Paediatric virtual simulation

ABSTRACT

BackgroundSimulation has multiple benefits in paediatrics – experiential learning, hands-on skills practice, communication, task prioritisation and human factors challenges to name but a few. We also recognise the significant value of the debrief, and how supporting a peer-led learning conversation helps to both further and consolidate knowledge. During COVID-19, routine face-to-face simulation delivery in our Trust has stopped, begging the question of how we can continue to support our colleagues’ clinical knowledge and skills, bearing in mind that many are now shielding at home.ObjectivesOur solution was to design paediatric emergency simulated scenarios and deliver them virtually to remote learners via video conferencing software, as we believed that this could lead to both effective teaching and learning. We set out to explore the different ways in which this could feasibly be achieved, and through feedback from our learners, establish which methods were most effective. Our goal was the ensure real-time interactivity through engagement from the learners, as this has been a criticism of observing and our involvement with remote simulation in the past.MethodsWe developed 3 distinct forms of virtual simulation1. Simulation By-Proxy The set-up was as per traditional face-to-face simulation, with a high-fidelity manikin in a hospital bed surrounded by medical equipment and visible monitoring. The remote learners were shown a webcam view and were asked to work as a team to clearly instruct an in-situ confederate nurse and doctor (with no initiative of their own) to manage a complex child with pneumonia and sepsis.2. Real-time Input No manakin or bed-space were used. Remote learners were shown a power-point-type presentation which described an evolving clinical case of a paediatric burn. Integrated software allowed real-time group participation in word clouds, prioritisation tasks and multiple-choice questions with anonymous results visible within the presentation (like asking the audience in Who Wants To Be A Millionaire).3. Direct Facilitation No manakin or bed-space were used. Remote learners were shown a power-point presentation which described an evolving clinical case of paediatric toxic shock syndrome. Learners were numbered upwards from junior to senior, and took turns directing the care of the patient sequentially. Slides showed clinical images such as bedside monitoring, blood gases and laboratory blood results. The scenario was proactively facilitated by the host as the clinical reasoning and management became more complex.ResultsOverall, virtual simulation was very well received in a time when learning has become much more accessible but also more didactic. Our feedback questionnaire from 12 remote learners showed they both enjoyed and engaged with the scenarios, and particular highlights included capturing the sense and pressure of an emergency in methods 1 and 3, passing team leadership on as a baton in method 3, but also the anonymity and group interactivity of method 2. All scenarios benefitted from debrief in the traditional manner.ConclusionsWe believe that virtual simulation has a role in the current healthcare environment, and is both possible and educationally valuable, with many different strengths that can be combined for a blended learning environment.