LAU Gilbert and Rose-Mary Chagoury School of Medicine Logo

Under the High Patronage of His Excellency
The President of The Lebanese Republic General Michel AOUN

3rd International Conference on Medical Education

Simulation for Education and Patient Safety

March 24, 2017: Hilton Metropolitan Hotel, Beirut, Lebanon

March 25, 2017: LAU Clinical Simulation Center, Byblos, Lebanon

Abstracts


Friday, March 24, 2017                                                  

LOCATION: HILTON METROPOLITAN HOTEL- BEIRUT


PLENARY 1:
Adapting Medical Simulation to the Rapid and Massive Structural and Organizational Changes Occurring in Healthcare
Speaker: Rene Amalberti, MD, PhD

Ageing populations worldwide are placing increasing pressures on healthcare systems, and transforming the nature of care needed. Healthcare systems must continuously innovate and adapt if they are to meet the challenge of delivering safer, better care to more complex patients within limited healthcare budgets into the future.

We are simultaneously facing a revolution in treatment modalities. Over the past 30 years the average length of hospitalisation has been falling, and by the 2030s the proportion of patients requiring lengthy hospitalisation will contract even further, and more care will be provided entirely outside hospitals. There is a rapid shift into hospitals from a logic of stay to a logic of flow which greatly impact on the management of Quality and Safety and the strategies used for decades to manage risks and train professionals. To achieve this historic transformation in models of care, a similarly profound conceptual shift is required. The conventional focus on particular episodes of care, like admissions or surgery, must be replaced by a broader view, taking in the entire patient journey. That is, a system-wide perspective is needed, that appreciates the complexities of navigating the entire care environment.

To meet these unprecedented challenges, networks of complex, interconnected healthcare services—delivered within and outside hospitals—a significant refurbishment of medical training is needed.  Although there is a growing acceptance of medical simulation, whatever it is human, synthetic, electronic, if not more often mix simulation, there is clear growing need to adapt to this new context of care, widen the perimeter of simulations, train professionals as well to safe patient’s journey, transitions and interfaces as to dedicated technical skills. Safety in healthcare is a constantly moving target. As standards improve, contexts change, and concern for safety grows, we come to regard an increasing number of events as patient safety issues which in turn offer new opportunities for the design of innovative medical simulation training

All of these key aspects of the change occurring in the Healthcare systems, in patient safety, and their consequences in widening medical simulation will be discussed in the oral presentation.

The objectives of this plenary are 1) to discuss the changes occurring in Healthcare and understand the impact on training, 2) Revisit patient safety as a concept that should be viewed as the management of risk over time, 3) Teach how to use a much wider repertoire of strategies and interventions to manage risk and feed simulation training programs and 4) Explore implications for patients, frontline clinicians and managers.

PLENARY 2:  
Future of Simulation-Based Education
Speaker: Antoine Tesniere, MD, PhD

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WORKSHOPS A- E:
ARE RUNNING IN PARALLEL, registration to
one of these workshops is required (places are limited)

WORKSHOP A: Debriefing for Impact - A Basic Structure

Facilitator: Peter Dieckmann, PhD

Overview:

Post-simulation discussions are said to trigger reflective learning, which in turn is assumed to foster the applicability of what was learned in practice. Studies, however, show that the reflection levels reached in debriefings to not always reflect the level of aspiration declared by instructors. During this hands-on workshop, the facilitator will discuss the reflection level coding scheme adopted by his research group. Participants will learn to use it to rate reflection levels during debriefings and to stimulate their thinking around how they can guide the reflection levels with their interactions. 

Learning goals:

  • Use a coding scheme to rate reflection levels during debriefings
  • Guide the reflection levels during the debriefing

Target audience: Educators of various expertise, discipline and profession.


WORKSHOP B: Lessons from Aviation: Opportunity and Barrier to Practicing Leadership and Teamwork Medical Simulation Training
Facilitator: Rene Amalberti, MD, PhD

Overview:

Aviation safety has historically started to build up mainly upon the “certification” of two isolated components: the pilot, and the aircraft. Main tools for pilot reliability were selection, initial and recurrent training, and periodic proficiency checks. But a key word for success was undoubtedly simulator training, allowing anticipation of emergency situations. However, accidents involving well trained pilots flying aircraft in good working order still persisted. Hence emerged the idea that, rather than individual pilot performance, team work and crew performance were the decisive topics for flight safety.  Cockpit Resource Management (CRM) training, addressing group dynamics related behaviours, appeared in the 80’s as a follow up. A terrific series of work followed to establish the fundaments for an effective leadership and teamwork continuous training.

