Posts Tagged ‘CMS’
Posted on September 8, 2012, by garymrossi
Please join us for the next Boston Simulation Community Research and Education Meeting this coming Tuesday, September 11th from 5:30-7pm at the Center for Medical Simulation, 65 Landsdowne Street, Cambridge MA.
September 11th, 2012: “Prop Chart” a cost-effective, visual model to analyze the effectiveness of simulation training courses
Annemarie Fransen, MD and Guid Oei, MD PhD
Training of medical staff is essential for safe patient care. The nature of a medical training can range from lectures to medical simulation with expensive simulators. However, training of medical experts can be challenging. Not only, because of hierarchical problems, but also because of fear of failure and unwillingness to change, or play a role. To support deliberate practice in learning by simulation as while simultaneously controlling costs, we developed a visual model, named the Prop chart. This chart can also be used for evaluating existing medical simulation programs. The background and the use of the Prop chart will be presented by a videoconference during the research meeting on the 11th of September.
More about Drs Fransen and Oei
Annemarie Fransen, MD
- Resident at the department of Obstetrics & Gynecology of Máxima Medical Centre, Veldhoven, The Netherlands.
- PhD student
Guid Oei, MD PhD.
- Obstetrician at the Máxima Medical Centre, Veldhoven
- The Netherlands and Professor at the department of elektrotechnical engineering of Eindhoven Technical University, The Netherlands
- Medical director at the simulation centre Medsim, Eindhoven, The Netherlands
The Boston Community Simulation Community Research and Education Meetings provide a friendly and informal venue for simulation educators and researchers to present work-in-progress, acquaint each other with relevant ideas from other disciplines and connect with others. Please join us!
Posted on September 7, 2012, by garymrossi
 The Center for Medical Simulation welcomes Janice Palaganas, PhDc, RN, MSN, CRNP, CEN as its newest Faculty member. Prior to joining CMS, Janice was the implementing Director of Accreditation and Certification for the Society for Simulation in Healthcare and continues as a member of the Board of Review for the Council for Accreditation of Healthcare Programs. She was previously the Chief Operations Officer and Director for Research & Development for the Medical Simulation Center at Loma Linda University. Janice has experience as faculty for schools of nursing, public health, MBA programs, emergency medicine and medicine. She received her Bachelor’s of Science in Nursing, as well as two Masters degrees as an Adult Nurse Practitioner and Geriatric Nurse Practitioner; and one Masters certificate in Home Health Management from the University of Pennsylvania. She is currently completing her PhD in Nursing at Loma Linda University exploring healthcare simulation as a platform for interprofessional education (IPE). Since 2008, Janice has been involved nationally and internationally researching healthcare simulation for interprofessional education and was the Meeting Chair of the 2012 Healthcare Simulation and Interprofessional Education Symposium in San Diego, CA, participating in the Invitational Meeting that brought together 22 major healthcare professional organizations to come to consensus on how healthcare simulation can be a vehicle for IPE.
Janice has extensive Emergency Department experience at multiple facilities ranging from level I trauma centers, community hospitals, and fast tracks as an Emergency Nurse, Fast Track Nurse Practitioner, Clinical Educator, Clinical Nurse Specialist, Trauma Nurse Practitioner, Manager, and Director for Emergency and Critical Care Services, as well as Legal Nurse Consultant and House Supervisor. She has presented at conferences regarding projects in simulation and on behalf of the Council for Accreditation of Healthcare Simulation Programs. She has been an invited keynote speaker nationally and internationally to discuss simulation, patient safety, and/or accreditation. Amongst other leadership roles, she is Chair of the Interprofessional Education Affinity Group and a member of the Certification Committee and Technology & Standards Committee in the Society for Simulation in Healthcare, as well as an author for the National League for Nursing’s (NLN) study on high-stakes assessment using simulation for nursing students. From her work with the NLN and SSH Accreditation, Janice has a particular interest in video assessment tool development. She is also lead editor for the upcoming textbook, “Defining Excellence in Simulation Programs.”
On a more personal note, Janice enjoys anything that comes out of her kids’ mouths, photography, digital art, charcoal and acrylic art, and dance. She is a techie at heart. She is also a classically trained pianist and (in a former life) was a dancer, choreographer and hip-hop instructor.
Please join all of us here at CMS in welcoming Janice to our team!
