inspire @ imsh 2016

INSPIRE @ IMSH 2016Welcome

08:30 am January 16, 2016

San Diego, California, USA

International Network for Simulation-based Pediatric Innovation, Research and Education


Administrative Items• WIRELESS:


Acknowledgments


Introductions


Mission

We aim to improve the delivery of medical care to acutely ill children by answering important research questions pertaining to resuscitation, technical skills, behavioral skills, debriefing and simulation-based education


INSPIRE Research Themes

TRAINING AND ASSESSMENT

Debriefing Develop/assess/implement effective techniques for debriefing real/sim events

IPE, Teamwork, Communication

Develop/assess/implement effective techniques for team training

Procedural, Psychomotor Skills

Develop/assess/implement effective techniques for skills development retention

HEALTH CARE INNOVATIONS

Technology Develop/assess/implement novel technologies designed to improve processes of care and pediatric patient outcomes

Acute Care and Resuscitation

Develop/assess/implement novel techniques for improving care of pediatric patients

Human Factors Assess the role of human factors when providing care to pediatric patients

Patient Safety Explore the key variables that influence patient safety and assess strategies to mitigate


Schedule - AM• 0730 – 0830: Ongoing Projects• 0830 – 0845: Network Welcome & Intros• 0845 – 0930: New ALERT Presentations - I• 0930 – 1030: Working Group – I• 1030 – 1050: Screen-based Simulation &

Serious Games • 1050 – 1110: PediSTARS India• 1110 – 1130: Reporting Guidelines Update • 1130 – 1230: Lunch Provided & Network Update


ALERT Working Group I

1. Ali N – Team Leadership during Neonatal Resuscitation2. Gross I – Rapid Cycle Deliberate Practice to improve

Airway Management Skills3. Gangadharan S – In situ Simulation for Families of

Chronically Ill Survivors of Critical Illness4. Song JL – Teaching Infant CPR to Families in the

Pediatric Emergency Department5. Walsh B – Factors for High Quality Paramedic Pediatric

Care using In situ Simulation6. Whitfill T – Improving Pediatric Acute Care in Community

EDs through Collaborative Simulation


ALERT Working Group I

• What did you achieve today?• Gaps/questions• Timeline/Next steps

• 2 weeks• 2 months• 6 months• 1 year

Screen-based Simulation & Serious Games Initiative

Todd P Chang, MD MAcM

Children’s Hospital Los Angeles / University of Southern California



Disclosures (TPC)

• Grant Funding provided by American Heart Association & National Board of Medical Examiners

• No Conflicts of Interest to report



Serious Games Initiative• 1050 – 1110: PediSTARS India• 1110 – 1130: Reporting Guidelines Update • 1130 – 1230: Lunch Provided & Network Update


Objectives

1. Define serious games and the attributes that define best practices of games and game-based learning

2. Describe the next steps on how INSPIRE is navigating the newest steps in serious game-based research

EntertainmentVideo Game


What is Serious Games?

SimulationScreen-based Sim

Serious Games

EntertainmentVideo Game


What is Serious Games?

A game in which the primary purpose of

gameplay is the acquisition of a

cognitive, psychomotor, or

affective skill


Attributes

Jane McGonigal’s definition of GamesGoalRulesFeedback MechanismVoluntary Use


Attributes

Incremental ChallengeAdaptation

MysteryNarrative

ConflictControlSafety

Fantasy


Examples

SO WHERE ARE WE IN HEALTHCARE SERIOUS

GAMES?



1st Game-based Learning Summit


Next Steps

1. White Paper on Serious Games in Healthcare2. Establish standards for Research using Serious Games,

within a Simulation Framework3. Establish known funding streams (academic, community,

federal, industry) for serious games-related development & research

4. Develop a Portal for all INSPIRE-led game-based research


Next Steps





Anticipate Submission near April 2016


Next Steps

1. White Paper on Serious Games in Healthcare2. Establish standards for Research using Serious

Games, within a Simulation Framework3. Establish known funding streams (academic, community,




Next Steps


within a Simulation Framework3. Establish known funding streams (academic,

community, federal, industry) for serious games-related development & research



The Portal






The Portal





• Single Login• Standard consent

• Easy Game Porting• Standard data

metrics & reports


The Portal




4. Develop a Portal for all INSPIRE-led game-based research• Governed by only 1 Institutional Ethics/IRB

• Streamlined process for Ethics/IRB Approval• Facilitated Contacts with potential Funders

