Distributed Simulation as a modelling tool for the development of a simulation-based training programme for cardiovascular specialties

Tanika Kelay,Fernando Bello,Roger K Kneebone,Iqbal S Malik,Charis Costopoulos,Matthew Gold,Kah Leong Chan,Mohammad Yasin,Emmanuel Ako

doi:10.1186/s41077-017-0049-y

Tanika Kelay, Fernando Bello + Show 7 more

Open Access

https://doi.org/10.1186/s41077-017-0049-y

Copy DOI

Abstract

Aims and backgroundDistributed Simulation is the concept of portable, high-fidelity immersive simulation. Here, it is used for the development of a simulation-based training programme for cardiovascular specialities. We present an evidence base for how accessible, portable and self-contained simulated environments can be effectively utilised for the modelling, development and testing of a complex training framework and assessment methodology. Iterative user feedback through mixed-methods evaluation techniques resulted in the implementation of the training programme.ApproachFour phases were involved in the development of our immersive simulation-based training programme: (1) initial conceptual stage for mapping structural criteria and parameters of the simulation training framework and scenario development (n = 16), (2) training facility design using Distributed Simulation, (3) test cases with clinicians (n = 8) and collaborative design, where evaluation and user feedback involved a mixed-methods approach featuring (a) quantitative surveys to evaluate the realism and perceived educational relevance of the simulation format and framework for training and (b) qualitative semi-structured interviews to capture detailed feedback including changes and scope for development. Refinements were made iteratively to the simulation framework based on user feedback, resulting in (4) transition towards implementation of the simulation training framework, involving consistent quantitative evaluation techniques for clinicians (n = 62). For comparative purposes, clinicians’ initial quantitative mean evaluation scores for realism of the simulation training framework, realism of the training facility and relevance for training (n = 8) are presented longitudinally, alongside feedback throughout the development stages from concept to delivery, including the implementation stage (n = 62).FindingsInitially, mean evaluation scores fluctuated from low to average, rising incrementally. This corresponded with the qualitative component, which augmented the quantitative findings; trainees’ user feedback was used to perform iterative refinements to the simulation design and components (collaborative design), resulting in higher mean evaluation scores leading up to the implementation phase.ConclusionsThrough application of innovative Distributed Simulation techniques, collaborative design, and consistent evaluation techniques from conceptual, development, and implementation stages, fully immersive simulation techniques for cardiovascular specialities are achievable and have the potential to be implemented more broadly.

Highlights

This paper explores the use of Distributed Simulation [1] as a modelling tool for the development and implementation of an immersive simulation-based training programme for cardiovascular specialities
Initially, mean evaluation scores fluctuated from low to average, rising incrementally. This corresponded with the qualitative component, which augmented the quantitative findings; trainees’ user feedback was used to perform iterative refinements to the simulation design and components, resulting in higher mean evaluation scores leading up to the implementation phase
Quantitative feedback about the integrated simulation framework and components The users’ mean evaluation scores for realism of the simulation training framework, realism of the simulation training facility and relevance for training are presented in Figs. 4, 5 and 6

Summary

Introduction

Background This paper explores the use of Distributed Simulation [1] as a modelling tool for the development and implementation of an immersive simulation-based training programme for cardiovascular specialities. Drawbacks include practical issues such as the cost and expense of dedicated high-fidelity simulation centres, accessibility, and moving beyond the use of bench-top simulators that focus primarily on technical skills training [2], to more contextualised immersive training environments that can trigger a range of responses in clinicians, allowing team-based training to include human factors components, e.g. teamwork, communication, leadership and cooperation. The Distributed Simulation concept has involved several applications, from surgical training [5,6,7,8], clinician engagement workshops [9] and patient/public engagement forums [10,11,12]. The concept extends further through its vision to provide an approach to learning, which can be tailored to the needs of groups, and it can be used to underpin collaborative user-based design to drive forward innovations in training for emerging specialities that have to date been lacking in terms of robust development [1]

Methods

Results

Discussion

Conclusion