When Life Gives you Lemons, Innovate!: A Study Reviewing Technical Needs, Obstacles, and Resident Physician Experiences during a Necessary Transition to Virtual Simulation due to the COVID-19 Pandemic (1090-003968) (Research Abstract Professor Rounds: Group 7)
Start time: Friday, January 29, 2021, 1:00 PM End time: Friday, January 29, 2021, 2:00 PM Session Type: Research Abstracts (Completed Studies)
Grand Strand Medical Center is a 371-bed community hospital serving several surrounding counties. Our hospital system supports 6 ACGME accredited residencies (IM, Gen Surg, FM, TY, EM, Anesthesia). As a part of the Hospital Corporation of America system, the Grand Strand Health Education and Simulation Center has been involved in resident simulation training for 5 years. In March 2020, at the onset of the COVID-19 pandemic, HCA determined that in-person simulation scenarios were not safe for resident physicians, so we adapted! With ongoing input from our residents, we implemented virtual simulation on a WebEx platform. This study reviews the technical requirements necessary for virtual simulation, discusses obstacles encountered during the implementation of our virtual simulation journey, and review the experiences of the resident physicians who have been an integral part of the success of our virtual simulation scenario development.
With limited staff and financial constraints brought on by the pandemic, we were hesitant to transition to virtual simulation. We utilized mobile skills training to relocate task trainers to the learners in a one-on-one environment. In April 2020, our team completed its first virtual simulation activity. We utilized the office of the Sim Coordinator with a 3-screen arrangement. Screen One: Laerdal LLEAP platform viewer, Screen Two: shared screen for patient vitals monitor and supplemental studies (EKG, CXR, patient photo, labs) and Screen Three: operated by educator running the scenario and debrief and is hub for recording. Scenarios are adapted from our case repository to serve the objectives of those involved in each case. The educator notes team performance, strengths and areas for improvement on a PLUS-DELTA-like Debriefing Tool form. Formal debriefing is held and learners complete a post-simulation event evaluation form with 9 questions on a Likert scale and comments.
The consensus from resident learners involved in the use of simulation via a virtual WebEx platform has been unanimously positive. To date, a total of 11 learners have completed feedback forms. 100% of learners feel they are receiving a valuable learning experience and would recommend this modality to their colleagues, while 91% of learners strongly agreed that their skills and competencies were appropriate for the simulation scenario and that the debriefing process provided valuable feedback for the learning process. Learners have commented, “Great environment to work on my weaknesses without the consequences of harming a patient”, “Good, efficient use of our time, educational, lifelike”, “It was comparable to being in the SIM lab” and “overall, despite being virtual it was still a valuable learning experience”.
The Grand Strand Health Education and Simulation Center has been at the forefront of virtual simulation for the past two months in the setting of the COVID-19 pandemic. With a small staff and limited clinical hours, we have been able to provide an alternative to in-person simulation that has proved a powerful learning tool to our learners. Major obstacles we have encountered are twofold. First, resident physician learners have noted inadequate closed loop feedback provided by the educator that has negatively affected resident satisfaction. Mediators were provided additional education and the situation was resolved. Second, learners noted an inability to hear or see certain sound or video recordings provided during scenarios. Technical troubleshooting within WebEx has provided resolution of said issues. In the future, we will expand virtual simulation to the entire hospital. Based on feedback, we will implement AR with virtual simulation to simulate exam findings for learners.