All of these ideas and concepts have followed the same path in healthcare with a two-decades time-lag. CRM, leadership and teamwork are now frequent if not systematic part of medical simulation programs. However, training leadership and teamwork is full of traps as well in Aviation as in the medical field. Scenarios are often out of calibration, and evaluation and debrief are often not that appropriate.

The workshop reminds this evolution both in Aviation and Healthcare, and addresses, based on practical situations, how to design relevant scenarios for leadership, team training, relevant evaluation and debrief.

Learning goals:

  • Take lessons from Aviation on leadership and teamwork simulated training  
  • Learn how to design relevant scenario for training
  • Learn the on-line coding of behavioral markers

Target audience: Healthcare professionals of various expertise, discipline and profession.

WORKSHOP C: How to Increase Simulation Realism by Becoming a Hollywood Director
Facilitator: Mr. Lance Baily

Overview:

Lights. Camera. Action! Looking to shoot your own simulation center promotional video, or put together a sim lab orientation film for your learners? Getting great footage is the most important aspect of great film-making to tell clear, coherent stories that instruct your audiences through crucial visual details. Did you know a low camera angle connotes a different meaning to audiences than a close up? How does camera movement tell your story and what do these camera angles mean in our learning labs?

SimGHOSTS Founder and film-maker Lance Baily is excited to provide a hands on workshop to get you “behind the camera” and directing your first “big picture”! This course will introduce the basic fundamentals of storyboarding, digital cinematography, lighting, and basic audio recording. Use these basic video production techniques to create Sim Lab orientations, promotional material or training tutorials. Lance brings seventeen years of video production experience to your day, ranging from small wedding videography to editing television pilots with Tom Hanks. Learn Lance’s hard-earned production secrets through hands-on exercises accomplished by small groups. Each group will learn how external constraints can add to the creativity of projects, enhancing learning for all audiences.

Learning goals:

  • Introduce the basic fundamentals of storyboarding, digital cinematography, lighting, and basic audio recording
  • Use the basic video production techniques to create Sim Lab orientations, promotional material or training tutorials.
  • Learn how external constraints can add to the creativity of projects, enhancing learning for all audiences.

Target audience: Healthcare professionals of various expertise, discipline and profession.

WORKSHOP D: Simulated Patient (SP) Methodology for Education and Practice
Facilitator: Debra Nestel, PhD, FAcadMEd, CHSE-A

Overview:

High quality simulated or standardized patient (SP) work requires training for role portrayal and for feedback.  This workshop focuses on the first of these - training SPs role portrayal. The approach draws on the tradition of theatre practitioner Stanislavski and comprises four steps: (1) developing the person’s character, (2) explaining the learning activity to the SPs, (3) exploring the clinical context and (4) rehearsing. Underpinning the approach is the notion that the character of the person to be portrayed remains prominent, allowing the SPs to develop a shared and coherent understanding of their role, the scenario and the overall activity (Nestel et al, 2014). Participants will be expected to join in simulation activities in the workshop to experience the approach for themselves. There will also be an opportunity for some discussion of the practicalities of SP methodology in our practice.

Learning goals:

  • Demonstrate a new approach for training SPs role portrayal
  • Discuss practicalities of SP methodology

Target audience: Educators of various expertise, discipline and profession. Standardized patients educators


WORKSHOP E: Integrating Simulation in the Curriculum of Health Sciences Schools: The LAU Experience
Facilitators: Vanda Abi Raad, MD, MHPE, Sola Bahous, MD, PhD, Nadia El Asmar, MD, Maha Habre, MSN,RN,CEN, Lamis Karaoui, PharmD, BCPS & Aline Saad, PharmD, BCPS

Overview:

Simulation technology has become an integral part of education in health sciences schools. Teaching and assessing using simulation technology has a number of advantages over the traditional healthcare curricula. Simulation-based education (SBE) is generally learner-centered where students are exposed to procedures or patient interactions they might or might not normally encounter. Situations tend to be lifelike with immediate feedback features, and learners can practice in an interprofessional setting where it is acceptable to make mistakes and learn from them. Clinical simulations, particularly as they pertain to procedural skill learning, offer a significant opportunity for deliberate practice.

