Simulation for Patient Safety Slideset 1 Rachel Yudkowsky, MD MHPE UIC CPC

2 Objectives By the end of this week, you should be able to: Describe simulation types and dimensions. Explain how simulation can promote patient safety. Match different types of simulations to different learning objectives. Design a simulation-based activity using Kolb’s cycle of experiential learning

3 Outline for the week Readings Slide set 1 Assignment 1 Independent work Slide set 2 Assignment 2 Group work Slide set 3Wrap up

Simulation – an approximation of reality Allows the elicitation and expression of behaviors of interest in a controlled setting

5 Simulation for patient safety Standardized Patients Task Trainer Models Responsive Mannequins

6 Standardized Patients are persons who have been trained to portray a particular patient presentation in a consistent and reliable way. At UIC: Professional Actors

7 What can be taught and assessed with SPs? History and Physical exam skills Communication/ Interpersonal skills Professionalism Ethics Decision making Patient management

8 Physical Findings Simulators ensure students can recognize abnormal signs Lung sound simulator Eye model Ear model Pelvic model Cardiovascular model (eg Harvey) Human Patient Simulator

9 How can we use simulated encounters to enhance patient safety? Clinical skills: teaching workshops Assessment: single encounter vs OSCE Feedback: patient/family perspective Faculty development: standardized learners Team simulations – standardized staff

10 Example: Resident Communication Tasks Bad news Informed consent Treatment refusal Domestic violence Advance directives Medical error

Encounters take place in a clinic setting and are video- recorded for feedback and remediation Available on-line from any computer

Practicing Procedural Skills: Simulator Models

13 How many times have you done this on a patient? ( M4s, 2006) Never Insert IV37 % Lumbar Puncture86 % EKG43 % ABG32 % Phlebotomy12 % Airway – intubated/bagged 52 % Patient Safety

One solution: practice procedural skills on task trainer models

15 Inserting an IV

16 Suturing

17 Lumbar Puncture

18 Arterial Blood Gas

19 Phlebotomy

20 Responsive patient simulators (Mannequins) Physiological responses Decision making Crisis management Teamwork

21 How might you use simulation to improve patient safety?