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- Herausgeber: John Wiley & Sons
- Kategorie: Wissenschaft und neue Technologien
- Sprache: Englisch
A focused guide for healthcare simulation operations in education and training
With the growing use of simulation within the field of healthcare, Healthcare Simulation: A Guide for Operations Specialists provides a much needed resource for developing the roles and responsibilities of simulation operations specialists. The book illustrates the current state and evolution of the simulation professional workforce and discusses the topics necessary for the development of these pivotal roles.
The book promotes the value of simulation-based education in healthcare and its associated outcomes while clarifying the operational requirements of successful simulations. Featuring numerous contributions from international experts, consultants, and specialists, Healthcare Simulation: A Guide for Operations Specialists presents advances in healthcare simulation techniques and also features:
- Coverage of the best practices and available technologies for healthcare simulation operations specialists within healthcare education, training, and assessment
- Interdisciplinary, practical examples throughout to help readers better understand the presented material
- An overview of the many facets of day-to-day operations within a healthcare simulation program
- Discussions regarding the concurrent need for understanding proper patient care that accompanies the human-to-machine interface in patient simulation
Healthcare Simulation: A Guide for Operations Specialists is an excellent reference for healthcare simulation professionals including administrators, medical directors, managers, simulation technologists, faculty members, and educators in academic and healthcare settings. The book is also a useful supplementary textbook for graduate-level courses related to simulation and certificate programs in simulation education and simulation operations.
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Seitenzahl: 416
Veröffentlichungsjahr: 2015
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Table of Contents
COVER
TITLE PAGE
CONTRIBUTORS LIST
CONTRIBUTORS BIOS
ACKNOWLEDGMENTS
1 INTRODUCTION
REFERENCES
2 HEALTHCARE SIMULATION OPERATIONS
INTRODUCTION
GAP #1: TECHNOLOGICAL EXPERTISE
GAP #2: TRAINING
GAP #3: DIVISION OF LABOR
GAP #4: COMMON LANGUAGE and CULTURE
GAP #5: MISUNDERSTOOD IT
MINDING THE GAPS AND IDENTIFYING SOLUTIONS
CONCLUSION
REFERENCES
3 EVOLUTION OF THE SIMULATION OPERATIONS SPECIALIST (SOS)
BRIEF HISTORY OF THE EVOLUTION OF SIMULATION IN HEALTHCARE
INCREASING NEED FOR SIMULATION OPERATIONS SPECIALISTS
THE SOS IN THE BEGINNING
MORE THAN SIMULATORS
PAST AND PRESENT TRAINING OPPORTUNITIES
REFERENCES
4 THE SIMULATION OPERATIONS SPECIALIST AS INNOVATOR
SIMULATION OPERATIONS SPECIALISTS (SOS): WHERE DO THEY COME FROM?
HOW MIGHT THE SOS Be Best Utilized?
THE SOS OF THE FUTURE
CONCLUSION
REFERENCES
5 THE SIMULATION OPERATIONS SPECIALIST AS ARTIST and PRODUCER
MOULAGE
ENVIRONMENTAL REALISM
IN-HOUSE VERSUS CONTRACTED SIMULATOR DEVELOPMENT
BUILDING A FOUNDATION OF RESOURCES
HYBRID SOLUTIONS FOR SIMULATOR DEVELOPMENT
TESTING YOUR DIY SIMULATOR
PROTECTING INTELLECTUAL PROPERTY
FUNDING FUTURE DEVELOPMENT
CONCLUSION
REFERENCES
6 MEDICAL AND CLINICAL TERMINOLOGY FOR THE SIMULATION OPERATIONS SPECIALIST
THE BRAIN AND CENTRAL NERVOUS SYSTEM
DEEP VEIN THROMBOSIS (DVT)
EDEMA
RESPIRATORY SYSTEM
GASTROINTESTINAL SYSTEM
BOWEL OBSTRUCTION
GENITOURINARY SYSTEM
MUSCULOSKELETAL SYSTEM
THE INTEGUMENTARY SYSTEM
CONCLUSION
REFERENCES
7 SIMULATION OPERATIONS, CURRICULUM INTEGRATION, AND PERFORMANCE IMPROVEMENT
INTRODUCTION
THE MENTAL MODELS BEGIN AND END WITH SYSTEMS THINKING
CONCLUSION
REFERENCES
8 FINDING THE FIT: WHAT THE SIMULATION OPERATIONS SPECIALIST HAS TO OFFER AND WHAT THE EMPLOYER NEEDS
INTRODUCTION
THE EMPLOYER’S NEEDS
KNOWLEDGE OF SIMULATION
THEMES
CONCLUSION
REFERENCES
9 FOUNDATIONS FOR THE SIMULATION OPERATIONS SPECIALIST
INTRODUCTION
SOS RECRUITMENT AND ONBOARDING
SOS FOUNDATIONS FROM THE WORLD OF INFORMATION TECHNOLOGY
SERIOUS GAMES
MULTIPLE PLATFORM EXPERIENCE
DRIVERS
UTILITIES
COMPUTER NETWORKS
WIRED VERSUS WIRELESS NETWORKS
NETWORK ADDRESSES
PUBLIC AND PRIVATE NETWORK ADDRESSING SCHEMES
MANUAL AND AUTOMATIC ASSIGNMENT OF IP ADDRESSES
ROADBLOCKS TO CONNECTIVITY
NETWORK MANAGEMENT CONCEPTS
SOS FOUNDATIONS FROM THE WORLD OF AUDIOVISUAL TECHNOLOGY
RESOLUTION, BANDWIDTH, AND FREQUENCY RELATED TO A/V COMMUNICATION/TRANSMISSION
SOS FOUNDATIONS FROM THE WORLD OF THEATER AND DRAMA
SOS FOUNDATIONS FROM THE WORLD OF ACADEMIA
SOS FOUNDATIONS FROM THE WORLD OF HEALTHCARE
CONCLUSION: CONTEXT MATTERS
REFERENCES
10 PROGRAMMING PATIENT OUTCOMES IN SIMULATION: CONCEPTS IN SCENARIO STANDARDIZATION AND AUTOMATION
INTRODUCTION
OUTCOME-BASED, EVENT-DRIVEN TEACHING (OET): OUTCOME VERSUS THE EVENT
SIMULATION OPERATIONS SPECIALIST, SUBJECT-MATTER EXPERT, AND PROGRAMMING
SAO: SCENARIO DESIGN/PROGRAMMING CONCEPTS
CONFUSION IN SIMULATION DESIGN PROGRAMMING TERMINOLOGY
STAGES OF SAO SCENARIO DEVELOPMENT
STUMBLING BLOCKS TO SUCCESSFUL SCENARIO IMPLEMENTATION
CONCLUSION
REFERENCES
11 SIMULATION OPERATIONS SPECIALISTS JOB DESCRIPTIONS
WRITING A NEW JOB DESCRIPTION
THE FIRST STEP: WHAT WILL THE SOS DO?