[email protected]

…visit the IMSH Serious Games ShowcaseMark X Cicero – Disaster Triage game

Jim Gerard – Virtual Pediatric simulator

David Kessler – Infant LP Champagne Tap game

Marc Auerbach – Infant Intubation simulator


If you are interested

mailto:[email protected]


Disclosures (MAA)

Reporting Guidelines for Simulation-based Research

Adam Cheng, David Kessler, Ralph MacKinnon, Todd P Chang,

Vinay Nadkarni, Betsy Hunt, Jordan Duval-Arnould, Jeffrey Lin,

Barry Issenberg, David Cook, Martin Pusic, Joshua Hui, Marc

Auerbach, for the INSPIRE Investigators




Serious Games Initiative• 1050 – 1110: PediSTARS India• 1110 – 1130: Reporting Guidelines Update • 1130 – 1230: Lunch Provided & Network Update


Objectives

1. Describe the Development & Publication process of Reporting Guidelines in Simulation-based Research


INSPIRE@IMSH 2015

INSPIRE @ IMSH Network Update

Vinay Nadkarni, MD MS & Betsy Hunt, MD MPH PhD

January 16, 2016

San Diego, California, USA



Schedule - PM• 1130 – 1230: Lunch & Network Update• 1230 – 1300: Progress ALERT Presentations• 1300 – 1345: New ALERT Presentations - II• 1345 – 1445: Working Group Meetings – II• 1445 – 1515: Completed Project Presentations• 1515 – 1530: Break• 1530 – 1615: Cognitive Simulation • 1615 – 1645: Future Directions, Discussion • 1645 – 1730: Funding, Question & Answer


Disclosures (VN / EAH)


Acknowledgments


Leadership


Research Committee


Mission

We aim to improve the delivery of medical care to acutely ill children by answering important research questions pertaining to resuscitation, technical skills, behavioral skills, debriefing and simulation-based education


What do we do?

• Vision– Answering important questions– Pillars of research

• Building programs of simulation research– Sharing resources

• Bringing down walls between institutions


Mentorship


Productivity


Growth

2011 2012 2013 2014 2015 20160

50

100

150

200

250

Sites


Growth

2011 2012 2013 2014 2015 20160

100

200

300

400

500

600

700

Members


Productivity in 2015

• 11 New Projects• 10 Grants Awarded• 24 Abstracts, Workshops &

Presentations• 36 Publications


Consultative Submission

Study protocol

Specific Consultative Questions

Online submission (http://www.INSPIRESim.com/)

Research Design Committee feedback

Any grant proposal Grant feedback

One-time access to Experts and feedback


Study Protocol Submission

Study protocol

Online submission (http://www.INSPIRESim.com/)

Research Design Committee feedback

Any grant proposal Executive Oversight Committee feedback

Invitation to present at IMSH or IPSSW


Writing up a project

• Accountability– Clear expectations/roles

• Engagement will vary from person to person, site to site– A priori milestones, timelines, tasks– Shared decision making

• Opportunities for Authorship– What does each individual gain from participation– Sub-groups (projects within projects)– Network by-line


Example


Writing Groups• Primary Author

– Responsible for the main writing – Corresponding author

• Production Manager– Manages the entire process– Sets deadlines– Compiles sections written by others into a single draft– Formats the paper in accordance with the journal’s style

• Core Group (3-5 people)– Responsible for the content of the paper– Divide pieces of manuscript – Make decisions concerning the manuscript


INSPIRE Manuscript Oversight Committee (MOC)The MOC will ensure that INSPIRE research projects are peer-reviewed for publication in a manner that ensures timely and effective communication of research findings to our stakeholders and that INSPIRE members are properly credited for their hard work. Additionally, the MOC will advocate for the involvement of young researchers in the publication process.


MOC Guiding Principles

1. To be listed as an author an individual must significantly contribute as described by the International Committee of Medical Journal Editors criteria (www.icjme.org). Authors must meet ALL 3 criteria:

a) Substantial contribution(s) to conception and design, acquisition of data, or analysis and interpretation of data

b) Drafting the article or revising it critically for important intellectual contentc) Final approval of the version to be published.

