Episode 18: Same Kind of Different. Dr. Pierre Barker’s Reflections About Progress in Patient Safety

Join us as Dr. Pierre Barker, a recognized expert in healthcare quality, provides vital insights into the current landscape of patient safety as seen through his narrative. In 1999, The US Institute of Medicine report “To Err is Human” revealed sobering data on the loss of life in the US due to medical error. This ignited a call for systematic change and prioritization of patient safety throughout US healthcare and in other countries. But where do we stand today?

Dr. Pierre Barker answers that question for us. He is Chief Scientific Officer at the U.S. Institute for Healthcare Improvement. Offering a global perspective, he attended medical school in South Africa and has practiced pediatrics for more than 30 years in South Africa, the UK, and the US. He has worked extensively with the WHO to improve maternal and newborn outcomes. He is a Clinical Professor of Pediatrics at the University of North Carolina, Chapel Hill. Always optimistic but equally direct, Dr. Barker shares how despite advances, healthcare still faces patient safety challenges as evidenced by gaps between evidence-based care and actual practice.

Episode 17: Drs. Janice Palaganas and David Rodgers, Must-hear Perspectives from IMSH 2024

Two renowned leaders in healthcare education joined us at this year’s International Meeting on Simulation in Healthcare (IMSH). They are Dr. Janice Palaganas and Dr. David Rodgers. Listen as we hear their perspectives on two trending topics. Dr. Palaganas shared what it will take to further advance clinical simulation as teaching method. Dr. Rodgers spoke on the use of artificial intelligence (AI) to augment a simulation program’s talent and resources.

Janice Palaganas, Ph.D., holds positions as a Professor of Interprofessional Studies at Massachusetts General Hospital Institute of Health Professions (MGH IHP) and as an Assistant Professor at Harvard Medical School in the Department of Anesthesia. Her expertise—and her passion—lies in utilizing healthcare simulation for interprofessional education and optimizing simulation outcomes through diverse debriefing methods.

David Rodgers, Ph.D., holds positions at Indiana University (IU), as Director for its Interprofessional Simulation Center in Bloomington and as an assistant professor of clinical medicine in the IU School of Medicine. With over 25 years of experience in simulation, Dr. Rodgers has a wide range of knowledge in sim center operations and educational program development. As a prolific speaker and researcher, his experience in using AI is compelling.

Episode 16: Over A Million Lives Touched. Dr. Singhal’s Neonatal Journey of a Lifetime

Join us as Dr. Nalini Singhal shares highlights of her lifelong journey in revolutionizing neonatal care. A renowned neonatologist and co-developer of the Helping Babies Survive programs, Dr. Singhal's work has trained over a million healthcare professionals worldwide. In this episode, Dr. Singhal discusses topics relevant to all of us in simulation like peer-to-peer learning, clinical outcomes, continuous quality improvement. She also makes it clear; technology is no substitute for helping learners learn.

Dr. Nalini Singhal is a Professor of Pediatrics (neonatology) at the University of Calgary, Calgary, Canada. She is a member of the American Academy of Pediatrics (AAP) Steering Committee for Helping Babies Survive, and a member of the Canadian Neonatal Network (CNN) Governing Board. Dr. Singhal has spent the last 25 years helping to develop and implement simple programs like Essential Newborn Care for the WHO/AAP to help save newborn lives. And her interest in advancing global neonatal outcomes is unparalleled.

Episode 15: ERC and UEFA, A team Lineup that Made the 2023 ERC conference a Winner!

This year's annual European Resuscitation Council conference brought a new and potentially very impactful collaboration: The ERC and the UEFA (Union of European Football Associations). Football, or Soccer, is the world's largest sport, both in terms of active players and spectators. In this special episode from the ERC conference, you will hear more about this unique opportunity for lay provider CPR training to ride on the back of organized football to increase survival from out-of-hospital cardiac arrest, but also learn more about the ERC organization and future plans.

Episode 14: What is the new frontier for patient simulation?

Hear Dr. Barry Isenberg, President-elect of the Society for Simulation in Healthcare (SSH), share how the next stage in the growing importance of patient simulation will be about equating the benefits of simulation to bona fide clinical results.

Dr. Isenberg is the Director of the Gordon Center for Simulation and Innovation in Medical Education at the University of Miami Miller School of Medicine. In this podcast, he presents an overview of some key milestones in the history of patient simulation. He then shows how those milestones and much of what the patient simulation community has learned has left the simulation community poised to take patient simulation to a new level, not only focused on educating learners but on improving patient outcomes.

Episode 13: Are We Bringing Enough Curiosity to How We Approach Simulation?

A “learning organization” is characterized by the value it places on curiosity. Learning organizations pursue an abundance mindset looking at problems as opportunities. In this way, their curiosity fosters experimentation, vision, a commitment to mission, and even a natural sense of optimism and self-confidence. Other organizations may adopt a scarcity mindset, emphasizing command and control, restrictive problem-solving, and avoidance of perceived risk. Curiosity goes untapped.