EXISTING JOB DESCRIPTIONS AND CLASSIFICATIONS
NEGOTIATING INTERNAL AND EXTERNAL PROCESSES TO GET THE JOB DESCRIPTION APPROVED AND FILLED
CONCLUSION
REFERENCE
12 SIMULATION RESEARCH AND THE ROLE OF THE SIMULATION OPERATIONS SPECIALIST
INTRODUCTION
SIMULATION OPERATIONS SPECIALISTS AS A RESOURCE
DATA COLLECTION AND INTEGRITY
RESEARCH METHODS AND PROJECT EXAMPLES
CONCLUSION
ACKNOWLEDGMENTS
REFERENCES
13 INTERNATIONAL PERSPECTIVES ON THE ROLE OF THE SIMULATION OPERATIONS SPECIALIST
THE PLACE FOR SIMULATION OPERATIONS SPECIALISTS AND THEIR CONTRIBUTION TO THE USE OF SIMULATION AROUND THE WORLD
CHALLENGES FACED BY SIMULATION OPERATIONS SPECIALISTS OR “ANY OTHER DUTIES AND ACTIVITIES AS IDENTIFIED BY THEIR LINE MANAGER”
SIMULATION INNOVATIONS
RESEARCH BY SIMULATION OPERATIONS SPECIALISTS AROUND THE GLOBE
CONCLUSION
REFERENCES
14 PROFESSIONAL DEVELOPMENT FOR THE NEXT GENERATION OF SIMULATION OPERATIONS SPECIALISTS
INTRODUCTION
TRADITIONAL MODELS OF OPERATION
THE EXPANDING ROLE OF THE SOS
CERTIFICATION
CONTINUING EDUCATION EFFORTS
PROFESSIONAL ADVANCEMENT
CONCLUSION
APPENDIX 1 COMMONLY USED SIMULATION TERMS, TERMINOLOGY, AND MEDICAL ABBREVIATIONS
REFERENCES
APPENDIX 2 SIMULATION OPERATIONS SPECIALISTS JOB DESCRIPTIONS EXEMPLARS
WEBSITE
CORE WORK VALUES
SUPERVISOR/MANAGERIAL CORE WORK VALUES
TECHNICAL EXPERTISE
TRAINING
COLLABORATION/COMMUNICATION
TECHNOLOGY EVALUATION
TECHNOLOGY SUPPORT TECHNICIAN
DESCRIPTION OF WORK:
EXAMPLES OF COMPETENCIES:
CONTRIBUTING:
JOURNEY
ADVANCED
MINIMUM TRAINING AND EXPERIENCE:
APPENDIX 3 CONNECTIONS
APPENDIX 4 FILE FORMATS
APPENDIX 5 RESOURCES FOR MOULAGE, PROPS, AND SOUNDS
INDEX
END USER LICENSE AGREEMENT
List of Tables
Chapter 06
TABLE 6.1 Common Pulse Sites
TABLE 6.2 Heart Rhythms
TABLE 6.3 How to Describe Wound Drainage
Chapter 07
TABLE 7.1 Criterion Objective Conditions and Standards Definitions
TABLE 7.2 Criterion Objective Task or Performance Definition
TABLE 7.3 Taxonomy of Performance
Chapter 09
TABLE 9.1 IP Address Numbering Ranges and Schemes
List of Illustrations
Chapter 06
FIGURE 6.1 Human silhouette with neurologic symptoms that may be simulated.
FIGURE 6.2 Human silhouette depicting cardiac symptoms that may be simulated.
Chapter 07
FIGURE 7.1 Human Performance Value Stream.
FIGURE 7.2 Accountability evolution.
FIGURE 7.3 The nine roles of simulation operations.
FIGURE 7.4 Human error vs. latent organizational weaknesses root causes.
FIGURE 7.5 The elements of a human performance system.
Chapter 08
FIGURE 8.1 Mind map for CDS University’s Center for Innovation and Learning SOS position.
Chapter 09
FIGURE 9.1 Network router with built in switch—(a). Network Switch with separate router—(b).
FIGURE 9.2 Comparison of the IPv4 and IPv6 address schemas.
FIGURE 9.3 Sender IP address (computer), recipient IP address, and subnet as represented by three octets. Final octet defines either the sending device or the receiving device.
FIGURE 9.4 Example of an A/V configuration with complex signal chain routing.
FIGURE 9.5 SOS knowledge domains.
Chapter 10
FIGURE 10.1 State/frame/node represents the physiological snapshot of a patient simulator; while they appear differently, the concepts are similar.
FIGURE 10.2 A trend can include more than one parameter. In this example only the SpO
2
parameter is illustrated. In combination with additional parameter trends, multiple parameters can be automated in concert.
