Case:
You have been asked to develop a five-year strategic plan for simulation services in your hospital. Through your literature review you recall an article by David Gaba, ‘The future vision of simulation in healthcare’. All your dreams have been answered. In 2004 Gaba mapped the dimensions of organisational applications of simulation. You are thrilled to find his projection of two possible histories viewed from 2025; one optimistic – simulation integrated into the very fabric of health care; and one pessimistic – lamenting the abject failure of simulation to progress past and ad-hoc expensive education luxury. Now your challenge lies in which history rings most true in 2016 and how do we move forward for the next five years?
In 2016, the term ‘simulation’ covers a wide range of activities – procedural skills, team training, quality improvement, mannequins, simulated patients, virtual reality and much more. And yet healthcare simulation remains inaccessible, badly delivered or simply failing to live up to promise in many contexts.
To kick off our first episode of Simulcast, Jesse and I decided to tack a step back and look at the ‘state of the art’ of healthcare simulation in 2016. We used David Gaba’s landmark paper – The future vison of simulation in health care from 2004 – as a starting point.
David Gaba is one of the grandfathers of healthcare simulation. Trained as a biomedical engineer, a pilot and then as an anaesthesiologist, he brought a unique vision to how to train better for the work we do in healthcare.
When he wrote this paper in 2004, healthcare simulation was in its infancy, and mostly delivered around expensive mannequins in dedicated simulation centres. I had just done my first Crisis Resource Management (CRM) course as a participant at Monash simulation that same year, and was an immediate convert to the possibilities.
In the podcast we look at the clarity Gaba offered us in that paper – how to think about the dimensions for healthcare simulation delivery – the technology used, the participants, the learning objectives, the environment of delivery.
But he also offered us two future visions of simulation for 2025. One is optimistic – in which healthcare sim is embedded and integrated with care, training and quality improvement. The alternate vision is one in which simulation never really ‘made it’.
We bring our own biases and hopes to the discussion…..
Episode 1 – The Future Vision of Simulation in Health Care. Are We There Yet?
Great job guys!
( Not unexpected though 😉 )
I really liked the comments on research in simulation. I think a lot of sim educators have challenges with this also in terms of funding bc our decision makers want to know that what they spend money on it also works. So we still need to improve on what research questions are we asking and what we mean by “working”. That will also make it easier to get our sim research published.
And of course it is no surprise that the comment about developing sim as a “career path” and how we introduce students into sim was something I really can relate to.
Great job – this podcast is so needed and very much appreciated. I’m looking forward to future episodes.
Many thanks. Like VB i grew up in a high fidelity mannequin based centre of expertise, around 2004 , with some absolutely brilliant teachers shaped heavily by links to Stanford (and hello to you Brendan Flanagan and others out there) The key to simulation centre survival has become flexibility and diversification and the use of simulation in a broader sense. We are in many ways in the business of customer service. and the provision of expertise to other units, participant groups etc. I am very optimistic about the future of the expanded aims of sim, to a much greater degree than I would have said 5 years ago. Your work is a major contributor to my optimism. Thank you.
This simulcast worked well and provoked thought and is well worth listening to.
Some suggestions for you:
In earlier- lead with the dilemma. What is the future of Simulation – centre based high fidelity and highly controlled or broader with diluted expertise and more risk of something going wrong. What drives these choices ?
Can we please have a session on the economic and hospital or health political complexities of sim. How do we get CEO’s to fund it and not see it as an expensive luxury? Could you access a CEO to see what acts as their triggers? Cost/risk/adverse events plus the positives- patient care and the chance to display innovation in their hospital? What is their take? What are the alternatives to hospital funded simulation. Loved the comment about insurers funding simulation. yes please.
Like Sandra I also look forward to an expansion on sim research and the translation of content to clinical “outcome”
You are both very nice knowledgable people that agree with each other. Find something or someone you can disagree with. Even if its a devils advocate. “Jesse- I think Sim should only be done within highly controlled simulation environments. It is just too risky to do in in-situ and we are too busy”.
I started with something positive, gave some suggestions and am now tempted to end with something positive at the risk of providing a “Lorte Sandwich” I am going to stop there. You know you are good. You don’t need me to tell you. I have subscribed. Cheers Ian S @ianMeducator
Thanks Ian
Very useful thoughts – appreciate you taking the time. Especially like more ‘devils advocate ‘ !
But also glad you are in the optimist camp
🙂
vb
Thanks Sandra. Glad such an experienced ‘simulationista’ as yourself liked it. Yes we’re doing a segment soon on research and will channel those issues you raise.
vb
Thanks for doing this Jesse and Victoria….I’m excited about using more SIM in our ED
Thanks for dropping by Liz. Be sure to keep us in the loop with how you progress implementing sim in the ED.
Jesse and Vic, Thanks so much for this great start-up podcast. Such a good starter topic and a really professional presentation (which is to be expected). I am so looking forward to the podcasts to come!
Stephanie O’Regan
Thanks Stephanie.
Hope also to get around and do some short ‘door stop’ recordings at simhealth – so be warned !
Greetings
Thank you Jessie and Victoria for bringing us Simulcast. Your efforts are appreciated.
In this last year, since meeting you both at SMACC Chicago, I have left the bedside and now have the privilege of working as the Director of a new lab, the Centre for Interprofessional Clinical Simulation Learning in beautiful Victoria, BC, Canada.
During this year, I have spoken to many individuals both in healthcare and in our community. With guarded optimism, colleagues consistently wish us success and with equal consistency members of our community are often surprised to learn that in far too many contexts we do not currently “practice the practice.”
I look forward to future episodes. An optimistic future where indeed simulation is integrated into the very fabric of our health care.
With respect. Professional regards.
Darin
Thanks so much for the supportive feedback. Please don’t hesitate to get in touch with ideas for collaboration or podcast topics.
Also, your thoughts would be valuable in our monthly Journal Club posts.
Thanks again.
Hi Darin
Great to hear from you. Well done on your career evolution!
And yes – agree – its the translation of evidence to practice that challenges us just as much in education as it does in clinical practice. Its good to be creative enthusiasts but we have a responsibility to match that with rigour.
Thanks
vb