Posted on August 22, 2012, by garymrossi
Taught by CMS’ Harvard faculty, the “Simulation as a Teaching Tool Workshop” is a 4-day intensive immersion in healthcare simulation that is specifically designed for those educators seeking to develop high quality simulation programs. It covers high level elements and concepts involved in using simulation as a teaching tool.
Drawing on the disciplines of aviation, healthcare, psychology, experiential learning, and organizational behavior, participants learn how to teach clinical, behavioral, and cognitive skills through simulation. Participants explore simulator based teaching methods applicable across the healthcare education spectrum, including undergraduate and graduate medical, nursing and allied health domains.
The daily formats vary and include simulation scenarios, lectures, small and large group discussions, and practical exercises with feedback. Ample opportunities are provided for networking and sharing experiences. Attendees join a growing community of Institute graduates who are positioned as leaders in the field.
Register Now – Seats are limited!
Dates: October 2-5, 2012
Tuition for this workshop is $4,225
To learn more about the workshop, or to apply, visit the Center for Medical Simulation (CMS) website’s IMS webpage at
http://www.harvardmedsim.org/ims/html. You can also email CMS at info@harvardmedsim.org , or call Gary Rossi, CMS’ COO at 617.768.8267
IMS New York Flyer
Posted on August 7, 2012, by garymrossi
 The Jay W. Forrester Award was recently presented to John Carroll, Brad Morrison and Jenny Rudolph at the 30th International System Dynamics Conference, held at the University of St. Gallen, Switzerland. The Forrester Award recognizes the best work in the field of system dynamics published in the previous five years. Doctors Carroll, Morrison and Rudolph were recognized for their paper, “The dynamics of action-oriented problem solving: linking interpretation and choice,” published in the Academy of Management Review in 2009 (full citation: Rudolph, J, Morrison, J. B., Carroll, J. (2009) The dynamics of action-oriented problem solving: linking interpretation and choice. Academy of Management Review. 34(4): 733-756.) It was based on Dr. Rudolph’s doctoral dissertation conducted at the Center for Medical Simulation (CMS).
The paper develops and tests a formal system dynamics model of sensemaking and action, using anesthesia as the empirical setting. The data for the study came from simulated cases carried out at the Center for Medical Simulation and provides a large sample of fine-grained observational and quantitative data from a controlled environment. The model is tightly grounded in the data and gives insight into the feedbacks between sensemaking and action that can cause anesthesiologists both to discover and fail to discover and correct a common diagnostic problems.
Everyone at CMS congratulates Dr. Rudolph, Dr. Carroll and Dr. Morrison on this outstanding achievement.
Posted on July 19, 2012, by garymrossi
Taught by CMS’ Harvard faculty, the Simulation as a Teaching Tool Workshop is a 4-day intensive immersion in healthcare simulation that is specifically designed for those educators seeking to develop high quality simulation programs. It covers high level elements and concepts involved in using simulation as a teaching tool.
Drawing on the disciplines of aviation, healthcare, psychology, experiential learning, and organizational behavior, participants learn how to teach clinical, behavioral, and cognitive skills through simulation. Participants explore simulator based teaching methods applicable across the healthcare education spectrum, including undergraduate and graduate medical, nursing and allied health domains.
The daily formats vary and include simulation scenarios, lectures, small and large group discussions, and practical exercises with feedback. Ample opportunities are provided for networking and sharing experiences. Attendees join a growing community of Institute graduates who are positioned as leaders in the field.
Dates: October 2-5
Tuition for this workshop is $4,225
To learn more about the workshop, or to apply, visit the Center for Medical Simulation (CMS) website’s IMS webpage at
http://www.harvardmedsim.org/ims/html. You can also email CMS at info@harvardmedsim.org , or call Gary Rossi, CMS’ COO at 617.768.8267
IMS NEW YORK October 2012 Flyer
Posted on July 2, 2012, by garymrossi
 The next Center for Integration of Medicine & Innovative Technology (CIMIT) Boston Simulation Consortium Quarterly Meeting will be held on Tuesday, July 10th from 5:30-7pm at the Center for Medical Simulation at 65 Landsdowne Street, Cambridge MA. Light snacks will be served. This quarterly meeting is scheduled during the standing time for the Boston Simulation Community Research and Education Meeting on the 2nd Tuesday of the month. These meetings provide a friendly and informal venue for simulation educators and researchers to present work-in-progress, acquaint each other with relevant ideas from other disciplines and connect with others. Please join us!
