Archive April 2018

Experience: The greatest teacher.

Experience: The greatest teacher.

Our experiences shape us into who we are…for the most part. We grow up, the family we were born and those relationships shape some of our early understanding of relationships, values and so on. We learn how we are treated and how we like to be treated.

We go to school, become educated, make friends and our experiences generally shape us into future practitioners. We encounter really amazing teachers and instructors… and also some not-so-great ones.

What did these experiences do for our personal and professional development? Did we experience and accept behaviours such as “it’s okay to yell at another medical staff member in front of others” or “nurses eat their young”? Did we help colleagues that we’re struggling? Did we lose our empathy in order to “toughen up”? Are we too tired to care? Or, did we stand up? Did we say something?  Whatever our experiences are, we have the ability to choose who we want to be as healthcare practitioners and as human beings.

How does this relate to simulation-based education and training? You can model each one of the experiences as listed above in order to educate future practitioners that horizontal violence is wrong, that everyone needs help sometimes, that empathy should be a valued skill in caring for others. Much of the education that we deliver is procedure-based and delivering safe care, but there’s an opportunity to integrate behaviour-based safety as well. Developing simulations that address critical workplace issues can be extremely valuable for ourselves, learners and the future of our respected professions.

The truth is that some people have been shaped by kindness and have never experienced real hardship, while others have been affected by tragedy and personal battles. Regardless of one’s circumstances, we can agree that experience is the greatest teacher. It shapes us into who we are.

This week, I challenge you to teach someone on a topic that you feel is very important. I’d love to hear about what you did and what the impact was.

Be the Change.

Matthew
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About the Author: Matthew Jubelius is a subject matter expert in healthcare simulation. He is a consultant, educator and wants to change the future of people development, education, and training. Matthew has championed the design, implementation, and evaluation of simulation-based education and training programs, including quality improvement measures for post-secondary institutions, private industry, and the federal government.

Matthew can be reached through www.amoveotraining.com for simulation consulting, program development, employee training and speaking engagements.

#simulation #education #healthcare #qualityimprovement

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Sticking with the Immersive Scenario Design

Sticking with the Immersive Scenario Design

A core theme in simulation-based education and training is standardization. That is, when a scenario designed and planned, all trainee groups go through the same designed experience. Why? Consistency, fairness and a clear standard of expected competency.

If a scenario is designed with specific learning objectives, all teams must meet those objectives and participate in the debriefing process. The competency and standards are the same for everyone. If the scenario is designed according to Advanced Cardiac Life Support (ACLS) guidelines, the protocols apply to everyone, equally.

Working with thousands of simulation trainee groups, I remember a specific experience when an instructor was kind of showing off. This particular day, we had several observers in the control area. We had run through and completed a simulation experience and the scenario was announced “Complete. Proceed to the debriefing area”. The instructor turned to everyone and said “watch this” (which in my humble opinion the equivalent of “hold my beer”). The instructor crashed the simulator and the EMS trainee team looked at each other, said “seriously?” and went into another ACLS scenario that was not part of the plan. Afterwards, I asked the instructor what was with the departure of the planned design, the response was “well, anything can happen in EMS”. True, however, this presented a teachable moment with the instructor for several reasons.

I completely understand and appreciate the instructor’s viewpoint that anything can happen in EMS and we had a great professional exchange. We discussed items that might not have been considered such as the added time that the impromptu ACLS scenario added, the extra debriefing for the group and discussed what the added value was of the experience. There were other items that weren’t accounted for. The added time had delayed the operations and administration team in their workflow, other centre users that were delayed, the extra resources that were used, and that we did not have the adequate time to discuss the experience with the observers who also needed debriefing. Also, the other EMS trainee groups asked why they did not get the extra simulation experience and expressed their frustration. The group was right, they did not receive the same standard as others. The deviation of the design plan had a massive rippling effect.

Remember, simulation-based education is about standardization, consistency and sticking with the design. It’s important to be mindful that deviating from the plan can have unforeseen impacts. With clear learning objectives, trainees will shape the experience through their actions and response. It’s about the learning experience.

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Cheers,

Matthew

About the Author: Matthew Jubelius is a subject matter expert in healthcare simulation. He is a consultant, educator and wants to change the future of people development, education, and training. Matthew has championed the design, implementation, and evaluation of simulation-based education and training programs, including quality improvement measures for post-secondary institutions, private industry, and the federal government.

Matthew can be reached through www.amoveotraining.ca for simulation consulting, program development, employee training and speaking engagements.

#simulation #education #patientsafety #leadership

Simulation-based Education Matters

Simulation-based Education Matters

It’s been nearly a decade and I can still recall the day that simulation-based education and training made sense to me and witnessed the profound benefits for healthcare practitioners, workers, and patient safety.