Chapter 13
FIGURE 13.1 Representation of the Vital Sign Simulator configuration on a personal computer with two graphics card outputs (Zegezottel, 2013).
FIGURE 13.2 Representation of the customized OSCE application process.
Guide
Cover
Table of Contents
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HEALTHCARE SIMULATION
A Guide for Operations Specialists
Edited by
LAURA T. GANTT
East Carolina University College of Nursing, Greenville, NC, USA
H. MICHAEL YOUNG
Level 3 Healthcare, Mesa, AZ, USA
Copyright © 2016 by John Wiley & Sons, Inc. All rights reserved
Published by John Wiley & Sons, Inc., Hoboken, New JerseyPublished simultaneously in Canada
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 750-4470, or on the web at www.copyright.com. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008, or online at http://www.wiley.com/go/permissions.
Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.
For general information on our other products and services or for technical support, please contact our Customer Care Department within the United States at (800) 762-2974, outside the United States at (317) 572-3993 or fax (317) 572-4002.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic formats. For more information about Wiley products, visit our web site at www.wiley.com.
Library of Congress Cataloging-in-Publication Data:
Healthcare simulation : a guide for operations specialists / edited by Laura T. Gantt, H. Michael Young. p. ; cm. Includes bibliographical references and index.
ISBN 978-1-118-94941-2 (hardback)I. Gantt, Laura, 1957–, editor. II. Young, H. Michael, 1960–, editor.[DNLM: 1. Education, Medical. 2. Clinical Competence. 3. Educational Technology. 4. Health Personnel–education. 5. Patient Simulation. W 18] R834 610.71–dc23
2015036801
This book is dedicated to the memory of Joshua C. Brehm.
Laura T. Gantt
For her patience, support, and enduring love, I dedicate this book to my wonderful wife, Nora L. Young. Thank you for the past 30 years, and the life that awaits us. I can’t imagine it without you.
H. Michael Young
CONTRIBUTORS LIST
Guillaume Alinier, PhD, MPhys, PGCert, CPhys, MIPEM, MInstP, SFHEA, NTFUniversity of Hertfordshire, Hatfield, UK
S. Scott Atkinson, BBA, NREMT-PSumma Health, Akron, OH, USA
Evan J. Bartley, BSECU College of Nursing, Greenville, NC, USA
Timothy R. Brock, PhD, CPT, ID(S&L+)The Institute 4 Worthy Performance LLC, Winter Park, FL, USA; The ROI Institute, Birmingham, AL, USA; The Institute for Performance Improvement L3C, Chicago, IL, USA; Full Sail University, Winter Park, FL, USA; Webster University, St Louis, MO, USA; and Franklin University, Columbus, OH USA
Adam Dodson, NRP, CCEMT-P, NCEEJohns Hopkins Medicine Simulation Center, Baltimore, MD, USA
Thomas A. Dongilli, AT, CHSOSWinter Institute for Simulation Education and Research (WISER), Pittsburgh, PA, USA
Laura T. Gantt, PhD, RN, CEN, NE-BCEast Carolina University College of Nursing, Greenville, NC, USA
Jesika S. Gavilanes, MAOregon Health & Science University, Portland, OR, USA
Gene W. HobbsUniversity of North Carolina, Chapel Hill, NC, USA
Mary Holtschneider, RN-BC, BSN, MPA, NREMT-P, CPLPDurham VA Medical Center, Durham, NC, USA
Cheryl Hunter, BSN, RNTarleton State University, Stephensville, TX, USA
Valeriy Kozmenko, MDParry Center for Clinical Skills and Simulation, Sioux Falls, SD, USA
Amar Patel, DHSc, MS, NRPWakeMed Health & Hospitals, Raleigh, NC, USA
Morgan Scherwitz, MSN, RNHendrick Medical Center, Abilene, TX, USA
Lindsey Scott, MSN, RNConsultant, Austin, TX, USA
Emily Shaw, MA, CMI, EMT-BMimic Technologies, Simugreat, SAGES, Baltimore, MD, USA
H. Michael Young, BBS, MDiv, CHSELevel 3 Healthcare, Mesa, AZ, USA
CONTRIBUTORS BIOS
Guillaume Alinier, PhD, MPhys, PGCert, CPhys, MIPEM, MInstP, SFHEA, NTF, has worked in the field of healthcare simulation education, research, and facility design for the last 15 years. He obtained a Master in Applied Physics from the University of Portsmouth (UK) and his PhD from the University of Hertfordshire (UK). He holds a full professorship from Hertfordshire where he setup and directed a large simulation center designed for undergraduate and postgraduate interprofessional activities. He holds a visiting position with Northumbria University in Newcastle, UK, since 2009. His primary position at present is with Hamad Medical Corporation Ambulance Service (Doha, Qatar) as Assistant Executive Director of Research; he also helped revamp the training program of paramedics. Since the start of his career in healthcare simulation, Dr. Alinier has received several awards from the UK Higher Education Academy (NTF 2006, SFHEA 2009) for his work in teaching and learning with students, for mentoring colleagues, and supporting the development of several simulation centers around the world. He is a regular keynote speaker at international conferences and has published extensively. He has been chair or co-chair of major simulation conferences, such as ASPiH 2007, SESAM 2008, and IMSH 2012. He is actively involved with the simulation societies through various roles, including the International Nursing Association for Clinical Simulation in Nursing (INACSL) as a member of its Standards Advisory Board and the Society for Simulation in Healthcare (SSH) as member of the CHSOS Certification Committee, Program Accreditation Council, and Meetings Oversight Committee.
