Tale of Two Learners: Using Different Virtual Formats Based on Learner Experience Level (1090-003978) (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)
In March 2020, the COVID-19 global pandemic shut down all in-person educational events at the Ann & Robert H. Lurie Children’s Hospital of Chicago, as it did to most academic centers nationally. Lectures and other didactic sessions were quickly adapted to a virtual format, but simulation sessions remained cancelled because of the close contact and hands-on format of learning required. As learners clamored for education, our simulation group developed new formats for virtual simulation using existing technology for two very different groups of learners: medical students on their pediatric clerkship rotation and pediatric subspecialty fellows across emergency medicine, critical care and cardiology fellowships, who do not usually have the opportunity to participate in simulation together. Our aim is to describe the virtual formats, report our learners’ experience and lessons learned.
Our center’s pediatric clerkship includes 2 in-person simulations for groups of 4-6 medical students that cover respiratory distress and hypovolemic shock. Our fellows usually participate in monthly in-person simulations of varying topics. A similar virtual format for these 2 groups was held over Zoom so 5-6 learners could participate from home. All sessions started with a pre-brief to create a safe learning space and orient learners to the virtual setting. Simulations ran by facilitators providing data from the case and performing tasks as requested by learners. Learners requested history, physical exam findings, or direct interventions from facilitators. Student simulations involved a croup case; fellows' cases involved complex resuscitations. Vital signs were projected on a separate zoom tile. Post-simulation debriefings followed our usual practice using the PEARLS framework to discuss content, communication and teamwork skills. All participants received surveys after the sessions.
Six virtual medical student simulations took place with 22 participants, and 15 completed the post-survey. Reponses were compared to post-survey responses from 84 students who completed in-person simulation sessions earlier in the academic year. Important differences in responses include that fewer students in the virtual sessions agreed that “teamwork and communication issues were addressed in the debriefing” (73% vs 100% during in-person). Narrative comments from students who participated in virtual simulations reported it among the top three clerkship activities for learning and felt it was equally effective or better than their previous simulation experiences in other rotations. Two subspecialty fellow virtual simulations took place with 12 participants, but only 5 completed the post-survey. Comments reflected the difficulty in communicating between virtual and non-virtual participants who were masked.
Virtual simulations requiring minimal technology can support learning of learners at different levels. Key tips learned by our educators were to use breakout rooms to stagger entry, provide multiple facilitators and display vital signs through a separate zoom tile. The pediatric subspecialty fellow groups appreciated being able to learn from each other during the simulation and debriefing, as joint simulations have been difficult to schedule in the past. Challenges that needed to be worked out was translating team learning when distanced, avoiding talk-over, and unique communication issues across the virtual platform.