EMS World

MAY 2016

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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20 MAY 2016 | EMSWORLD.com "That is also effective, especially when we're dealing with these discrepancies between the need for training and equip- ment sitting idle and resources being wasted. Sometimes simple is good too." The key is to make sure simulation is used and learning scenarios built around clear, succinct learning objectives. "We make sure every scenario we do has a specific objective, whether that's focused on history-gathering or making a differential diagnosis and choosing a treatment path," says Heigel. "Every scenario should have a really specific objective so the instructor knows going in exactly what it's intended to teach and what the students are supposed to learn." Summative scenarios—concluding ones held at the end of a class—may be long and complex. Formative scenarios—those held during learning—need not be so lengthy, if a discrete objective can be accomplished more briefly. With whatever equipment or tools you have, make the most of them. At Delaware Tech, manikins aren't limited to the lab— Boyer brings them to the classroom to use as teaching aids. "So if I'm talking about pharmacology, for example—how medications impact the sympathetic nervous system—instead of speaking hypothetically, I can project the actual computer control for the simulator, with all its functions, and say, 'OK, we're going to give epinephrine. Let's talk about what epinephrine does to the sympathetic nervous system.' And then we can give it to the simulator and all watch together what happens as it starts to take effect," B e s t P r a c t i ce s f o r S i m u l a t i o n Tr a i n i n g i n H e a lt h c a r e S e t t i n g s Simulation-based training can be extremely effective for EMS personnel, but only if the training is done by knowl- edgeable faculty, using educational scenarios that reflect and are relevant to real-life EMS situations. Unfortunately many simulation-based training courses fall short of what they could be delivering. That's the take- away from the National Association of EMS Educators (NAEMSE) from the SUPER study and its subsequent vision paper. "Specifically with regard to paramedic education, NAEMSE's research found that while programs often had or had access to simulation equipment, almost one third of them were either not using it at all or not using it as intended," says Kim McKenna, MEd, RN, EMT-P, lead author of the SUPER study and chair of NAEMSE's task force on simulation. "The respondents noted that faculty training, inadequate personnel and lack of time contrib- uted to this lack of use." The good news: The NAEMSE's vision paper offers many useful suggestions for maximizing the value of EMS simulation training in healthcare settings. With the help of McKenna and NAEMSE President John Todaro, EMS World has compiled them into a trio of simulation training best practices: #1: Improve faculty/trainer training—Medical simula- tion equipment is expensive. So when an EMS educational facility buys such equipment, the people in charge should enlist the manufacturer to provide expert help in training faculty and integrating the simulation equipment into the facility's curriculum. "EMS educators spend a lot of money buying simulation equipment, but they don't have a lot of experience work- ing with this equipment," says Todaro. "The manufacturers need to fill this gap by comprehensively training faculty in how this simulation equipment works, how it can be incor- porated into the curriculum and how the results from such training can be evaluated afterward." Someone has to step up: According to the SUPER study, 48% of respondents felt their current level of EMS faculty simulation training was inadequate. The problem is not the level of training provided by manufacturers, but rather the fact that "it should only be the starting point, with EMS educational facilities getting support from a number of sources," says McKenna. #2: Make simulations part of core curriculum, not just add-ons—Lacking adequate training in how to work with EMS simulators, many educators tend to use them as adjuncts to core EMS training, rather than integrating their hands-on capabilities into all elements of the curriculum. Fortunately this shortfall can be addressed by faculty con- sciously seeking ways to use simulators as much as pos- sible during training. A case in point: "Move away from just having students 'say' they are doing something to actually having them 'do' things," says McKenna. "As an example, actually have them draw up the dose of epinephrine in a pediatric ana- phylaxis case rather than just saying how much of the drug they would administer. You will find that a substan- tial number of learners who can tell you the right dose struggle to actually administer it properly. The simulation allows you (and your students) to learn those important lessons and make mistakes in a safe environment rather than struggling or failing on a real call, with a real patient." #3: Use simulators in realistic settings—EMS simula- tion training is more effective when done in settings that mimic real-life scenarios, such as outdoors with a wrecked car and associated debris for a simulated roadside incident. "The loftiest goal of simulation is to provide highly realistic experiences in which students can safely apply knowledge and practice skills without endanger- ing a live patient," says the vision paper. Unfortunately, "Unpublished data from the SUPER study showed that most paramedic program simulation is conducted in the program skills lab, classroom or simulation lab, rather than in realistic field settings such as an ambulance or in situ outdoors or indoors." To improve the outcomes of EMS simulation training, this needs to change. James Careless is a freelance writer with extensive experi- ence covering computer technologies.

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