Hear how one simulation organization put curiosity first and grew to have an international presence in improving patient outcomes. In this podcast, our guests Dr. Vijayanand Jamalpuri and Dr. Vinay Nadkarni introduce, PediSTAR, India’s renowned Pediatric Simulation Training and Research Society. Both doctors share how PediSTAR started out using simulation primarily for research. They had no idea that PediSTAR would soon grow from a small organization motivated by a sense of curiosity to become a world leader in bringing simulation to others with remarkable life-saving results.

Episode 12: How do we assess if a learner can be trusted to care for a human life?

Across healthcare, assessing competency has become a major concern. And it is an awesome responsibility. Schools of nursing and schools of medicine want to ensure that their graduates are prepared to care for patients. Hospitals and other institutions want to grow and develop their staff to become even better care providers. Relying on competency as a sole measure of readiness, however, creates a challenge. Competency is about meeting standardized levels of proficiency. It is not about whether a learner can be trusted to care for a human life without supervision.

In this Part 2 of a two-part series, hear Olle Ten Cate, Phd, outline a simple model for assessing whether a learner is ready to care for a patient autonomously. A pioneer in his field, Dr. Cate is Director of the Center for Research & Development of Education at the University Medical Center Utrecht, the Netherlands. In this podcast he makes a compelling case for assessing Entrustable Professional Activities (EPAs) as a determinant of a learner’s readiness for independent practice. He outlines five critical areas that are foundational to trust that every organization should consider. In Dr. Cate’s words, "Trust is the foundation of medical education. It's not just about acquiring knowledge and skills but also about demonstrating reliability and responsibility."

Episode 11: How much do you trust your learners to perform on their own?

Competency is at the forefront of everyone’s mind in healthcare. There is barely a hospital, school of nursing, or school of medicine that is not concerned with whether their practitioners and/or soon-to-be graduates are suitably competent to deliver safe patient care. But is competency enough to assess a practitioner’s or a learner’s true readiness to fulfill their appointed role? The answer lies in first answering two questions. How much would you trust a learner to perform their role on their own? And, why?

In this Part 1 of a two-part series, Hear Olle Ten Cate, Ph.D., share his expertise in assessing Entrustable Professional Activities (EPAs) and how by focusing on EPAs one can make the process of assessing competency much more powerful. Known throughout the medical education community, Dr. Cate is Director of the Center for Research & Development of Education at the University Medical Center Utrecht, the Netherlands. In this podcast, he explains how competency and EPAs have become critically merged. Competency is about meeting standardized levels of proficiency. EPAs are about assessing if a learner can be trusted to care for a human life without supervision. Listen to how Dr. Cate makes differentiating between competency and EPAs simple.

Episode 10: Do you know what the experts were saying at SESAM ’23?

If you attended this year’s meeting, the Society in Europe for Simulation Applied to Medicine (SESAM), you know that this year’s conference focused on some pivotal shifts in how key experts are looking at patient simulation. If you didn’t attend, you should know what some of those experts said. Not only was this year’s SESAM conference one of the best attended, but it was also notably optimistic about the future of patient simulation. The agenda addressed new directions that patient simulation is taking, directions that are bound to improve the delivery of healthcare globally.

In this special SESAM review, hear our hosts Michael Sautter and Bjorn Egeland speak with SESAM leaders and attendees. Guests included Cristina Diaz Navarro, Associate Dean for Simulation and Clinical Skills Chair of the SESAM; Elsa Søyland, CEO of the Stavanger Acute Medicine Foundation for Education and Research (SAFER); Representatives from the Scottish Emergency Medical Retrieval Service; and several SESAM attendees. All remarked that this year saw an increased emphasis on Competency-Based Education and best practices for learner assessment. But this year’s agenda was also heavily weighted towards the use of simulation as a means for quality improvement. As one of our guests highlighted, simulation is being used increasingly as a forensic tool to better understand risk, identify areas for systems improvement, and improve care delivery. All this spells a new future for simulation.

Episode 9: Are Simulation Specialists in Hospitals Speaking the Right Language?

If you are leading patient simulation efforts in hospitals, are you pursuing an education paradigm or are you pursuing what hospitals seek—a performance improvement paradigm? Education speaks a uniquely different "language" from the world of hospitals. Education focuses on imparting the knowledge and skills necessary for a nurse, doctor, or other healthcare worker to demonstrate a foundational level of competency. Hospitals focus on translating that competency into better care quality, patient safety, and operational efficiency. Certainly, hospitals expect their staff to embrace continuing education. But a hospital's language is ultimately about performance improvement.

Hear Paul Phrampus, MD, share his experience in using simulation to improve performance and patient outcomes at a hospital system that includes 40 hospitals in the U.S. and overseas. Respected in simulation globally, Dr. Phrampus is the Director of the Winter Institute for Simulation, Education, and Research (WISER), and is a professor in the Departments of Emergency Medicine and Anesthesiology at the University of Pittsburgh School of Medicine. In this podcast he explains in sensible real-world terms why simulation specialists in hospitals must learn to speak a vernacular based on their institution's "daily operational realities of practical care." In his words, for simulationist in hospitals to succeed, their dialogue must be "about creating solutions for institutional problems - not how do we wow people with better education."