S. Scott Atkinson, BBA, NREMT-P, began his career as a basic EMT and firefighter, while moving forward with his EMT advanced and paramedic certifications. He has worked in the field as a paramedic in the inner-city and as part of the Critical Care Transport Team in many areas of Ohio, West Virginia and Pennsylvania. He is certified as a Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) instructor, and has also served as a Tech Level III Hazmat Team Member and 240 hr firefighter. He started, and still actively manages and runs, the Virtual Care Simulation Labs at Summa Health System and is currently building a new simulation center through a 1.5 million dollar state grant. He holds an Associate’s Degree in Information Technology and is currently working toward the completion of his Bachelor’s degree in Business Administration. Mr. Atkinson belongs to many simulation user groups and was past chair of the Society for Simulation in Healthcare’s (SSH) Simulation Operations and Technology Section (SOTS). Mr. Atkinson is a prominent simulation technologist and educator and has been instrumental in several educational development programs, as well as new simulation center start-ups. He has developed and is preparing for the start of the first simulation technologists’ associate degree program through the University of Akron to begin in the spring of 2016. He will teach from a specially designed simulation lab that he and his team had designed and built for simulation technology instruction. Mr. Atkinson is an entrepreneur and has designed and built a cardiac simulator with his simulation team, which was recently licensed through a prominent simulation company. In his free time, he is a real estate agent and also owns and operates several businesses.
Evan J. Bartley, BS, has worked in the field of instructional technology over the last 5 years at East Carolina University (ECU) College of Nursing. He began working as a simulation technologist and has stepped into a managerial role, supervising not only the support of simulation technologies, but distance education and other instructional technologies. Mr. Bartley received a Bachelor’s degree from ECU in 2009 in Information and Computer Technology with a concentration in Information Security. Mr. Bartley is currently working on his Master’s at ECU in Instructional Technology and is COMPTIA Security+ certified.
Timothy R. Brock, PhD, CPT, ID(S&L+), is the CEO of the Institute 4 Worthy Performance, a Practice Leader with the Institute for Performance Improvement (TIfPI), and an Associate with the ROI Institute. He is a Certified Performance Technologist (CPT) with the International Society for Performance Improvement (ISPI) and a Certified Instructional Designer with a specialization in Simulation and Labs (ID(S&L+)) with TIfPI. Dr. Brock earned his PhD at Capella University in Education with a specialization in training and performance improvement. He is a retired air force field grade officer who began using advanced simulation technologies for training and education in 1979. He retired from Lockheed Martin Global Training and Logistics in 2012 where he was the manager of their Science of Learning and Performance Improvement team for global military and healthcare learning and simulation training solutions. He is a member of the Society for Simulation in Healthcare and serves on two committees: the Technology and Standards Committee and the Preparatory Materials Committee for the Healthcare Simulation Operations Specialist certification. Dr. Brock is also a member of the CPT Oversight Sub-Committee with ISPI. He is a published author and frequent international conference speaker. He can be reached at [email protected].
Adam Dodson, NRP, CCEMT-P, NCEE, has been in Emergency Medicine and Emergency Medical Services (EMS) for over 20 years. He obtained his Paramedic Degree and License through Cecil College and began teaching in 1997 for the U.S. Army Medical Department Center and School (AMEDDC&S). Adam’s career with Johns Hopkins Hospital began in 1997 as a Critical Care Paramedic. He was instrumental in the development of new employees as a field training officer. He started using simulation and teaching in 2003 with the University of Maryland and University of Maryland—Baltimore County (UMBC). Adam has taught interdisciplinary hospital team members for more than a decade and is the Lead Simulation Specialist at the Johns Hopkins Medicine Simulation Center. He often meets with clients from foreign countries and discusses challenges of teaching in austere environments or creating simulation centers. He has worked on international projects with the Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO), the United States Agency for International Development (USAID), the United States Department of Defense, Johns Hopkins International (JHI), and Johns Hopkins International Global Services. In 2015, he assisted in the launch of a train-the-trainer program in Nigeria. Adam serves as a technical advisor for the Johns Hopkins University Biomedical Department, creating several low-cost task trainers for countries around the globe. Adam also chairs the Benchmarking Subcommittee for Hospital-Based Section of the Society for Simulation in Healthcare (SSH), and he is the Vice-Chair of the Simulation Operations and Technology Section. He has spoken at several conferences on innovations in simulation and pushing the boundaries of technology.
Thomas A. Dongilli, AT, CHSOS, has worked in the healthcare simulation industry for over 21 years. Tom is the Director of Operations at the Peter M. Winter Institute for Simulation, Education and Research (WISER). In this role, Tom supplies operational leadership to WISER’s main facility and its’ seven satellite centers: WISER has been providing simulation services since 1994. Prior to this role, Tom was the Chief Anesthesia Technologist for the University of Pittsburgh Medical Center. Tom has extensive experience in simulation center design, integration, and operations and has designed simulation centers both nationally and internationally. He also contributes expert knowledge and experience in the practical design, implementation, operation, and monitoring of simulation based facilities and medical learning systems. Some of Tom’s published works include chapters in A Manual of Simulation in Healthcare and Concepts, Trends, and Possibilities for Using Clinical Simulation in Nursing Education. Tom has also authored many courses pertaining to simulation center operations, including TechSim, Designing Your Simulation Center, and Operational Best Practices for Your Simulation Center. Tom’s area of clinical interest is in the field of in situ simulations and patient safety; he has created simulation-based programs for Mock Codes, Clinical Site Assessments and most recently authored a course called “The First 5 minutes, What to do Until the Code Team Arrives.” Tom was the 2014 International Meeting for Simulation in Healthcare planning committee co-chair. Tom has been an active member of the Society for Simulation in Healthcare since its inception. Tom currently has a role in the following committees with the Society for Simulation in Healthcare: CHSOS Exam Prep committee and the Oversight Committee. Tom was the lead author on the creation of the Society for Simulation in Healthcare’s Policy and Procedure manual.
