Simulcast Journal Club is a monthly series that aims to encourage simulation educators to explore and learn from publications on Healthcare Simulation Education. Each month we publish a case and link a paper with associated questions for discussion. Inspired by the ALiEM MEdIC series, we moderate and summarise the discussion at the end of the month, including exploring the opinions of experts from the field.
The journal club relies heavily on your participation and comments and while it can be confronting to post your opinions on an article online, we hope we can generate a sense of “online psychological safety” enough to empower you to post! Your thoughts are highly valued and appreciated, however in depth or whatever your level of experience. We look forward to hearing from you.
The Article :
Kerrey, Benjamin, MD, MS, Boyd, Stephanie, et al. Developing a Profile of Procedural Expertise: A Simulation Study of Tracheal Intubation Using 3-Dimensional Motion Capture. Simul. healthc.. 2020;15(4):251-258. doi:10.1097/SIH.0000000000000423
The Case Study :
It had been a month since Harvey had been unable to intubate an unstable, septic neonate but the memory of desperately yet unsuccessfully manipulating the laryngoscope remained fresh in his mind. He remembered the looks of polite confusion from his junior staff when he failed, as if their perception of him had dropped dramatically but they didn’t know how to articulate it. Fortunately for him and the patient, it had been nothing an LMA couldn’t fix and the baby had recovered beautifully. Much faster, in fact, than Harvey had recovered from that particularly bruising identity threat.
He’d realised that he’d reached an alarming state of unconscious competence as a NICU registrar, to the point where his muscle memory intubated so well his brain had contributed very little. 3 years as a Consultant without intubating though, had atrophied those particular neurones, and skills wise he’d seemed left with nothing.
Expertise, he thought to himself, was a funny thing. Hard to define, hard to measure, and even harder to maintain.
This month we’re exploring procedural expertise, and simulation’s role in describing and identifying what procedural expertise actually looks like in practice.
As always, enjoy the paper and we look forward to your thoughts!