestions
- ThereforeJohn, please intubate the trachea
- NotPerhaps its time to intubate
21.
- Maintain a global perspective
- Be proactive not reactive
22.
- Simultaneous diagnosis and therapy
- Requires sounding the alarm
- Requires a high index of suspicion
23. R and R Strategy
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- Initial therapy despite limited info
24. Fixation Errors
- These occur regardless of level of expertise
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- Failure to question diagnosis
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- Failure to admit theres a problem
25. Preventing Fixation errors
- Maintaining aglobal perspective .
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- When managing an unstable patient
- Call for help early; may include:
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- Cognitive skills (a 2 ndopinion)
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- Motor skills (a difficult line)
- Realize what brain is good and bad at.
26. WHO is ELVIS?? 27. 13 x 39 = 28. Other Challenges Simulated
Critical Care Line Calls.Brindley Crit Care 2007 Novel Critical
care Education.Brindley CMAJ 2006 Telephone SimulationBrindley Crit
Care 2007 Blindfolded Simulation Brindley et al. pedning ICM 2007
29. Research InsertCompellingEvidence Here 30. Research
challenges
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- Anything that cant be expressed in numbers is meagre and
inadequate
- Not a departure from medical teaching
31. Some things are simple 32. Some things are not i.e. culture
change
- Nothing more difficult than introduction of a new order:
- The innovator has for enemies all those who have done well
under the old, and lukewarm defenders in those who may do well
under the new. Machiavelli,
33. Medical Simulation is:
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- Education, error-reduction, and research
- Complementary to traditional education
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- High-tech, low-tech, no-tech
- Likely to be an expectation
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- CRM, communication, role modeling