I had never observed a simulated training event and was curious what was going to happen. The concept of using patient simulators was intriguing and I was optimistic about how the learner was going to perform.  The cohort had completed their traditional lecture and lab-based education and was “ready” to deliver care.

The simulation experience was based on Advanced Cardiac Life Support (ACLS) guidelines and the learning objectives were:

  1. Recognize a life-threatening ECG rhythm
  2. Activate emergency system and call for assistance
  3. Administer appropriate ACLS medications and perform CPR

Before the experience, I observed the learner’s behavior and they appeared very confident. “Let’s see what happens,” I thought to myself. The lights went out and the simulation began.

The patient simulator was breathing, showing signs of distress and the software performed spectacularly according to the preset programming (shout out to engineers). The learner entered the event area and began to assess the simulated casualty. The ECG was set up and displayed a life-threatening rhythm that needed defibrillation and immediate drug therapy. Something wasn’t right; the learner interpreted the incorrect ECG rhythm and started giving the wrong medication.  The simulator responded in real-time, vital signs became more complicated and the patient simulator condition worsened.  Within a very short time, the situation became unmanageable for one person, yet there was no call for support. There was no call for help. The scenario continued and ultimately the experience had concluded. In this case, things did not end well.

In the debriefing phase, the facilitator went into more detail about what happened; based on the learner’s performance and connected the pieces to a meaningful learning experience. The scenario was repeated and the learner’s performance was dramatically improved, resulting in better outcomes for the simulated patient. Truly remarkable learning.

Why does this matter? The immersive experience in a controlled environment provided an additional layer of safety, where potential errors could be addressed and corrected well out of harm’s way.

Simulation-based experiences have the ability to positively impact patient safety, help people and teams deliver appropriate interventions.  Simulation – the replication of an experience, can also expose system weaknesses and provide opportunities for healthcare quality improvement.

By designing and facilitating experiences based on models of current and best practices, we have the opportunity to address current challenges and impact the future of healthcare delivery.

Even after thousands of simulation experiences, I remain passionately curious about how people interact with complex systems. Failure can be an enormous learning experience, especially in a setting where there is absolutely no risk to patients.

I believe that we can make a difference in creating safer and effective systems.

Matthew

About the Author: Matthew Jubelius is a subject matter expert in healthcare simulation. He is a consultant, educator and wants to change the future of people development, education, and training. He has championed the design, implementation, and evaluation of simulation-based education and training programs, including quality improvement measures for post-secondary institutions, private industry, and the federal government.

Matthew can be reached through www.amoveotraining.com for simulation consulting, program development, employee training and speaking engagements.

Building on Strengths

Building on Strengths

People are awesome! Think about it. I really believe that individuals and teams are capable of accomplishing great things. Flight, capturing and storing electricity, the creation of the internet, advances in modern medicine… Yes, people can do great things.

We often hear about these successes from a distance through media and can list numerous famous individuals because we see their name in the highlights. Have you ever wondered what made them successful and strong? Although I will never know the true answer, this causes me to reflect on several questions a little closer to home: What are my strengths? What makes me successful? What am I most proud of?

There are many things that contribute to our strengths and we all have varying degrees. Some people are physically gifted with an abundance of muscle mass or athletic talent, some have outstanding intellect, while others carry enough empathy to completely understand and calm one’s soul. Whatever our strengths are, how much time do we devote to building on them?

There are different theories of how long it takes to become excellent or master a subject; for example, Malcolm Gladwell and the 10,000 hours concept. However, what about the personality traits that make us amazing, is there a time requirement? Does the learning stop after 10,000 hours?

I believe that we continually evolve as we grow from our experiences. One of my strengths is that I love to educate and inspire others. Another is that I’m very passionate about creating safer communities and know that we can do more to train effective healthcare and safety personnel. I truly believe that we can make a difference. For me, there is no time requirement. This is me, every single day and I know that I’m not alone. My passion doesn’t have an off switch.

We all have the capacity for greatness. We’re also given 24 hours in a day and we know that it takes time to work on our strengths. This week, think about what you’re amazing at. What are your strengths and passions? How will you build on them?

Have a great week,

Matthew

About the Author: Matthew Jubelius is a subject matter expert in healthcare simulation. He is a consultant, educator and wants to change the future of people development, education, and training. He has championed the design, implementation, and evaluation of simulation-based education and training programs, including quality improvement measures for post-secondary institutions, private industry, and the federal government.

Matthew can be reached through www.amoveotraining.ca for simulation consulting, program development, employee training and speaking engagements.

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