The Use of High Fidelity Human Simulation for Interdisciplinary Skill Training and Team Building for the Care of a Patient with Spinal Cord Injury
Thomas Jefferson University Hospital, Ocean City, NJ, USA
Introduction: High Fidelity Human Simulation is an area of interest in medical and allied health academic training centers. The benefits of this learning experience have been well documented in the literature including development of critical thinking in a low stakes environment, assessment of interdisciplinary team communication effectiveness, and the utilization of decision-making skills in a simulated environment 1-3. The objective of this poster is to describe a human simulation lab experience involving an interdisciplinary team of practicing clinicians who manage the care of patients with spinal cord injury.
Methods: The primary facilitators attended a comprehensive, interactive human simulation workshop to develop skills for all aspects of simulation learning. The facilitators then devised a case scenario that was representative of a patient that would reflect the characteristics of a patient who would be treated on the rehab unit. The facilitators assigned roles of participants, collaborated with a Human Simulation Lab Coordinator for manikin and room set up, as well as prepared to operate the manikin’s verbal and cardiovascular response to an event of medical instability. Therapists were the first responders to an unwitnessed fall in the therapy gym. As the therapists requested assistance from alternate clinicians and emergency response systems, the facilitators staged entrance of alternate clinicians to allow each participant adequate time to demonstrate skills and collaborate with available resources. A pre-briefing was held before the simulation with a designated time period for de-briefing after the scenario to cultivate personal and team responses and reflections regarding the simulation4.
Results: Two outcome measures were utilized in assessing the effectiveness of this simulation lab experience. The Jefferson Teamwork Observation Guide (JTOG) was utilized to assess the participant’s response to the communication and the roles/contributions each participant/discipline provided5. A likert scale assessment was also completed by participants reflecting their comfort level with the clinical skills and clinical decision-making aspects of this simulation lab. Upon analysis of results, it was demonstrated that clinicians with more experience in the inpatient rehabilitation setting were more comfortable in leadership and delegation roles. The skills that scored the lowest levels of comfort were floor recovery of a patient with SCI and comfort with handling the needs of a decompensating patient in a gym area.
Conclusions: The use of a human simulation allows for an alternative method of assessing skills and fostering development of clinical reasoning skills. This experience yielded results similar to those existing in the literature regarding the ideology of practicing clinical skills in an environment which would cause no harm to a human patient6. This human simulation experience has prompted the participants to re-evaluate policies and procedures that currently guide our practice in emergent situations as well as allowed clinicians to individually reflect on current skill set and reflect upon the effectiveness of our team.
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