Whether the medical practitioner is a new resident, an ICU nurse, a young battlefield medic or an experienced surgeon, the traditional method of learning a new technique has been to observe or read about a new technique, then attempt it on a patient. Simulation and using the “virtual environment” can accelerate the introduction and integration of new technologies into the clinical care. Simulation integrates tools, team training and virtual environments for scenario testing into one compressive philosophy intent on improving confidence, competence, operational performance and patient outcomes.
A collaborative partnership across CIMIT member hospitals and universities, the CIMIT Boston Simulation Consortium builds upon the success of the individual institutional simulation centers and Risk Management Foundation (RMF/CRICO) of the Harvard Medical Institutions and unifies the Boston community as a worldwide hub for healthcare simulation. The collective experience and resources of these premier simulation centers offer an unparalleled opportunity to partner with academia, government and industry to advance the field of healthcare simulation and to fully integrate clinical simulation as a quality and safety tool in health care practice.
Upcoming meeting of the Boston Simulation Community Research and Education Meeting:
September 11, 2012: We will have a Work-in-Progress presentation about “Prop Chart” a visual model to analyze the effectiveness of simulation training course. Our presenter will be: Annemarie Fransen, an obstetrician from the Netherlands.
Posted on June 12, 2012, by garymrossi
The Boston Simulation Community will hold its monthly Research and Education meeting this evening, Tuesday, June 12th, from 5:30-7pm at the Center for Medical Simulation, 65 Landsdowne Street, Cambridge MA. Ann Mullen BSN, CCRN will be presenting, Does The Anxiety Of Seasoned Clinicians In The Simulation Environment Differ From That Of Novices? Ann’s important and interesting project grapples with an issue we have all faced as either instructors or participants in simulation programs.
 Ann Mullen is Program Manager at the Shipley Medical Simulation Center at Newton Wellesley Hospital. Her presentation of her work-in-progress will be an interactive session that asks us to provide feedback and ideas on her survey questions and research design.
The Boston Simulation Community’s Research and Education meetings provide a friendly and informal venue for simulation educators and researchers to present work-in-progress, acquaint each other with relevant ideas from other disciplines and connect with others. These meetings are held on the 2nd Tuesday of most months. Please join us! If you would like to be added to the email list for these meetings contact Paul Montgomery at pmontgomery@harvardmedsim.org
Next meeting: July 10, 2012
Comined meeting with the CIMIT Boston Simulation Consortium
Ann Mullen BSN, CCRN, Work-In-Progress:
Does The Anxiety Of Seasoned Clinicians In The Simulation Environment Differ From That Of Novices?
Introduction
Simulation instructors have noticed that participants often express anxiety related to the simulation experience. Some say they are nervous about being videotaped, others say they do not like to be watched, and they are afraid of being embarrassed or feeling stupid. This anxiety seems to be more pronounced in senior clinicians; medical students and new nurses frequently volunteer for classes and do not display signs of anxiety. Simulation educators try to address this issue by providing information and reassurance, but theproblem often persists.
Simulation engages the learners in a realistic environment, and a certain amount of anxiety isbelieved to enhance the learning process. This heightened state of activation can aid in learning and retention. (DeMaria et al 2010). However, excessiveanxiety can make it difficult for learners to listen to instructions and learn new concepts. (Bong, Lightdale, Fredette, & Weinstock 2009). It is important for educators to be aware of the emotions experienced by the participants. This knowledge will prepare them to respond to the learners and meet their educational needs.
Theoretical background
Hans Selye examined the effect of stress in his landmark study (Selye 1936) and demonstrated that the physical response to injury included hormonal changes that were separate from the damage caused by the injury. He proposed the general adaptation theory to describe this response. He also used the term “distress” to describe stress caused by injury or illness, and noted that a stress response “eustress”, can also be induced by positive life events such as marriage or the birth of a child.
Subsequent studies have indicated that a certain level of emotional activation enhances learning and retention (DeMaria et al). However, the dose response curve is still uncertain; what is the amount of stress what will enhance learning? Too little stress will not engage the learners; too much may inhibit learning and induce defensive reactions.