Laura T. Gantt, PhD, RN, CEN, NE-BC, is an Associate Professor and Interim Associate Dean for Nursing Support Services in the College of Nursing. She began her formal work with healthcare simulation in 2006 when she was hired to establish simulation and teaching labs in the new East Carolina College of Nursing building. The departments under her supervision include the Concepts Integration Labs, Learning Resource Center, Instructional Technology, Student Development and Counseling, and Student Services. Laura has published a number of journal articles and book chapters on simulation and emergency nursing topics. She developed the outline for this book and then began searching for a technology expert to co-author it. She and Michael Young met in March of 2013. She has served on the CHSOS Committee since April of 2013. Previous to the time that she went to work at ECU, Laura was an administrator for the emergency, ambulatory, and transport service line at Pitt Country Memorial Hospital (now Vidant Medical Center); she still practices as a staff nurse in Vidant’s Minor Emergency Department. Laura is a Certified Emergency Nurse (CEN) and also holds a certification as a nurse executive (NE-BC). She has a BSN from Duke University, MSN from the University of North Carolina, and a PhD in Nursing from the University of Colorado.
Jesika S. Gavilanes, MA, is currently the OHSU Simulation Operations Director for the Oregon Health & Science University Simulation Center in the Collaborative Life Sciences Building (CLSB). She has worked at the Oregon Health & Science University (OHSU) for over 18 years. She has been involved with simulation operations since 2002. She first became a simulation technician in 2003 and now oversees a team of seven simulation operation specialists. She completed her Masters in Teaching at Portland State University in August of 2008. In her role as Operations Director, Ms. Gavilanes oversees the operations of the 20,000 sq. ft. Interprofessional OHSU Simulation Center. She is the current Chair of the Oregon Simulation Alliance and has led the efforts of developing and implementing a Statewide Sim Tech Academy, educating over 80 sim techs across the state and Pacific Northwest. Ms. Gavilanes has been involved with simulation facilities across the country assisting with logistics, operations, and simulation implementation for the past 10 years. She currently is serving her third year as the Chair for the Society for Simulation in Healthcare Technical Operations Track. Ms. Gavilanes is also a member of the International Nursing Association for Clinical Simulation and Learning (INACSL).
Gene W. Hobbs has worked within the healthcare simulation field for 13 years, first at Duke University Medical Center, and then at the University of North Carolina at Chapel Hill (UNC-CH). In his faculty role at UNC, Gene serves as a clinical instructor for the Department of Pediatrics and Associate Director of Simulation for the School of Medicine focusing on interprofessional education throughout campus. Research has been an integral part of Gene’s career that started as a research technician and Certified Hyperbaric Technologist 22 years ago. Gene is a Founding Board Member of the Rubicon Foundation, Inc.; he is also project manager for their Research Repository, which earned him the 2010 DAN/Rolex Diver of the Year Award. Gene has authored or co-authored 14 peer reviewed articles and over 50 abstracts. Gene’s most recent publication in Critical Care Medicine with Dr. Noa Segall and colleagues utilized simulation to evaluate patient load effects on response time to critical arrhythmias in cardiac telemetry.
Mary Holtschneider, RN-BC, BSN, MPA, NREMT-P, CPLP, is Simulation Education Coordinator at the U.S. Department of Veterans Affairs, Durham VA Medical Center in Durham, North Carolina. She also serves as the Veterans Integrated Service Network (VISN) 6 Simulation Champion and Co-Director of the Durham VA Inteprofessional Advanced Fellowship in Clinical Simulation. She frequently writes and speaks on simulation-related topics and is the Simulation Columnist for the Journal for Nurses in Professional Development. Her areas of simulation interest include hospital in situ training, interprofessional team communication and team development, stroke/cardiac emergency response, and using simulation for process and quality improvement initiatives.
Cheryl Hunter, BSN, RN, received her BSN from Tarleton State University (TSU) in 2008 and began her nursing career in emergency nursing, where she continued to practice until 2013. Ms. Hunter accepted her current position as the Simulation Lab Supervisor at TSU, Department of Nursing in 2012. Ms. Hunter has been one of the leads in the development of the new Center for Clinical Simulation and Competency (CCSC). She has participated in a number of simulation-focused research projects and has presented at the International Meeting for Simulation in Healthcare (SSH) as a member of a discussion panel and poster presenter. Ms. Hunter is currently working toward her MSN. Most recently, Cheryl received the Tarleton State University Enhancing the Student Experience Award for her work in developing and implementing a multi-agency, community-based mass casualty disaster simulation.
Valeriy Kozmenko, MD, graduated from Lugansk State Medical University (Ukraine) in 1992 and obtained training in Anesthesiology and Critical Care. After moving to the United States, Dr. Kozmenko worked at Louisiana State University Health Sciences Center since 2002 and was soon promoted as Director of Human Patient Simulation. His scholarly activities include more than 50 presentations and publications and seven book chapters; his scholarly activities have been well recognized in the international simulation community. In 2013, Dr. Kozmenko was awarded a patent on an innovative medical simulation computer system that he developed. Since October of 2013, Dr. Kozmenko has served as the Director of the Parry Center for Clinical Skills and Simulation at the University of South Dakota Sanford School of Medicine. In 2015, the Society for Simulation in Healthcare recognized Dr. Kozmenko and Brian Wallenburg with the fifth place award for developing and implementing an innovative simulation scenario programming concept.
Amar Patel, DHSc, MS, NRP, is the director for the Center for Innovative Learning at WakeMed Health & Hospitals in Raleigh, North Carolina. He is a nationally registered paramedic and received his BA from Goucher College, an MS from UMBC, and his DHSc from Nova Southeastern University. Prior to becoming the director for the Center for Innovative Learning in 2007, Dr. Patel served as an advanced life support program instructor and the project manager of medical simulation for the Maryland Fire and Rescue Institute at the University of Maryland, College Park. In this role he was responsible for developing new curriculum, as well as integrating simulation methodology and the technology into all of the advanced life support (ALS) programs. He was the lead developer of simulation scenarios and the technical simulation expert at the local and state level. Today, Dr. Patel is an editorial board member for Carolina Fire Rescue EMS Journal. He has published many articles on simulation center architectural design, program administration, and audio-visual design. He continues to provide consultation for programs looking to integrate the simulation methodology or expand the utilization of simulation technology. Dr. Patel is involved in simulation-based research that focuses on integration and implementation of simulation as means to improve human and system processes. Dr. Patel was a contributing author for Defining Excellence in Simulation Programs, published by Wolters Klumer in 2014.
Morgan Scherwitz, MSN, RN, is the Nurse Manager of the Antenatal Triage Unit at Hendrick Hospital in Abilene, TX. She received her BSN from York College of Pennsylvania and her MSN from Liberty University before becoming Laboratory Manager at Tarleton State University in Stephenville, TX. After 6 years of creating and overseeing the simulation and nursing skills labs at Tarleton State University, she moved to Abilene, Texas, where she currently resides with her husband and five children. She recently co-authored the chapter “Transitioning a Simulation Center” with Michael Young in Defining Excellence in Simulation Programs. She has also been a simulation center design consultant.
Lindsey Scott, MSN, RN, began her career as an Emergency Medical Technician where she used her skills in the field of critical care. She received her BSN from York College of Pennsylvania and worked as a bedside nurse in the critical care unit. She later worked at Lancaster General Hospital in the Trauma-Neuro ICU where was able to participate in writing protocols and assisting in research. After moving to Austin, TX, Lindsey transitioned to position as a travel nurse in the ICU and pursued her Masters of Nursing with an emphasis in education through Grand Canyon University. Lindsey’s most recent role was as a Program Coordinator with a Licensed Vocational Nursing department where she also helped with new simulation laboratories.
Emily Shaw, MA, CMI, EMT-B, has a decade of experience in simulation, which includes simulator development of the Virtual IV product line with Laerdal DC, providing education on scenario programming as Simulation Specialist for Laerdal Medical, and operating a simulation center for MedStar Health. Her current position is as the Northeast Territory Manager for Mimic Technologies, a pioneer in robotic surgery simulation. Her medical training started with combined post-baccalaureate and pre-med classes from Towson University and UMBC and the first year of medical school courses as part of the Johns Hopkins MA program. She completed her EMT-Basic certification in 2007 and her EMT-Paramedic program in 2011. Emily is a Certified Medical Illustrator with a Master of Arts degree in medical and biological illustration from Johns Hopkins Medical School; she also holds a Bachelor of Arts in fine art from Maryland Institute College of Art. In 2003 while at Hopkins, she was awarded a Vesalius Trust Alan W. Cole scholarship for her thesis project on trypanosome KDNA replication. For the past 14 years, she has been the sole proprietor of Illustrating Medicine (illustrating-medicine.com) with clients such as National Institutes of Health, Johnson & Johnson, and Lippincott Williams, & Wilkins. As an active member of the Society for Simulation in Healthcare (SSH), Emily volunteers with the SOTS Section as the Editor-in-Chief for the forthcoming Simulation Technology Operations and Resource Magazine which is to be published online quarterly by SSH. She also volunteers on the Hospital-Based Simulation Programs SIG having established their social media in 2014 including a Twitter feed: @SSH_HBSP. Emily gives back to her community by volunteering as an EMT-B at the Chestnut Ridge Volunteer Fire Company in Baltimore County, as well as serving on the Board of Governors for the Mount Washington Improvement Association. She remains active in the Association of Medical Illustrators by serving on the Board of Governors with the Executive Committee as Secretary, on the Sponsorship, Membership, PR Committees, and is the Twitter Editor of @AMIdotorg.
H. Michael Young, BBS, MDiv, CHSE, has worked within the healthcare simulation field over the last 9 years, first at Tarleton State University (TSU), and then for Level 3 Healthcare. In his role at TSU, Michael grew into a role best described as the simulation systems administrator, but like so many of those working in simulation operations, enjoyed the more generic title of Simulation Technology Specialist. As an active member of the Society for Simulation in Healthcare (SSH), Mr. Young served on the Board of Directors (2013) and the Accreditation Council. He currently serves as Chair of the SSH Certification Committee’s subcommittee overseeing the Certified Healthcare Simulation Operations Specialist (CHSOS) professional certification. Mr. Young is also working on his doctorate (Ed.D.) at TSU in Educational Leadership with a core emphasis in Instructional Technology, and more specifically focused on healthcare simulation in education. In 2014, Mr. Young sought and received the Certified Healthcare Simulation Educator (CHSE) professional certification. Michael began work with Dr. Laura T. Gantt on this book in 2013.
ACKNOWLEDGMENTS
For his exceptional contributions to helping this book take flight, the editors would like to acknowledge John M. Rice, Chair, Government Relations Committee and Past Chair, Technology and Standards Committee for the Society for Simulation in Healthcare.
For her administrative and personal assistance with references and documents for this work, Laura T. Gantt would like to acknowledge Shelby L. Donnelly of East Carolina University College of Nursing.
For their responsiveness to eleventh hour calls for help, suggestions for reference material, and encouragement, we acknowledge the members of the Society for Simulation in Healthcare (SSH) and the International Nurses Association for Clinical Simulation and Learning (INACSL).