2. Authorship and order of authorship will be assigned as early as possible in the research process. The first author will be responsible for leading the writing process and delegating roles to co-authors.

3. Authorship and the order of authorship are subject to change if contributions to the final work product are not consistent with the expectations outlined by the lead author. Any research team member can contact the MOC for assistance in decisions related to authorship order and inclusion as an author.

http://www.icjme.org/



4. All site investigators will be recognized as part of the “INSPIRE Collaborative” in all INSPIRE publications with the byline "...FOR THE INSPIRE INVESTIGATORS."

5. INSPIRE investigators who are not site PI's or co-PI's will generally be acknowledged in an appendix of site participants appropriate to that manuscript .

6. INPSIRE will attempt to appropriately attribute academic credit, with emphasis on acknowledgement of all involved and the MOC subcommittee will negotiate and mitigate disagreements among/between investigators about authorship

7. INSPIRE will prioritize young investigators as first, second and third authors, when possible and appropriate.

8. The MOC will facilitate identification and management of Conflicts of Interest, if they arise related to INSPIRE projects.



9. The MOC will assist with enforcement of timelines for analysis and publication of data. If any first author cannot complete the manuscript submission within 1 year following the end of data collection/closure of data collection, then first authorship will be re-evaluated and potentially reassigned by the MOC.

10. The MOC advocates consideration for publishing in journals that have an Open Access mandate so that our research is available as broadly as possible


Writing SuccessINSPIRE

contributors represent 95% of

all authors in Comprehensive

Healthcare Simulation: Pediatrics Textbook


Special Thanks toAnne Ades, Mark Adler, Jennifer Arnold, Marc Auerbach, Farhan Bhanji, Zia Bismilla, Choon Bong, Matthew Braga, Guy Brisseau, Linda Brown, Rebekah Burns, Aaron Calhoun, Doug Campbell, Todd P Chang, Adam Cheng, Kevin Ching, Mark Cicero, Suzette Cooke, Ellen Deutsch, Maria Carmen Diaz, Aaron Donoghue, Adam Dubrowski, Jonathan Duff, Jordan Duval-Arnould, Dylan Bould, Walter Eppich, Tobias Everett, Marino Festa, Marisa Brett Fleegler, Jim Gerard, Elaine Gilfoyle, Ron Gottesman, David Grant, Vincent Grant, Mindy Fiedor Hamilton, Ellen Heimberg, Lennox Huang, Betsy Hunt, Lindsay Johnston, Liana Kappus, David Kessler, Susanne Kost, Afrothite Kotsakis, Arielle Levy, Yiqun Lin, Lindsay Long, Joe Lopreiato, Tensing Maa, Ralph Mackinnon, Mary Beth Mancini, Deepak Manhas, Pete Meaney, Garth Meckler, Elaine Meyer, Mike Moyer, Elaine Ng, Akira Nishisaki, Denis Oriot, Frank Overly, Janice Palaganas, Mary Patterson, Dawn Taylor Peterson, Jonathan Pirie, Martin Pusic, Jennifer Reid, Nicola Peiris, Traci Robinson, Taylor Sawyer, Ella Scott, Yuko Shiima, Nicole Shilkofski, Elaine Sigalet, Kimberly Stone, Glenn Stryjewski, Stephanie Sudikoff, Nancy Tofil, Terry Varshney, Debra Weiner, Marjorie Lee White, John Zhong


Debriefing

Eppich W, Cheng A. How Cultural-Historical Activity Theory can Inform Interprofessional Team Debriefings. Clin Sim Nurs 2015;11:383-9.Eppich W, Cheng A. Promoting Excellence & Reflective Learning in Simulation (PEARLS). Sim Healthc 2015;10:106-15.


Teamwork, Communication


Procedural Skill Simulation

Tiyyagura G et al. The Greater Good: How Supervising Physicians make Entrustment Decisions in the Pediatric Emergency Department. Acad Ped 2015;4;14:597-602.


