welcome to neurosim

Welcome to NeuroSim

Barbara Stanley FRCAConsultant Anaesthetist Brighton and Sussex

University Hospitals NHS Trust

Welcome to NeuroSim WSHFT www.theneurosim.com

General

• Housekeeping• Lunch• Certificates• Questionnaire


Faculty Introduction• Dr Barbara Stanley – Consultant Anaesthetist Brighton and Sussex

University Hospital NHS Trust (Course Director)• Dr Paul Whitney – Consultant Anaesthetist Brighton and Sussex University

Hospital NHS Trust• Dr Carmen Lopez – Senior Anaesthetic Fellow King’s College Hospital NHS

Trust• Mr Sorin Buccur– Consultant Neurosurgeon Brighton and Sussex

University Hospital NHS Trust• Mr Mihai Dancuit – Senior Neurosurgical Fellow Brighton and Sussex

University Hospital NHS Trust• Mr Peter Foster – Senior ODP Brighton and Sussex University Hospital NHS

Trust


#NeuroSim


Why Simulation in Healthcare

Two Perspectives:

Patient Safety Educational


Medicine: A High-Risk Industry• Harvard Medical Practice Study (NEJM 1991;324:370-6)

identified a ‘adverse event’ rate of 3.7% and 27.6% of these due to negligence

• 1999 Institute of Medicine (IOM)report, To Err is Human - estimated that 44 000–98 000 preventable deaths occur each year in the USA due to medical error

• Vincent (BMJ 2001;322:517) NHS ~11% error rate with 50% preventable– ~50,000 patients pa die from medical error or accident.

Litigation cost £44billion• 2009 Data from the National Reporting and Learning

System for England and Wales suggests that of the 850,000 or so incidents reported annually.. around 3,500 involve death (2011 Health Foundation Evidence Scan: Levels of Harm)


Types of Error(2011 Health Foundation Evidence Scan: Levels of Harm)

• Human factors:– Inadequate training– Variations in healthcare provider training and experience

• Clinical Complexity– using complex technologies and multiple medications– high risk environments such as intensive care

• System Failures– poor communication and unclear lines of authority

between physicians, nurses and other healthcare professionals


IOM RecommendationsKohn LT, et al Institute of Medicine. ‘To err is human:building a safer health system’.

Washington D.C. The National AcademiesPress; 1999.

(Organizations) should also establish interdisciplinary team training programs—

including the use of simulation for trainees and experienced practitioners for personnel in areas

such as the emergency department, intensive care unit, and operating room


Educational PerspectiveMalcolm Knowles 1970•Adults are internally motivated and self-directed•Adults bring life experiences and knowledge to learning experiences•Adults are goal oriented•Adults are relevancy oriented•Adults are practical•Adult learners like to be respected

David Kolb 1984: "the process whereby knowledge is created through the transformation of experience. Knowledge results from the combination of grasping and transforming experience."


Kolb, Honey & Mumford and The NeuroSim


The Evidence for Simulation• “Compared with traditional interactive seminars, simulation-

based training leads to improved performance in patient care by senior trainees in anesthesiology” Simulation-based Training Improves Physicians’ Performance in Patient Care in High-stakes Clinical Setting of Cardiac Surgery Anesthesiology 2010; 112:985–92

• Several studies support the use of simulation to impart knowledge and skills at the provider level, with observational evidence suggesting superiority to traditional or problem-based learning [12,13].

• Studies evaluating simulated clinical performance have consistently demonstrated improvement after simulation training [14,15] Does training with human patient simulation translate to improved patient safety and outcome? Curr Opin Anesthesiol 2013, 26:159–163


“Tell me and I’ll forget, show me and I may remember, involve me and I’ll understand.”

Chinese Proverb


The Evidence for NeuroSim


Aims and Objectives• Guaranteed exposure to core topics of the curriculum in a

immersive environment (short module time/ lack of exposure to complications, motivation, concrete experience)

• Exploration of basic science knowledge and clinical practice issues with peers and faculty and link this to the experience of the scenario (Kolb’s experiential learning)

• Understand how these principles apply to patient management outside neuroanaesthesia (safety and expansion knowledge constructs. Links with adaptive expertise)

• Explore decision-making processes and behaviours (safety, communication, CRM)

• Actively engage in debrief and discussion in a constructive way (Kolb – reflection/theorise, feedback and safety)


Enjoy!!