After presentation of some key principles of effective simulation, the facilitators will address the systematic implementation in healthcare programs by using the framework “Plan-Implement-Evaluate-Revise”. Examples of the integration of SBE within and across the medical, nursing, and pharmacy schools at the Lebanese American University will be highlighted. This workshop is a forum for participants to share their experiences in SBE and enable valuable context-relevant discussions. Additionally, it will guide participants who are new to the concept of simulation on steps needed for the integration of SBE at their respective institutions.

Learning goals:

  • Address the systematic implementation of SBE in healthcare programs by using as example the LAU health sciences schools.
  • Guide participants who are new to the concept of simulation on steps needed for the integration of SBE at their respective institutions.

Target audience: Educators of various expertise, discipline and profession.

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PLENARY 3:
Simulation and Interprofessional Collaboration

Speaker: Marc Lazarovici, MD

Nowadays, medical practice takes place in highly interprofessional teams. However, interprofessional competencies are not part of most of the curricula for healthcare professionals. Simulation team trainings can offer a valuable ingredient in teaching interprofessional competencies from the very beginning of the professional education, as well as strengthening those skills in experienced healthcare providers. Different approaches and settings to use simulation team trainings in strengthening interprofessional collaboration are presented and discussed.

The Learning goals of this plenary are: 1) Be familiar with the importance and ubiquity of interprofessional collaboration in modern healthcare and 2) Be familiar with the applicability of simulation team training in interprofessional education.

PLENARY 4:
Teaching and Learning with Task Trainers 

Speaker: Debra Nestel, PhD, FAcadMEd, CHSE-A


This plenary presentation will explore contemporary approaches to simulation-based education for developing clinical procedural skills. Although evidence for the role of simulation as an educational method in this context will be outlined, the focus of the session is on sharing approaches to teaching and learning with task trainers. Effective simulations usually include specific elements – preparation, briefing, simulation, feedback/debriefing, reflection and evaluation. Each element will be explored with respect to creating effective learning events using task trainers. Additionally, theories that inform these educational practices will be offered to deepen meaning.

PLENARY 5:
Simulation for Impact. Creating, Recognizing and 
Using Learning Opportunities

Speaker: Peter Dieckmann, PhD

Simulation provides a lot of learning opportunities in different areas and is shown to be an effective teaching strategy. But it is not the tool itself that enables the learners to learn but the interaction around the tool between the humans involved. Creating a setting that allows participants to find the balance between feeling safe and daring to take up challenges is a key consideration to enable simulation-based learning. This plenary will explore elements in the simulation setting that facilitate the goal-oriented interaction between learners, facilitators, tools, and concepts.

PLENARY 6:
Building a Simulation Center

Speaker: Alexandre Mignon, MD, PhD, MBA

Medical simulation is rapidly becoming an educational breakthrough as an innovative way to teach, maintain and perfect medical knowledge, but also as a tool to evaluate technical skills and human-based non-technical skills. As pedagogy changes in the digital era (blended learning/flipped classroom), proactive learning is progressively replacing the traditional classroom where the teacher (“expert”) delivers knowledge to passive students. The students, whether medical, paramedical or midwifery, are urged to be pro-actively involved in their own process of learning. Massive Open-Online Courses combined with hands-on workshops are components of this revolution.

In this plenary, we will review the basics principles for designing a medical simulation center. Several steps are required to be validated in order to define the size and the functional organization of a Simulation Center and its future evolution. These steps are:

1. Purpose and aims of the simulation, 2. Unit of participation in the simulation curriculum, 3. Experience and healthcare discipline of the participants, 4.  Healthcare domains addressed by simulation, 5. Type of Knowledge, Skills, Attitude or Behaviors targeted in simulation, 6. Disciplines related to the age of the patient being simulated, 7. Technology applicable or requested for simulation, 8. Site for simulation, 9. Extent of participation in simulation, 10. Debriefing process in simulation

Once these 10 points discussed, analyzed, and finally validated, we will review how to establish the governance of a Sim Center (medical and executive direction), the timeline and scalability of the project, and its business plan. The following success factors will assist in achieving the vision within the TSC: 1) Design a sustainable, modular and scalable project (investment and functional budget) in the architectural and functional concepts to anticipate the future developments, 2) Focus on inter-professional learning environment, which is the way healthcare is currently delivered, 3) Maintain transparency in governance including budget and decision making, 4) Prioritize Sim Center resources to support the objectives, among which human resource (the real added-value) is the most important (instructors, highly committed and legitimate person, IT and mannequin technician).