Technology


Acute Care / Resuscitation

Abelairas-Gomez C et al. Efectos del refuerzo audiovisual en tiempo real sobre la ejecucion de las compresiones toracicas realizadas por escolares. Emergencias 2015;27:189-92.Lin Y, Cheng A. The role of simulation in teaching pedciatric resuscitation: current perspectives. Adv Med Educ Pract 2015Lee J et al. High-Fidelity Simulation in Pediatric Emergency Medicine. PEC 2015;31:260-5.Jones A et al. Visual assessment of CPR quality during pediatric cardiac arrest: Does point of view matter? Resuscitation 2015;90:50-5.


Human Factors

Chime NO et al. Comparing Practice Patterns Between Pediatric Emergency Medicine & Emergency Medicine Physicians. PEC 2015; In Press.Pusic MV et al. Learning Curves in Health professions Eucation. Acad Med 2015.Agra Tunas MC et al. Spinal muscular atrophy and respiratory failure. How do primary care paediatricians act in a simulated scenario? Anales Pediatr 2015.Rodriguez-Nunez A et al. Quality of chest compressions by Down syndrome people. Resuscitation 2015;119-22.


Patient Safety

O’Leary F et al. Identifying incidents of suboptimal care during paediatric emergencies. Resuscitation 2014.


INSPIRE as Link


INSPIRE as Sim Advocate


ALERT Progress Reports

1. Sigalet E – Feasibility & Efficacy of an Online Faculty Development Course on Effective Feedback

2. Mallory L – Simulation-based Assessment Tools for the General Pediatrics Milestones

3. MacKinnon R – Improving High School student CPR performance using an Online Leaderboard

4. Lemke D – Rapid Cycle Deliberate Practice Simulation-based Training

5. Chang TP – Improving In-hospital CPR performance using an Online Leaderboard


Progress ALERTs



ALERT Working Group II

1. Butler L – Physical Presence vs. Telepresence on Teamwork & Communication in Emergencies

2. Slamon N – Biometric Parameters of Critical Care Practitioners using HexoskinTM

3. Herskovitz S – Improving Infant Lumbar Puncture Success with Patient Positioning

4. Jang HY – PALS-on-Demand Skill Training5. Gangadharan S – In situ Simulation to detect Latent

Safety Threats in Critical Care Transport


ALERT Working Group II


• 2 weeks• 2 months• 6 months• 1 year


Schedule - PM• 1130 – 1230: Lunch & Network Update• 1230 – 1300: Progress ALERT Presentations• 1300 – 1345: New ALERT Presentations - II• 1345 – 1445: Working Group Meetings – II• 1445 – 1515: Completed Projects• 1515 – 1530: Break• 1530 – 1615: Cognitive Simulation • 1615 – 1645: Future Directions, Discussion • 1645 – 1730: Funding, Question & Answer


Completed Projects1. Scherzer DJ – Survey-based assessment of

pediatric trainees' epinephrine knowledge2. Auerbach M – ImPACTS3. Adler M - Approach to Confederate Training within

the Context of Simulation-Based Research


Completed Projects

• Lessons learned• Gaps/questions• Next steps

Break!

http://inspireSim.com/


Cognitive Simulation

Martin V Pusic, MD PhD

New York University

January 16, 2016



Disclosures (MVP)

INSPIRE @ IMSH 2016Future Directions & Open

Group Meeting


Jordan Duval-Arnould, PhD

Johns Hopkins University

January 16, 2016


Disclosures (JDA)

Funding Mechanisms for Simulation-based Research

Question & Answer


Ralph J MacKinnon, MBChB

Royal Manchester Children’s

Hospital

January 16, 2016

Todd P Chang, MD MAcM

Children’s Hospital Los Angeles

San Diego, CA, USA


Disclosures (RJM/TPC)

• Grant Funding provided by National Health Services (RJM), American Heart Association (TPC), National Board of Medical Examiners (TPC)

• No Conflicts of Interest to report


What are our Experiences?

• How many of us have attempted to obtain:– International Funding?– National / Government Funding for Research?– Government Funding for Education or Programming?– Industry Funding?– Military Funding?– Foundation / Charity Funding?– Hospital / University Funding?

• What has been successful? What have been failures?


Questions …

Thank you

[email protected]

http://www.INSPIRESim.com/

Twitter: @INSPIRE_Network


mailto:[email protected]

http://www.inspiresim.com/

inspire @ imsh 2016

Health & Medicine