Above photo: The team at the Whistler Health Care Centre practice a pediatric trauma case on Sim Jr.
The Coastal Simulation Program's outreach to rural sites continues apace with physicians and staff eager to run their own regular simulation events after a visit and training from the Lions Gate Hospital (LGH)-based sim team.
Over the last 18 months, the Coastal Simulation Program has:
- Organized 174 events
- Run 491 scenarios
- Trained 58 staff to provide sim-based education
Since the program started in February 2015, the team has taught 1,418 staff.
“It's important for us to continue the development of the outreach program, offering opportunities for rural sites to become self-sufficient in running their own simulation based events," says Karen Schafer, Regional Manager, Simulation Strategy, Clinical Education. “We are also continuing our regular courses to teach educators how to use simulation as an educational methodology."
The most recent visit for the team was with the Whistler Health Care Centre team, which practiced a pediatric head trauma case, which are not uncommon in the renowned ski and mountain biking community.
“Sick pediatric patients are scary," says Dr. Annie Gareau, who recently took the two-day Simulation Learning Strategies Course. “The more simulation we can do the better to desensitize ourselves from the emotional aspect of the case and to perform flawlessly. We also practiced a shortness of breath case, which included the use of our BiPAP machine (a specialized ventilator). We work without respiratory therapists in Whistler so the whole team has to familiarize itself with its use. The whole team clearly saw the benefit of the sim exercises for improvements in communication and how to work better as a team (role assignments, close loop communication etc)."
Last fall, the sim team also visited the Pemberton Health Centre, where the team headed by Dr. Nick Fisher chose the following scenarios to simulate:
- Pediatric trauma
- Advanced cardiac life support
- Pediatric asthma in a 5 year old
- Labour/delivery with postpartum haemorrhage and full neonatal resuscitation program (NRP)
- Head-injured trauma patient requiring intubation
“These were selected because they are all scenarios we have had here, and are likely to have again, but not frequently enough to allow us to maintain skills without practicing," says Nick. “On the back of this, myself, Dr. Andrew Finnigan and nurses Ian Kruger and Emma-Jane Hetherington took the simulation facilitators course in feedback in sim and have now incorporated sim into our educational activities."
The Pemberton team has an airway mannequin (no arms/ legs) onsite to practice CPR and airway management skills. So far, they have simulated three advance cardiac life support (ACLS) scenarios to build confidence and allow “facilitators to get to grips with them."
“Most of the other scenarios were run because we see them infrequently," says Nick. “It was identified that we did not have a magnet for disabling a type of defibrillator and we used a simulation scenario to introduce people to its location and how to use it."
Nick is also hoping to incorporate Fire and Rescue, Emergency Health Services and Search and Rescue more into their sim scenarios.
“In the future, I'd like to extend the simulation program to the wider health care community," says Nick. “For instance, we have AEDs (automated external defibrillator) in multiple locations in Pemberton, but it would be nice to give providers the opportunity to have hands on experience with them."
The Coastal Simulation Program is starting to attract attention from across North America for its innovation in telesim, where staff are trained remotely with the LGH-based team coaching them. Recently, they were asked to present at the National Forum on Quality and Safety.
This new approach, which is being used in Bella Bella and Bella Coola, has been spearheaded by Jaime Gallaher, Rural Regional Clinical Educator, Clinical Education, and Dr. Shannon Chestnut, physician lead for the Coastal Simulation Program. They will be presenting on telesim at a national conference (Simulation Summit in Ottawa) this fall and are expected to publish their innovative approach to simulation training soon.