Episode 8: Do We Risk Missing the Simulation Lessons We Learned during COVID?

For those in Hospitals who led simulation-based training, the COVID pandemic posed a continually changing array of training priorities. Those priorities began with donning and doffing PPE but quickly evolved to managing patients in isolation, difficult airway management, respiratory therapy, and the need to deliver emergency interventions across departments that were not prepared for the new pace at which care had to be delivered.

Hear Libby Thomas, PhD, share how she and others in England’s health system used simulation to keep ahead of changing training needs during the pandemic. Dr. Thomas is an Emergency Medicine Consultant at Kings College Hospital and Senior Lecturer in Emergency Medicine at Queen Mary University, London. As she explains, each day during the pandemic was a “blank canvas” with new problems to solve and new people to train. Much of the solution reflected a “train the trainer” paradigm that became essential to empowering new groups to problem-solve and dominate in their efforts to save lives.

The Use of Simulation to Prepare and Improve Responses (PDF)

Understanding Moral Injury (Video)

Episode 7: Do Midwives Hold The Key to Better Maternal Outcomes?

An estimated 295,000 women worldwide die annually due to childbirth. And there are concerning trends in areas like the United States where maternal mortality rates are on the rise. Care under the supervision of a midwife has often been associated with better outcomes, and so the question becomes why.

Hear Sally Pairman, MD, Chief Executive for the International Confederation of Midwives, share how much of the answer is rooted in how we look at birth. Birth, as she puts it, is a physiological process requiring wholistic facilitation from beginning to end. All too often birth is treated like a pathologic process where the treatment resembles treating an illness. As Dr. Pairman exclaims, it’s not illness. It’s health!

Episode 6: Is the “minute spirit” in stroke care enough?

The Helsinki Stroke Model confirmed that stroke patient outcomes can be improved through rapid diagnosis, treatment, and efficient transfer of patients to stroke specialists. Lives have been saved through this model and a resulting sense of esprit in the stroke care community often called the “minute spirit”.

Hear Martin Kurz, MD, a Neurologist at Stavanger University Hospital and President of the Norwegian Stroke Association, share how the minute spirit is not enough. He and his colleagues applied a simulation-based continuous improvement program to the Helsinki model and achieved a record-breaking median 13-minute door-to-needle time!

Episode 5: How Can You Make Time for Clinical Simulation?

Finding the time to conduct clinical simulation in healthcare is a universal challenge. Simulation training is often viewed as time away from patients. In what might be called an “ultimate simulation challenge,” the birthing unit of one hospital went from providing 700 to 8,500 simulations for its midwives over one year. And it improved outcomes for its nearly 5,000 deliveries annually.

Listen to May Sissel Vadla, MD, a specialist in public health and PhD fellow at the University of Stavanger, talk about how she used coaches, competitions, daily training, and automatic feedback to achieve these breakthrough results.

Episode 4: Why is Kangaroo Care Important?

There has been a global call for Immediate Kangaroo Mother Care which has been described as a lifeline for newborns, especially for ill or premature babies. Kangaroo Care has often been disregarded, as healthcare focuses on higher technology to help babies survive. And yet immediate Kangaroo Mother Care has been proven to reduce mortality rates by 25%.

Listen to Siren Rettedal, MD, a neonatologist talk about how Kangaroo Mother Care saves lives and why it should be part of neonatal simulation training, whether higher technology is involved or not.

Episode 3: Does Patient Simulation Work?

Evidence shows that simulation-based training works. But there is always a human element involved. And so, the real question becomes what features in simulation-based training can make simulation effective? There are fundamentals that are essential for success.

Ross Scalese, MD, is an expert on simulation fundamentals. He is a Professor of Medicine and Director of Educational Technology Development at the Gordon Center, University of Miami Miller School of Medicine. Here are insights into what makes patient simulation successful.

Episode 2: Can Patient Simulation be used for Continuous Improvement?

Patient simulation is most typically used as a means for educating and training individuals and teams. Many institutions, however, are now using simulation to continuously improve systems. This can lead to improved patient safety, care efficiency, and systems improvement breakthroughs.

Victoria Brazil, MD is an emergency physician and educator at the Emergency Department of the Gold Coast Health Service, Australia. Hear her share how simulation can lead to system-wide gains.

Episode 1: What is the future of OSCEs?

The Objective Structured Clinical Exam (OSCE) has been a standard for assessing student performance in healthcare education. The COVID-19 Pandemic, however, forced many institutions to change their traditional approach to OSCEs.

Often considered the father of the OSCE, listen to Ronald M. Harden, MD, OBE, make the case that the OSCE is still relevant despite a changing educational context.