Traditional Poster Round
Background: : Simulation is a proven method for effective medical education(1), yet it is currently under-utilized as a didactic tool in Southwest Alaska where providers have a broad scope of practice in a geographically remote setting. A previously conducted needs-assessment demonstrated that this population desires simulation to practice teamwork/communication skills and pediatric respiratory distress scenarios(2). This inspired us to develop a low-fidelity simulation curriculum designed to address these specific learning objectives(3).
Research Question: : Is a simulation program feasible in this geographically remote community hospital in Southwest Alaska?
Methodology: : Participants included Community Health Practitioners (8 total), Nurses (15 total) and Emergency Room technicians (2 total). We designed a survey to assess participant perceptions of the utility and feasibility of the activity specifically looking at feasibility domains of acceptability, demand, practicality and implementation. Surveys were administered to our participants after they took part in the simulation curriculum. