On April 17, as part of Medical Alumni Weekend, Benny Joyner, MD, MPH, clinical director of the UNC Clinical Skills and Public Simulation Center (CSPSC) and PICU Division Chief, shared recent dynamic simulation methodologies and teaching strategies currently utilized in the UNC School of Medicine with the Medical Alumni Council and National Loyalty Fund Committee. For the UNC Health Care article, click here.
Below is a summary of the event by Dr Kellish.
Cutting the cord with telesimulation
by Ashley Amorello Kellish, RN, DNP, CCNS, CCRN | Clinical Nurse Education Specialist, N.C. Children’s Hospital
On Friday, April 17th, Dr. Benny Joyner, Clinical Director of the CSPSC and PICU Division Chief, shared recent dynamic simulation methodologies and teaching strategies currently underway in the UNC School of Medicine with the Medical Alumni Council and National Loyalty Fund Committee.
During the presentation, Joyner gave the Council an overview of simulation techniques utilized at UNC School of Medicine. Examples included the use of standardized patients for student Objective Structured Clinical Examination (OSCE) experiences as well as the use of skill-based task trainers and mannequin based simulations. A recent example of this includes the MS1 session lead by Dr. Madanick in the Gastrointestinal (GI) learning block.
UNC School of Medicine and UNC Healthcare has a 30+ year rich history in the utilization of simulation techniques and methodologies. The presentation honed in on how simulation mirrors adult learning theory and can truly aid in educating our medical students at all levels. Recent publications from around the medical campus in the last year were shared in order to show simulation’s ability to touch a wide audience in a beneficial way.
Joyner really showcased a new use of simulation when he led a live “telesimulation” during the presentation. Situated in the Carolina Inn, he was able to remotely teach learners located across campus at the Clinical Skills and Patient Simulation Center (CSPSC). Telesimulation is a technique that allows faculty at UNC School of Medicine and UNC Healthcare to provide training to students and other staff located in critical access areas where many students train. This idea of being able to provide high level education while overcoming both space and geography barriers is extremely exciting to all involved!
Following the presentation, Joyner used a simple audio and video connection to the CSPSC utilizing the new CAE LearningSpaces recording system (center screen in the image). A team of learners was available in the CSPSC to evaluate a Laerdal SimBaby mannequin. The first learner evaluated the patient that was a six month old male infant with history of “flu-like” symptoms two weeks ago who presented to Emergency Department (ED) after decreased appetite and respiratory distress. The chest X-ray in the ED demonstrated cardiomegaly or an enlarged heart. The infant was admitted to Pediatric Intensive Care Unit (PICU) for observation secondary to concern for cardiomyopathy or disease of the heart.
While the patient was being evaluated, Joyner asked the Council members if they wanted to have the team treat a cardiac arrest with either a Ventricular Tachycardia or Ventricular Fibrillation EKG rhythm. The Council selected Ventricular Tachycardia and the patient state was changed (the right screen in the image is the simulator control computer). Once help was requested and arrived at the bedside, the learners coordinated their efforts to resuscitate the SimBaby. Joyner then questioned the Council members on how long the activity should go on before resolution. For these rhythms, Joyner planned for the patient to recover with a defibrillation or shock to the heart. Given the limited time of the presentation, Council members chose to have the patient return to a normal rhythm after two shocks from the defibrillator. Joyner then lead the team through the most important part of all- a focused debrief of their teamwork and clinical decision making.
Following the telesimulation, Joyner introduced a new resource built to facilitate collaborations in simulation throughout campus: a brand new website! This new website is designed for aggregating all the simulation news, resources, and efforts in one place. It is the Joyner and his team’s hope that this information, now readily available can align the use of shared resources on campus and also dramatically increase simulation offerings; programs currently lacking resources can go to one place to be able to search, share, and see how simulation can improve their practices.
Joyner, Clinical Director of the CSPSC and PICU Division Chief, was assisted at the Carolina Inn by the CSPSC Director Mrs Julie Messina and Associate Director of Simulation Mr Gene Hobbs. The team of learners at the center included Pediatric Chief Resident Dr Mark Connelly, Pediatric Critical Care Fellow and UNC Medical Alumni Dr Meg Kihlstrom, and CSPSC Assistant Director Mr Brian Loveland as well as CSPSC Technical Support Analyst Mr Jackson Szeto providing support for the technology they utilized. Overall, Dr. Joyner was really able to share his passion for simulation as a mode of teaching and show how learners can truly benefit from the available resources all over campus!