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Saturday, March 25, 2017

LOCATION: CHAGOURY HEALTH SCIENCES CENTER- LAU BYBLOS


PLENARY 7:
The Past, Present, and Future of Healthcare Simulation

Speaker: Mr. Lance Baily

In his best selling book Outliers, Malcolm Gladwell examines the factors that contribute to high levels of success. Gladwell considers why the majority of Canadian ice hockey players are born in the first few months of the year, how Microsoft co-founder Bill Gates achieved his extreme wealth, and why the Beatles became one of the most successful musical acts in human history. Throughout his book, Gladwell theorizes how historical and cultural circumstances can pave the way for such phenomenal success.  

What can the healthcare simulation industry learn from a similar of exploration of its own past, present, and future? Simulation Evangelist Lance Baily has applied Gladwell’s theories to our industry and will explain why his projects, including HealthySimulation.com and SimGHOSTS.org, have made such huge global impacts in just five short years. By understanding the core truths behind the success of these projects, participants will take away valuable arguments they can use to advocate for the expanded use of simulation in their own home institutions.

Finally, Lance will explore how the historical and cultural forces that are now in motion will transform healthcare simulation as we know it from a small community of early-adopters to a universal standard embraced by all.

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WORKSHOPS 1- 4:
ARE RUNNING IN PARALLEL, registration to
one of these workshops is required (places are limited)

WORKSHOP 1: Obstetrical Emergencies Cases

Facilitators: Alexandre Mignon, MD, PhD,  Hanane Barakat MD, Ziad Hubayter, MD & Mira Abi Saad, RN

 Overview:

Obstetrical emergencies are rare and mostly unexpected where immediate adequate action, and good teamwork are required. The realistic simulation of such situations allows the training of decision-making and teamwork. Both common and rare obstetrical emergencies will be presented in this workshop allowing the participants to observe and take part in an emergency rapid response system.

Learning objectives:

  • Identify and manage correctly an obstetrical emergency.  
  • Develop and practice interpersonal communication skills and teamwork in emergencies.

Target audience: Obstetricians, anesthesiologists, midwives, nurses anesthetists, operating room nurses.

WORKSHOP 2: Emergency Room Cases
Facilitators: Marc Lazarovici, MD, Mariana Helou, MD, Alain Tanios, MD & Maha Habre, RN

 Overview:

Emergency situations require immediate decisions and good teamwork. The realistic simulation of such complex situations allows the training of decision making and teamwork. Both common and rare medical emergencies will be presented in this workshop, allowing the participants to practice both their medical as well as their interpersonal and teamwork skills.

Learning goals:

  • Swift and correct treatment of emergency room cases
  • Good teamwork in the emergency department

Target audience: All medical specialties, emergency room physicians and nurses


WORKSHOP 3: Moulage and Makeup
Facilitator: Mr. Jalal Al Froukh

Overview:

Reality enhancement in medical simulation can improve the learning outcomes from the training sessions especially with trauma case scenarios. One of those enhancement methods is moulage; moulage is the art of mimicking patient physical appearance like trauma, age, skin rash and others by applying special molding and colorization tools.

This workshop will help learners to know and use the materials involved in moulage besides creating some types of most commonly used moulage scenarios.

Learning objectives:

  • To understand moulage in simulation and its tools
  • To practice moulage materials preparation
  • To create trauma moulage of wounds

Target audience: Simulation technicians and Simulation educators


WORKSHOP 4: NTS-Bingo and Hand-it-on - Two Workshop Concepts to Help Participants Improve their Non-Technical-Skills
Facilitator: Peter Dieckmann, PhD

Overview:

Non-Technical-Skills (NTS) are an important part of the abilities, healthcare professionals require to diagnose and treat patients. However, understanding NTS to a degree that simulation instructors can teach them to their participants is easier said than done. In this workshop, the facilitator will demonstrate two exercises that can be used to understand NTS in a deeper way and that can be used to teach NTS to healthcare professionals of various expertise, discipline and profession. Both concepts work with off-healthcare issues and thus allow to minimize cognitive load in a way that participants can focus on their learning of NTS. NTS-Bingo uses trigger videos to help participants to identify NTS concepts and to describe which behavioral elements they connect with these concepts. They view the clips, mark examples of behaviors on NTS Bingo cards and then discuss their solution in small groups. Hand-it-on is a very interactive exercise that requires actual collaboration to solve a physical task - handing on objects to each other according to simple rules. The nature of the exercise produces a wealth of aspects that can be discussed in the debriefing to optimize the learning of NTS. Participants in this work shop will be able to replicate the workshops in their teaching settings.

Both concepts are published as open access and participants can read the descriptions before the workshop as preparation or after the workshop to support the replication in their teaching settings.

NTS Bingo: goo.gl/Qm6yKM and Hand-it-on: goo.gl/pQK270.

Learning goals:

  • Understand Non-Technical-Skills (NTS) in a deeper way
  • Use the presented two workshops and concepts to teach NTS to healthcare professionals

Target audience: Healthcare professionals of various expertise, discipline and profession.

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WORKSHOPS 5- 8:
ARE RUNNING IN PARALLEL, registration to
one of these workshops is required (places are limited)


 WORKSHOP 5: Medical Emergency Cases

 Facilitators: Antoine Tesniere, MD, PhD, Anna Farra, MD, PhD, Bassem Habr, MD, Rania Sakr,MD, Yara Kouyoumjian, Pharm D, BCPS & Jihad El Masri, RN

Overview:

Emergencies are very common in the critical care setting and staff need to quickly recognise and manage these situations.  The realistic simulation of such emergencies allows the training of participants in making decisions under a rapidly-changing clinical environment as well as ccommunicating and interacting effectively with team members. 

Learning goals:

  • Identify and manage correctly a medical emergency. 
  • Communicate and interact effectively with team members during an emergency and appreciate the impact of team dynamics on patient safety.

Target audience: All medical specialties, in particular critical care physicians, nurses and inhalation therapists


WORKSHOP 6: Pediatric Emergencies
Facilitators: Abeer Hani, MD, Ninette Hawat, MD, & Maroun Matar, MD

Overview:

Dealing with acute pediatric emergencies can be challenging. Compared to adults, children have anatomical and physiological differences that place additional demands on health care providers when caring for critically ill children. Pediatric health care providers require training opportunities to acquire the knowledge and skills to appropriately manage children with critical illness. Simulation is one of the best ways to learn complex situations. This workshop will present two common cases in a child and a newborn.

Learning objectives:

  • Review the guidelines.
  • Improve communication skills and teamwork between the different members of the team.

Target audience: Pediatricians, anesthesiologists, midwives, pediatric nurses, inhalation therapists.

WORKSHOP 7: The Must-Have Healthcare Simulation Technology Specialist!
Facilitator: Mr. Ferooz Sekandarpoor

Overview:

Over the past 15 years there has been increased adoption of simulation in healthcare education as a method to educate and train healthcare professionals. During this time the complexity of simulators has also developed to match the demand for greater and greater realism.
Simulators are great …. when they work! It has been said at simulation conferences around the world that “if the educator or coordinator is absent, someone else can fill in — but when the Sim Tech is absent, simulation comes to a screeching halt!” Yet why is it that so often the people who are the backbone and support of simulation technologies ignored, misunderstood or undervalued?

In this presentation by SimGHOSTS Vice President Ferooz Sekandarpoor, we will highlight the importance of this new emerging professional role, the tasks they manage, and how to best find, support, and promote these crucial individuals tied so closely to the success of our simulation programs.

Learning goals:

  • Introduce participants to the way the University of British Columbia, Canada is utilizing simulation technology specialists
  • Highlight the Role of Simulation Technology Specialist
  • Inform participants about what SimGHOSTS, “the Gathering of Healthcare Simulation Technology Specialists” is doing around the World

Target audience: Simulation technicians and Simulation educators

WORKSHOP 8: Implementing Objective Structured Clinical Examination (OSCE) in Health Sciences Schools
Facilitators: Debra Nestel, PhD, FAcadMEd, CHSE-A, & Nadia El-Asmar MD    

Overview:

In this workshop, the facilitators will provide participants with an opportunity to share their experiences of implementing OSCEs. After presentation of some key resources on the OSCE, they will consider implementation systematically by addressing planning for the time period before the OSCE, during the OSCE and after the OSCE. Examples from medical, nursing and allied health settings will be included. Participants will be expected to draw on their experiences to enable valuable context relevant discussions. However, the workshop will also be suitable to those who are new to the OSCE.

Learning goals:

  • Address the planning, the implementation and the evaluation of OSCEs in various Health Sciences settings
  • Discuss participants’ experiences of implementing OSCEs

Target audience: Educators of various expertise, discipline and profession.


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