Medisinsk simulering - et unikt verktøy for å implementere kunnskap i praksis. Elsa Søyland

Transkript

1 Medisinsk simulering - et unikt verktøy for å implementere kunnskap i praksis Elsa Søyland

2 Et samarbeid mellom

3 SAFER - Stavanger Acute medicine Foundation for Education and Research «From nice to have to need to have!?» 3

4 1. Train as you treat your patients 2. Use simulation training wherever possible 4

5 ..går sammen om en sterkere læresirkel 5

6 Felles mål: SAFER - Stavanger Acute medicine Foundation for Education and Research Styrke akuttmedisin og pasientsikkerhet som felles satsningsområder for Universitetet i Stavanger, Stavanger Universitetssykehus og Laerdal Medical. Bidra til bedret treningen og kompetanseutviklingen for helsepersonell Samarbeid om praktisk rettet forskning Bidra til styrking av stimulerende lokale, nasjonale og internasjonale nettverk 6

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8 Deltakere SESAM 8

9 Optimal Student Learning for High Quality Patient Care Goal for using simulations:

10 SAFER - Stavanger Acute medicine Foundation for Education and Research Utvikling aktivitetstall År

11 SAFER - Stavanger Acute medicine Foundation for Education and Research Evulosjonsstigen 11

12 User groups Pediatric Pre Midwives Medical General Offshore ED Anaesthesiologists Nursing nurses hospital students practitioners nurses and and obstetricians EMT s and and doctors the and operating doctors team 12

13 SAFER - Stavanger Acute medicine Foundation for Education and Research Bringing simulation to the market... 13

14 Trauma team training in situ at the Emergency Room 14

15 Simulation Translate knowledge into effective action Integrate competencies Understand the impact of team dynamics on patient treatment Decision making Thinking clearly in an emergency Improve patient outcomes

16 Debriefing - where most of the learning occurs Discussion of set learning objectives Reflection on practice Reinforcement of good practice Learn from mistakes Creation of a team spirit Creation of new/individual learning goals

17 SAFER - Stavanger Acute medicine Foundation for Education and Research Train as you treat your patients 17

18 SAFER - Stavanger Acute medicine Foundation for Education and Research Kunnskapsoverføring Enkel overføring Instruktør Student Peter Dieckmann DIMS

19 «In theory there is no difference betwen theory and practice, in practice there is» 19

20 SAFER students Dagens studenter Morgendagens klinikere Simsallabim?

21 From solist.to symphony 21

22 SAFER - Stavanger Acute medicine Foundation for Education and Research SAFER sine fokus Øke kompetanse og repertoar på læringsformer Øke kompetanse og repertoar på implementering Øke kompetanse og repertoar på evaluering Overføre dette til fasilitatorene (faculty development >250 personer) Arbeide med de riktige prosjektene med potensiale for utvikling av MTO (menneske-teknologi-organisasjon) 22

23 SAFER - Stavanger Acute medicine Foundation for Education and Research Utgangspunktet Medical Science Educational Efficiency Local Organization Survival Utopia 100% x 100% x 100% = 100% Ideal? 90% x 90% x 90% = 72% Actual? 80% x 50% x 50% = 20% Chamberlain, D., & Hazinski, M. (2003). Education in resuscitation. Resuscitation, 59,

24 SAFER - Stavanger Acute medicine Foundation for Education and Research Educational Efficiency 24

25 SAFER - Stavanger Acute medicine Foundation for Education and Research Local Organization Bearbeidet fra Obstfelder, 2007 og Pfeffer & Sutton,

26 Medical Science Educational Efficiency Local Organization Survival Needs for learning Asking for results Tailored implementing Kirkpatrick s 4 levels 1.Reaction - what participants thought and felt about the trai 2.Learning - the resulting increase in knowledge and/or. evaluation occurs during the training in the form.. or test. 3.Behavior - transfer of knowledge, skills, and/or job behavior due to training program). Th training while the trainee is performing the job. Observation. 4.Results - the final results that occurred because of program (can be monetary, performance-b Tailored intervention Anchoring in the organization Clearly defined objective and solution Clearly defined problem Organizational readiness, paradigms 26

27 SAFER forsknings strategi SAFER Practices a multidisciplinary research and development programme to create SAFER practices in acute healthcare ( ) 27

28 Hege L. Ersdal 28

29 SAFER - Stavanger Acute medicine Foundation for Education and Research Background Tanzania was the first country to pilot test National implementation of a simple simulation based training program in neonatal care and resuscitation Haydom Hospital represents one site

30 SAFER - Stavanger Acute medicine Foundation for Education and Research Understood the needs of their patients Lack of knowledge skills confidence equipment optimal care Professional photographer Lynsey Addario ~ 9000 newborn die each day globally

31 SAFER - Stavanger Acute medicine Foundation for Education and Research Defined the goals for their patients 1. To enhance the skills of the Birth Attendants 2. To reduce the incidence of Early Neonatal Mortality by 50% 3. To reduce the number of Fresh Stillbirths by 25%

32 SAFER - Stavanger Acute medicine Foundation for Education and Research Implementation strategies A one-day simulation-based Helping Babies Breathe course did not change clinical practice

33 Evaluation - Methods Kirkpatrick level 1 and 2 Questionnaires and simulations Kirkpatrick level 3 Observed performance Ref. Ersdal HL et al. Resuscitation 2013

34 Implementation of low-dose high-frequency in-situ training Weekly HBB training In the labor ward Supported by local leaders Kirkpatrick level 3 and 4 Observed performance and perinatal outcome Ref. Mduma et al. Abstract IMSH 2014 Decrease in mortality by 40%

35 Implementation strategy Organisation perspective Goals and collaboration

36 Knowledge transfer to other industries

37 SAFER - Stavanger Acute medicine Foundation for Education and Research 37

38 SAFER - Stavanger Acute medicine Foundation for Education and Research 38

39 Train as you treat your patients SAFER - Stavanger Acute medicine Foundation for Education and Research 39

40 40

41 SAFER - Stavanger Acute medicine Foundation for Education and Research Goals Manage: Simple treatment principles Communication Decision making Situation Awareness Teamwork Procedures Correct use of equipment

42 SAFER - Stavanger Acute medicine Foundation for Education and Research Hvordan få det til? Helhetlig plan og kontinuerlig opplæring God behovsanalyse Omhyggelig valg av pedagogisk metode og materiell Deltakere skal selv forstå sammenhenger ikke huske God plan for implementering til praksis Helge Lorentzen,pedagogisk leder SAFER 42

43 Telesim Offshorekurs

44 A multiprofessional faculty Experts in emegency medicine and simulation as a learning method Anesthesiologist Conrad Bjørshol Paramedic Kjetil Torgeirsen Anesthesiologist Thomas Lindner Intensive Care Nurse Ingve Hetland

45 SAFER - Stavanger Acute medicine Foundation for Education and Research Facilitator Course- Train-the-trainer 45

46 Organisasjonsmodell Styret Daglig leder Pedagogisk leder (1,0) Kursadministrator (1,0) Driftskoordinator (0,6) Medisinsk/forsknings leder Post doc 1 (50%) Post doc 2 (50%) PhD stipendiater Prosjektsillinger (1,2) SUS Koordinator (0,5) UiS Koordinator (0,5) Offshore koordinator(1,0) Fødeavd. Nyfødt Intensiv etc Bachelor spl Videreutd spl Nettutd bachelor spl Anestesilege (5 x 0,2) Intensivspl (4 x 0,2) Paramedic (6 x 0,2) Anestesispl (1 x 0,2)