The simulation environment poses no risk to patients, but it may be more stressful than clinical care for some people (Quilici et al., 2005). Simulation educators must be aware of the factors that may impede learning, and consider the impact of distress and eustress.
Review of the Literature
The literature search included keywords: anxiety, simulation, anxiety measurement, performance anxiety, and stress. Most of the results were related to the use of simulation to decrease anxiety of novice practitioners by preparing them for clinical practice. There were very few articles that addressed the issue of performance anxiety in seasoned clinicians.
Gore, Hunt, Parke and Raines (2011) studied the effect of a pre-clinical simulation experience. Junior baccalaureate nursing students were randomized to two groups. The experimental group participated in a four hour simulation class prior to their first clinical day; the control group had the simulation class after the first clinical experience. The experimental group reported lower levels of anxiety in their first patient encounter, compared to the control group.
Dr. Kathie Lasater (2007) examined the experience of nursing students using focus groups. Thisstudy explored the effects of simulation on the development of clinical judgment, and several important themes emerged. Despite the lack of patient risk, the simulation experience was stressful. Students described feeling anxious and stupid, yet the experience resulted in deeper learning.
Bong et al. (2010) compared the physiological response of learners in a simulation sessions and a traditional tutorial program. They demonstrated a significant increase in heart rate and salivary cortisol levels in the simulation subjects. They also noted that this response tended to diminish in clinicians who participated in more simulation sessions.
Quilici et al (2005) examined stress in the simulation environment during an Advanced Trauma Life Support (ATLS) test, compared to emergency department trauma care. Heart rate and blood pressure measurements were compared at several points: at baseline, during an ATLS test and while participating in emergency resuscitation in the emergency department. They found that heart rate and blood pressure were significantly higher during ATLS testing compared to emergency care. This finding supported the hypothesis that the ATLS exam was more stressful than clinical care of trauma patients.
Müller et al. (2009) studied performance and stress response of experienced critical carephysicians. The Anaesthetists Non-Technical Skills (ANTS) tool was used to assess performance, and stress was measured by salivary amylase and cortisol levels. They noted significant improvement in performance as well as significant stress. This study demonstrates the benefits and the potential difficulties of simulation.
Clapper (2010) described the emotional component of the learning process. He encouraged educators to be aware of the power of emotions to create an environment forincreased retention and deeper learning. He also cautioned that fear, intimidation and mistrust can hinder learning by triggering the fight-or-flight response. Blazeck (2011) noticed that senior faculty members were not comfortable with simulation, a phenomenon she describes as Simulation Anxiety Syndrome.
Several authors recommended further study on the subject of simulation anxiety. Simulation education is a relatively new specialty and the research in thisarea is limited; many of the papers rely on participant satisfaction, and lack objective data. The current literature focuses on the positive effects of simulation: improved technical skill, better team performance, reduced anxiety for novice clinicians. More study is needed in the area of anxiety, as it may interfere with learning, and cause clinicians to avoid simulation classes entirely.
Methodology
The goal of the study is to describe the anxiety experience of clinicians in a high fidelity simulation class. A mixed method descriptive study will be conducted using a survey method. The survey instrument will measure anxiety using theState-Trait Anxiety Inventory (STAI). The subjects will be asked to respond to open ended questions to obtain qualitative information.
The survey will be distributed to clinicians who are registered to attend a simulation class at the survey site. The sample will be limited to clinicians who are taking their first simulation class. The survey is optional and anonymous; surveys will be completed in a private area, and deposited in a locked container. The introduction to the survey informs subjects that their participation is entirely voluntary and anonymous. Completion of the survey will constitute consent for inclusion. All data will be reported in aggregate form; no identifiable data will be made public.
Research Question:
Does the anxiety of seasoned clinicians in the simulation environment differ from that of novices?
Data Collection:
In addition to the survey questions described above, age and gender information will be collected. Clinicians will be asked to provide additional data related to role, clinical experience, length of time in current role, and at this institution. The survey instrument is attached to this proposal as Appendix A.
Strengths/ Limitations
The STAI is a validated instrument which is frequently used to measure anxiety in the research setting. The additional questions constitute an adaptation of this tool and have not been tested. Other anticipated limitations in the study include the use of a single site for data collection.
