The Association for Simulated Practice in Healthcare (ASPiH) held their annual conference on the 19th, 20th and 21st of November last year at the stunning Majestic Hotel in Harrogate. ASPiH is a new organisation formed in 2009, with the aim of sharing knowledge, skills, and expertise in the use of simulation. The theme of the conference this year was “Valuing Safe Professional Practice”, a theme well suited to the current climate of the National Health Service.
For the first time in ASPiH history, students were invited to present their innovative ideas on how healthcare could be improved with the use of simulation. With the support of the Department of Neurology, University Hospital of Wales, Cardiff, and the ASPiH Travel Bursary, we set out to learn and network with others from various professional backgrounds and to look out for current developments in simulation that may be suitable for application in the area of neurology and neurorehabilitation.
The main conference programme began with a keynote address by Professor Ieuan Ellis, Dean of the Leeds Metropolitan University, entitled “Real Health Challenges-simulated learning solutions”. He challenged the audience to train healthcare professionals to provide good quality healthcare. He put forward ideas about the role of simulation in healthcare education, emphasising the need for innovative ideas that would engage students to encourage learning.
In fact, we learned later that it was Dr Howard S Burrows, a neurologist from the University of Southern California (USC), who pioneered the concept of simulation in healthcare 50 years ago. He used actors to simulate patients with various medical conditions to teach medical students. Although initially met with remarks such as “Hollywood invading USC”, simulation has become an accepted part of modern medical education.
Following that, we (two final-year medical students) attended some of the workshops and presentations that ran in parallel throughout the two days.
One of note was “The use of vertebrate haptic feedback for cognitive behavioural change when moving and handling”. A harness with sensors which monitored the position of the spine was worn by healthcare professionals to ensure that they maintained a “neutral spine” position when moving and handling patients, to prevent musculoskeletal back injuries. The harness would produce haptic feedback to the wearer to warn him/her when deviating from the “neutral spine” position. The potential of the invention in neurorehabilitation was discussed especially for patients with spinal injuries relearning how to mobilise.
Another workshop was based on the theme of social media use within healthcare. With its ever expanding usage, social media has inevitably become an important factor in healthcare for both professionals and patients in the field of research, organisational and administrative work, and of course outright entertainment (good or bad). However, the workshop really got us thinking about how social media may have a role in the rehabilitation and treatment of patients. In neurology specifically, social media may be a tool for mildly dysphasic or dysarthric patients to communicate with other sufferers, without having to face the challenge of real-time face-to-face conversation.
It was also interesting to see exhibitions of relatively simple inventions that have or will contribute to simulation-based training. These included a gelatin-based model for pericardiocentesis which can be scanned with ultrasound, mannequins for laparoscopic surgery, and the use of animal tissue (pork belly) to resemble skin.
The first day ended with a keynote address by Dr Barry Issenburg, a leader in the field of simulation in healthcare, entitled “Achieving and Demonstrating Optimal Value from Simulation in Healthcare”. He highlighted the factors that determine the effectiveness of simulated learning. Interestingly, although research has continually supported the use of simulation in medical education in the United States of America, when applied in a similar manner in Korean Universities the outcome was different as a result of cultural differences, staffing levels, and working conditions.
On the following day, students from various healthcare courses such as medicine and nursing presented their innovations in the hope of attracting interest and constructive feedback. We presented the concept of the “Compass Mentis©”, a hand-held device which helps students simulate the necessary thought processes required to generate detailed and relevant differential diagnoses. Other student innovations include a mobile application to monitor ward activity, narrated videos for clinical examination, and patient stories using audiovisual clips to illustrate the patient perspective.
Later, Sir Stephen Moss spoke over lunch about the importance of maintaining quality in healthcare. He spoke about the importance of supporting frontline healthcare workers and valuing the “human impact” on patient care. His talk, which revealed the shortcomings described in the Francis report served as a reminder of the tragic consequences of complacency.
In the afternoon, we participated in a workshop entitled “Prioritising the Acute Medical Take using simulation”. Participants including doctors, nurses and medical students were challenged with prioritising a list of patients with acute medical and surgical conditions. The different reasons for prioritising became apparent in the discussion and facilitation during the workshop. Prioritisation which integrates and acknowledges human factors and medical aspects may be relevant to the planning of rehabilitation programs which often involve complexity and collaboration between doctors, physiotherapists, nursing staff, and the patients themselves.
The event concluded with closing remarks and prize giving to the winners of the workshop, oral and poster presentations.
All in all, the conference brought together healthcare professionals involved in simulation to share their ideas and work together towards improving patient care. The atmosphere was one of “a can-do-but-rehearse-it-first spirit” unstifled by hierarchy and fueled with the enthusiasm of creative minds. The limitless possibilities of simulation in healthcare for the assimilation of medical knowledge and its application in real clinical practice was an eye-opener.
A conference about simulation in medicine is not the stuff of coffee-table discussion, and funded study leave is in short supply but we would recommend this conference for the opportunities it provides to develop new ideas and to see how useful simulation can be in training. Would we go again? Yes.
Acknowledgements: We would like to thank Dr. Tom Hughes for his advice and support in writing this report. Our attendance in this conference would not have been possible without the support of the ASPiH Travel Bursary and the Department of Neurology, University Hospital Wales.
ACNR. Published online 3/4/14.