1. Simulation and its Future in Education Shahzad Waheed, MD, FAAP, FRCP(C)

2. Objectives History of simulation In Situ simulation Role of simulation in nursing education Communication and team work Patient safety and simulation Retention of Knowledge Janeway simulation program

3. What is Simulation Experimental Learning Opportunity to realistically experience a given task or situation while minimizing Or eliminating the normally associated risks to the operator, equipment, environment, or others involved

4. Advantage of providing a safe learning environment, standardized and reproducible content The ability to demonstrate problems of various levels of complexity

5. History of simulation Early 1960’s Standardized patients Resuscitation manikins with spring loaded chest for CPR training (Resusci Annie)

6. Late 1960’s SimOne: 1st computer controlled manikin Blinking Eyes Reactive pupils Opening jaw Palpable pulses Chest rise and fall

7. Formula One

8. Flight industry

9. War Games

10. Off site vs In Situ simulatio n Off Site: There are two main types of learning to target The individual and the team All other factors are controlled and considered part of the simulated environment

11. Off site vs In Situ simulatio n In Situ Simulation: Health care delivery system are potentially subject to evaluation, reflection, and improvement and, thus, sites for learning Four components: Individual learning Team Learning Unit level learning Organizational Learning

12. The role of simulation in nurse education Descriptive survey to evaluates the role of medium to high fidelity simulation in the preparation for clinical nursing practice Valuable method of learning Experience with high fidelity simulators enhanced the safety of their practice C.S. McCaughey, M.K. Traynor / Nurse Education Today 30 (2010) 827–832

17. Communication and Team Work

18. Communication/Team Work Descriptive study Team consisted of Pediatric residents, one junior nurse, one senior nurse and once nurse from critical care area Exposed to three Life threatening scenario Apnea-Bradycardia with respiratory compromise Near drowning Head injury with increased ICP The Journal of Continuing Education in Nursing · July 2008 · Vol 39, No 7

19. Communication/Team Work Nurses and physicians can collaborate as a team to decrease medical errors and improve patient outcomes Improved their communication with each other and appreciation of one another's contribution Greatly improve the multidimensional complexity of the nurse-physician relationship over time The Journal of Continuing Education in Nursing · July 2008 · Vol 39, No 7

21. Allan 2010

22. Patient Safety

23. SIMULATION-BASED TRAINING FOR NURSES IN STERILE TECHNIQUES DURING CENTRAL VEIN CATHETERIZATION Prospective study over the period of 12 months 46 nurses completed assessment and training in assessment and training in sterile technique skills AMERICAN JOURNAL OF CRITICAL CARE, January 2014, Volume 23, No. 1

27. Improved Patient Outcome

28. Retention of Knowledge

29. Mean scores for CPR cognitive knowledge Nurse Education Today (2006) 26, 218–227

30. Retention of Knowledge Pass scores in CPR cognitive knowledge Nurse Education Today (2006) 26, 218–227

31. Skidmore 2001

32. Simulation Program in Janeway

35. Multidisciplinary Simulation every Thursday Afternoon that include Residents, Nurses, Respiratory ER simulation every Thursday in AM Pediatric anesthesia have started running simulation sessions for their nurses

36. NICU does Bi Weekely Simulation Session Medical surgical ward Just started running simulation sessions for nursing staff

37. Simulation sessions: 2013 : 72 sessions 674 Participants 2014: 64 sessions 436 Participants

38. Future plan is to take simulation to different hospitals with in the provinces

39. Any Questions?