Posted on May 31, 2012, by garymrossi
Crisis Resource Management Training for Anesthesiologists
Meets the MOCA® Part IV Simulation Requirement
The Center for Medical Simulation (CMS Cambridge, MA) has just updated the 2012 – 2013 schedule for its one day Anesthesia Crisis Resource Management (ACRM) workshop for practicing anesthesiologists. These workshops meets the MOCA® Part IV simulation requirement and have been approved for continuing education credits by the CRICO/Risk Management foundation of the Harvard Medical Institutions. CRICO/RMF is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. CRICO/RMF designates this live activity for a maximum of 7.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.This activity is designed to be suitable for 7.5 hours of Risk Management Study in Massachusetts.
CMS’ Anesthesia Crisis Resource Management workshops are designed for those anesthesiologists seeking to practice their skills in managing critical events. The overall focus of these workshops is on learning the type of teamwork and generic skills needed when managing any kind of infrequent but critical event in anesthesia and opportunities will be made available to learn skills in managing certain specific events. During the workshops, participants requiring MOCA® certification will each have a turn as the primary anesthesiologist caring for the patient.
The Center for Medical Simulation is an endorsed program in the American Society of Anesthesiologists’ Simulation Education Network, and has ensured that this workshop complies with the American Board of Anesthesiologists’ Maintenance of Certification in Anesthesia MOCA® Part IV simulation requirements. MOCA® is a registered certification mark of The American Board of Anesthesiology, Inc.
Go to http://www.harvardmedsim.org/moca-registration.php to apply for this Workshop or contact Gary M. Rossi COO at 617.768.8267 – grossi@harvardmedsim.org .
ACRM – MOCA® Workshop Schedule through June 30, 2013
All workshops are held at 65 Landsdowne Street Cambridge, MA (Between MIT and Harvard Square)
2012
June 4, 7, 11
September 6, 17, 24
October 1, 4, 22, 29
November 12, 26
December 3, 17
2013 (Through June 30)
January, 7, 10, 14, 17
February 4, 11, 14, 25
March 4, 18, 25
April 8, 11, 22, 25
May 6, 20
June 3, 10, 17, 24
CMS will schedule private workshops for teams of 5 or more.
Call or email Gary M. Rossi COO for more information.
617.768.8267
grossi@harvardmedsim.org
www.harvardmedsim.org
Posted on April 20, 2012, by garymrossi
Join the Center for Medical Simulation and the New York Health and Hospitals Corporation for a live Twitterview on Monday, April 23, 2012 from 12:30 – 1:30 p.m. to discuss the importance of Healthcare Simulation
The New York City Health and Hospitals Corporation (HHC) and the Center for Medical Simulation will participate in a live Twitterview (interview on Twitter) to discuss the growing importance of healthcare simulation and its applications. Katie Walker, Director of HHC’s Institute for Medical Simulation and Advanced Learning (IMSAL) and Dr. Jeffrey Cooper, Executive Director at the Center for Medical Simulation (CMS) will share information on healthcare reform and the role that medical simulation plays as well as the instructor training course taught by faculty from the Center for Medical Simulation that will be hosted at IMSAL next week, April 24-27. Katie Walker and Dr. Cooper will also be available for questions. People interested in following the discussion can follow the handles @HHCnyc or @MedSimulation and #medsim.
Who: IMSAL’s Director, Katie Walker and
CMS Executive Director Dr. Jeffrey Cooper
When: Monday, April 23, 2012, 12:30 – 1:30 p.m.
Where: Twitter, handles @HHCnyc and @MedSimulation, #medsim
Posted on December 12, 2011, by garymrossi
Jeff Cooper, CMS Executive Director, was chosen to deliver the 2011 Lewis H. Wright Memorial Lecture at this year’s American Society of Anesthesiologist’s Annual Meeting. In his lecture, titled “APSF and Anesthesia Patient Safety: Leadership Lessons From the Legacy of Jeep Pierce”, Dr. Cooper described the beginnings of the patient safety movement and the founding of the Anesthesia Patient Safety Foundation (APSF). He spoke about the vison and leadership of its founders, who included Dr. Ellison “Jeep” Pierce, and commented on how anesthesiology was at the forefront of this sea of change nearly 20 years ahead of the rest of medicine. Dr. Cooper concluded by noting that focused research and clinical improvements over the past 26 years have made anesthesiology very safe. And, that although the anesthesia community should feel very good about these improvements in patient safety, there is still much work to be done.
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