1INTRODUCTION
Laura T. Gantt
East Carolina University College of Nursing, Greenville, NC, USA
Readers may recall the terms “digital native” and “digital immigrant” and the year(s) that they first became common vernacular. A digital native is typically one for whom technology has always existed; a digital immigrant, on the other hand, has migrated toward the use of technology out of necessity or a desire to integrate it into their lives (Prensky, 2001, p. 3). In this same way, it seems there are those of us who are simulation immigrants and others who are simulation natives. While I consider myself a native, I stop short of calling myself an expert. My background in emergency and flight nursing means that I have taken every type of certification course, many of which were “simulation based,” long before they were called that. This gave me an unexpected edge in obtaining a position in the healthcare simulation field at a time when incredible financial resources were dedicated to developing simulation labs, even though few people knew much about them.
I did not, however, have an edge in finding the educational resources I needed to build a successful team of professionals for a simulation program in a large nursing college with diverse undergraduate and graduate degrees. Nevertheless, with limited resources, I set about the task of educating myself in healthcare simulation. At first, I attended simulator training and simulation conferences, and read the few books and journals available.
After a few years of blind searching, I got smarter in my hunt for resources. Indeed, in some fields of study, simulation really has been around a very long time. I looked at how other disciplines conducted simulation-based training. This proved to be helpful in determining best practices for teaching with simulation, since other fields, such as aviation and gaming, have overlapping characteristics with healthcare.
However, when it came to training those who had to put it all together in the healthcare simulation lab, I learned the hard way that trying to apply lessons from other fields often does not work. Never was this clearer to me than when I encountered a new employee who could not learn the role or functions of the simulation operator or technologist in the lab. With previous employees, I guess I had been lucky enough to hire people with aptitudes for the work. However, for those who were inclined in the direction of technology, there were simply no journal articles, books, or guides to assist a person who might be struggling with assimilating the knowledge needed for this type of position. When I failed to find the information I needed to help my new hire, I was sure that I must not be looking in the right places yet. I was dismayed.
While I might have been distraught then, I was simultaneously elated and depressed to find that the problem I identified with a lack of resources for training simulation operators and technical staff had been previously well-described. As early as 1985, a National Research Council (NRC) report entitled Human Factors Aspects of Simulation (Jones, Hennessey, & Deutsch, 1985) outlined a number of issues, including the following:
The number of personnel required to support simulators is substantial (p. 22).
Difficulties in design and use of simulators could be reduced with analyses of the human skills and knowledge required for their operation and maintenance (p. 45).
The human operator of a simulator may be able to compensate for simulator shortcomings, but this may result in negative transfer in training (p. 50).
Activities of scenario generation and simulation control need to be described to permit understanding of functional flow (p. 65).
The types of simulators discussed by these authors include those used in aviation, motor vehicles, and nuclear power, but the above list could easily be applied today to patient simulators and those that operate them. While it may be argued that healthcare simulation has existed for several decades, resources have been slow to come along, particularly in the area of healthcare simulation technology. What the NRC wrote in 1985 was true then and, as often seems to be the case, little progress has been made in resolving simulation operator and technologist training across multiple fields.
To understand why the application of work from other fields that use simulation simply does not work when it comes to healthcare simulation may be, in part, because we do not yet fully know what it means exactly to be a simulation technologist or operations specialist. The position titles for this type of work vary wildly between organizations. The work itself involves knowing how to put human patient simulators together and troubleshoot them, how to network and program them, and how to operate them. While the human-to-machine interface is similar to other fields that use simulation, there is a difference with patient simulators that involves a relationship between living humans and patient simulators with a concurrent need for an understanding of proper patient care. In addition, simulation operations specialists (SOS), as I have come to call and know them, must also know what instructors and educators know about objectives and outcomes for varying levels and types of learners. They must know a good deal about the learners themselves and their roles; these learners may, at times, come from different disciplines and must, in the simulation lab and “in real life,” work well together. While most aspects of patient simulation technology may be taught over time, other parts are “art” and require a talent for creativity and vision. A flare for the dramatic and the ability to write a script and then improvise from it are skills not usually associated with healthcare. But a simulation lab is much more than an arena for skills training. Many days, it is more like the production of a complicated play.
In 2013, the Society for Simulation in Healthcare (SSH) leadership voted to approve the name of a new certification for those working in the simulation operations arena: Certified Healthcare Simulation Operations Specialist (CHSOS). This certification was not designed for any one type of position, but is inclusive of many of the evolving roles within healthcare simulation. For the record, the planning and outline for this book predated the CHSOS and the book should not be assumed to be a preparatory book for the exam.
Also in 2013, SSH announced that “Sim Ops” would be the theme for the annual preconference symposium. Both the certification and the symposium are evidence that simulation operations are an important area of specialization within healthcare education, training, and assessment. There are two sides to operations in simulation programs: administration and execution. On the administrative side, operations refer to governance of simulation programs through policy, guidelines, and financials. On the execution side, operations refers to the implementation of tasks as defined by administration and subject matter experts.
For the purposes of this book, the SOS is someone who has advanced knowledge and understanding of the many facets of day-to-day operations within a healthcare simulation lab. Because educators tend to be technologically challenged, the SOS usually has a technology background, but must also be part educator, part engineer, part director, and part artist. The resources that we have at our disposal to train SOS in any of the required realms are slim to none. The titles for the chapters in this book occurred to me over the course of an average month in the clinical simulation laboratory. For example, consider Chapter 8, which is about the fit between the employer and potential SOS. The chapter was originally entitled, “Just Call Me Gumby.” On a routine day in the simulation lab, those who bring the action to life are truly stretched into any number of positions, some flattering and others more compromising. “Sure, just call me Gumby” is the likely response to a faculty or staff question that begins with “Can’t you just………………………” Typically, this blank is filled in by the requestor with something like “fix this?” or “take care of that?” or “help this student?” or “relocate that class and/or piece of equipment?”
The purpose of this book is to help people who specialize in simulation operations figure out how to get started. The book begins with chapters on the current state of the simulation professional workforce and how it has evolved. From there the book moves through topics of interest to those in the simulation workforce related to the art, science, and innovation necessary for the role of the SOS.
Each of the chapter authors for this book was recruited not because they needed to share how to do a job, but because of the innovative work that they have done to develop the role of the SOS. There are a few “how to” simulation books already available. The focus of those has been the educator or instructor role in simulation or simulation center development and leadership. In this book, however, each author was asked to address a topic of interest, some from novice and others from expert perspectives, in which they truly are specialists of the highest degree. Each of these authors has become indispensable because they are doing groundbreaking work that perhaps no one else has even thought of, much less done. The types of simulation professionals who discuss their work in this book have become crucial to the work of healthcare educators and researchers alike.
One colleague of mine feels certain that the day is rapidly coming when those of us at the helms of simulation centers will become unnecessary and obsolete. We were the ones that got the simulators out of the boxes, got everything running, and figured out how to make it all work in the beginning. But we are not the future of healthcare simulation. Our protégés, whether they are educators, engineers, technologists, or managers, have outperformed us and taken it to another level that involves increasing amounts of technical knowledge, creativity, and innovation. They were out of the boxes before the simulators were. For those of us who helped get simulation started in healthcare, our collective job now is to help healthcare simulation progress from its current status by making sure that the next generation comes along with a bigger toolbox than we had.
REFERENCES
Jones, E. R., Hennessey, R. T., & Deutsch, S. (1985).
Human factors aspects of simulation
. Washington, DC: National Academy Press.
Prensky, M. (2001). Digital natives, digital immigrants: Part 1.
On the Horizon, 9
(5), 1–6. 10.1108/10748120110424816
2HEALTHCARE SIMULATION OPERATIONS: BRIDGING THE GAPS
H. Michael Young
Level 3 Healthcare, Mesa, AZ, USA
INTRODUCTION
Use of simulation in healthcare has become pervasive within undergraduate clinical and pre-hospital education, hospital continuing education programs, and in various medical school specialties. Often, clinical and medical faculty are responsible for the day-to-day operations of many simulation programs, typically in addition to their other responsibilities. Today, simulation operations is not just the domain of educators and program administrators, but also of various specialists, with different titles, roles, and responsibilities. A small simulation program will be fortunate to have one fulltime staff member, regardless of specialty, but larger programs will have diverse teams of specialists, especially those working in simulation operations. Nevertheless, simulation operations is still relatively new to many simulation programs that have long held the opinion that operations is the domain of administration. The technology that has emerged within the simulation program has become very sophisticated and complex thus can benefit from the utilization of expertise from a diverse group of professionals, including those inside and outside of the healthcare domain (Alinier, Pozzo, & Shields, 2008; Gantt, 2012, p. 580). The simulation community, in general, has grown and expanded because of enterprising clinical educators who took the lead as early adopters in the use of these simulation technologies known commonly as “patient simulators.” Simulation has long been a part of clinical education, but the advancing complexity and interoperability of today’s technology has advanced a meaningful dialogue about specialized staffing and a need for a broader system perspective (Jones, Hennessy, & Deutsch, 1985, p. 86). Early adopters comprised the initial simulation operations team, and many of these innovators still serve as the first line of support for their respective programs. Recruitment of the simulation operations specialist (SOS) draws primarily from a pool of RNs, EMTs, allied health, and IT professionals (Foster, Sheriff, & Cheney, 2008, p. 141; Society for Simulation in Healthcare [SSH], 2013, p. 10; Vollmer, Mönk, & Heinrichs, 2008, p. 628; Zigmont, Oocumma, Szyld, & Maestre, 2015, p. 551). However, educator workload has often necessitated the creation of additional operational roles. Such roles may include, but are not limited to, simulation technician, simulation specialist, simulation technology specialist, simulation operator, and others (Education Advisory Board [EAB], 2013, p. 25), as well as non-simulation specific roles. Thanks to the introduction of SSH’s Certified Healthcare Simulation Operations Specialist (CHSOS); these roles, and others, are now being organized into a new class of specialist now referred to as the SOS. As simulation technologies continue to become more sophisticated and interoperable, so too has the demand for more specialized staff who have strong backgrounds in information technology (IT), audiovisual (AV) technology, project management, and engineering. Such personnel work alongside their clinical counterparts in their simulation programs and are responsible for coordinating the preparation, maintenance, and implementation of healthcare simulation, also known as simulation operations.
Why Is Simulation Operations Emerging as a Specialty?
New professional roles are emerging as the result of the identification of gaps in the simulation program’s ability to address the demands in clinical and medical education. Such gaps include (i) the rising shortage of faculty (American Association of Colleges of Nursing [AACN], 2015), (ii) increasing demands on the time of faculty, and (iii) a growing need for specialized knowledge, skills, and attributes (or KSAs). The latter relates to the issues around multiple layers of technological systems that must work together; this requires additional expertise, or the sharing of task responsibilities with one or more SOSs in order to achieve both immediate and long-term goals of simulation operations. This chapter will first identify many of the “gaps” emerging out of simulation operations, in general, and suggest ways in which such gaps are “bridged” with the emerging roles now identified as SOSs. “Gaps” in simulation programs can be defined as those recurring challenges that fall outside the expertise of the simulation team members, whether faculty or staff. By distributing tasks among specialized support staff, such as the SOS, subject matter experts are free to focus on those tasks for which they are uniquely qualified.
GAP #1: TECHNOLOGICAL EXPERTISE
SOSs, in general, have made the task of setting up and operating simulators easier for busy fulltime simulation educators and program faculty, freeing them to focus on the scenario design and participant assessment rather than operational logistics. Despite the emergence of the various SOS roles, the technical demands of a simulation program may still exceed the expertise of existing staff (Vollmer et al., 2008, p. 628).
In general, when technological systems fail, who provides timely
