Board 233 - Program Innovations Abstract I’m new, I don’t know what to do! (Demystification of Technology for Appropriate High Fidelity Manikin (HFM) Integration) (Submission #1017)

Abstract

Introduction/Background An alternate method of High Fidelity Manikin (HFM) programing, operation and demystification of technology integration has been implemented throughout the Veterans Health Administration (VHA) facilitating standardized delivery of designed curricula. The VHA is the largest integrated health care system in the United States serving over 8 million enrolled Veterans including 153 Medical Centers with a total clinical provider population of over 300,000. Approximately 300 trainers throughout the VHA are responsible for integrating simulation training into their facilities competency and certification programs. These instructors are from varied clinical backgrounds with fewer than 100 having significant or standardized simulation experience or HFM programing experience. The Simulation Learning, Education, and Research Network (SimLEARN) program was established to integrate simulation process modeling, training, education and research throughout the VHA facilities. A gap analysis survey was disseminated throughout the facilities providing simulation based education. This survey identified 86% of the instructors were assigned to simulation education as an additional duty. Additionally, 77% of the facilities did not feel that their current simulation capability was able to meet their site’s educational objectives and the most frequently identified barrier to using simulation was a lack of trained simulation faculty (HAIG 2012). For SimLEARN to effectively deploy simulation curricula nationally, standardized operation of the HFM is critical. Currently there are two main Methods of HFM control, “Automatic” and “On the Fly”. The challenge of “Automatic” mode is it removes HFM physiology control from the operator and conversely the challenge of “On the Fly” operation requires individual changes to each physiologic parameter. Due to the varied background of clinical educators, lack of standardized training and minimal HFM programming experience a third option was needed. To fill this gap we created a HFM control method named “Semi-Automatic” which allows both flexibility and standardization. Methods Utilizing “Semi-Automatic” HFM operation, each curricula scenario was designed as an algorithmic flow sheet then programmed into a step-by-step list of learner actions, allowing the clinical simulation instructor to follow scenario progress in a top to bottom check-list manner. Selection of uniquely marked checklist steps changes all physiology parameters in accordance with the pre programmed scenario curriculum. HFM “On-the-Fly” operation can still be utilized at the discretion of the clinical simulation instructor based on learner’s medical interventions. “Semi-Automatic” operation enables the novice simulation operator an avenue for rapid physiology changes not offered by the “On-the-Fly” method and the flexibility not provided by the “Automatic” mode of HFM operation. A six month pilot program was implemented. A total of 58 clinical simulation instructors were given instruction on standardized operation of the scenarios and utilization of “Semi-Automatic” HFM operation. The learner backgrounds were various combinations of clinical and simulation experience. After each learner group completed the training course the scenario operation was evaluated and amendments implemented. Correspondence with the clinical simulation instructors post course has indicated a positive response to the operation and flow of the scenarios. An additional unintended outcome is the confidence and lack of anxiety the clinical simulation instructors have expressed due to the demystification of the technology interface. Multiple have stated they are able to concentrate on the educational rationale without the anxiety of “messing up” the scenario by inappropriate HFM operation. Results: Conclusion Utilizing the novel approach of “Semi-Automatic” HFM control facilitates standardized yet flexible control to the novice clinical simulation instructor while maintaining educational objectives of designed curricula. We feel that this third option mitigates the anxiety of technology integration into clinical education.