4th International Pediatric Simulation Symposia and Workshops

Seeking to move the field of pediatric and perinatal simulation forward, the International Pediatric Simulation Symposia and Workshops (IPSSW) is now firmly established as the largest gathering of peditriac and perinatal simulation specialists, doctors and nurses, worldwide. The 4th conference was held in Toulouse, France, 26-27 October.

Exhibitors: 10
Delegates: >250
Countries represented: 26
Invited speakers: 11                                                                                                                                           

Opening with simulation scenarios

Before the conference even opened, the audience could see what a busy day in the ER can be like when parallel simulation scenarios played out right before their eyes (below).  

IPSSW_opening simulation   IPSSW_opening simulation_2

 IPSSW_Ella Scott_Chair

Opening the conference, Ella Scott, Chair IPSSW2011 (left) said ''This is an exciting time for Pediatric Simulation as we stand at the brink of of a new era of international collaboration around pediatric simulation.

Membership of the IPSS (currently 40% are nurses and students) is growing rapidly and many countries from all over the world are represented.'' 

The scientific program

Covering a wide range of specialities within pediatric and perinatal simulation the program ranged from Crisis Resource Management and team training in PICU, NICU, ECMO, Anesthesia, birth related emergencies and Nursing Curricula to innovative technology and multimedia.

Not all training is effective!

IPSSW_Tim Draycott_2Keynote speaker Prof. Tim Draycott from Southmead Hospital, UK (right) addressed the question ''are we doing the right thing'' by referring to the tale of 2 'sim' cities, where, after training, one city doubled occurances of shoulder dystocia (while the other reduced them by 75%). He wondered what they did different to get such different outcomes. 

He said ''out of the 1500 women who die every day, 70% could have been prevented with better care, why training is definately required'', and that ''you should train your system as well as your staff.'' 

According to Draycott, training improves knowledge and performance and scores improve after working in teams. Though a strong advocate for simulation he says ''let's be careful and make sure the training is effective.'' 

What makes good simulation programs?

In light of the promising research from Southmead Hospital Prof. Draycott took the liberty to expand upon Issenberg's 'Right Conditions' for simulation training (Med Teacher 2005) when he provided new a set of right conditions, this time tailored to pediatrics. 

With Sepsis being the current number 1 killer for Mothers - he mentioned that the ability to use a monitor with SimMom makes this a very relevant scenario for simulation and very relevant for SimMom. 

IPSSW_Dr. Tim Draycott_workshop

Prof. Draycott demonstrates team-
work during a workshop using SimMom.
 

 The right conditions - in pediatrics

  • Institutional incentives to train
  • In situ training
  • Team training
  • Multi-professional 
  • 100% participation

Linking simulation based training and assessment to improved pediatric patient outcomes

In his keynote, Ass. Prof. Dr. Marc Auerbach from Yale-New Haven, Conn. USA (below right) said that simulation research in the 1980-2000 period was much about struggling for resources in a sceptical climate. In 2011 however, we have the legitimacy, many journals on simulation, and national and international standards.

With reference to Prof. Draycott and Southmead Hospital, he said the challenge now is to establish whether improved practice in one hospital translates to other work places. Stressing the importance of same context(comparing apples to apples) he concluded however that linking simulation based training and assessment to improved outcomes is feasible.    

IMG_9441During the Roundtable Discussion on multi-disciplinary in situ simulation in pediatric trauma care, Dr. Auerbach stated that ''high stakes, low frequency events are error prone and that ''frequent training is essential to proficiency.'' 

In the past, when doctors worked many more work hours, the time from novice to expert was fairly short. Today many more years of practice is needed to get to obtain the same level of expertise.

    

Auerbach on challenges with in situ simulation

  • Scenario design: How do we design scenarios that actually capture what we have seen doesn't work at our own department? 
  • Allocating time: Dr. Auerbach suggested to up the staff on the (still unannounced) training days.

   

Simulation applied to pediatric nursing

In her lecture Ms. Liz Berg (John Hopkins Hospital, Baltimore, USA) mentioned the increased prep time and getting people who have been in practice for a long time on board with the new strategy as primary challenges with simulation. Running pre programmed scenarios takes out some of the anxiety with the instructors however. In her opinion in situ mocks are especially helpful when operating in new environments, such as helipcopters. An overt versus a covert agenda was another topic of discussion. 

Simulation based learning: now and into the future

IPSSW_Dr. Roger Kneebone

In his keynote address Dr. Roger Kneebone from St Mary's Hospital, London, UK (left) elaborated on the following ideas:

  • We learn more than we realize (especially in a complex technical environment)
  • Engage with expertise outside medicine
  • The role of context (context is crucial to simulation)
  • Where do we come from and where are we going to 

First our knowledge is fractionized - and gradually we get to see the whole picture.

While the traditional apprenticeship model requires that experts teach, Kneebone said that ''with simulation we are seeing a shift from teaching to learning.'' 

  • On distributed simulation: it's important to make simulation available to more people hence it needs be less expensive.  
  • On hybrid simulation: it's a great advantage to learn suturing for example when the model is attached to a person (standardized patient) instead of in skills labs, because it allows to train communication skills with a patient.    
  • On connecting past and fututre: with ether anesthesia used up until recently, Dr. Kneebone reminded the audience that the past is closer than we think. And with today's use of robotics, laparascopic and keywhole surgery, he wondered what would be next.

Dr. Kneebone ended his session by pointing out that the primary challenges now are to:

  • Create more awareness around what there is to learn
  • Focus more effectively on the limited time in clinical practice  

IPSS core goals

  • Foster innovation in pediatric simulation education
  • Support and promote patient safety
  • Research
  • Advocate internationally for pediatric simulation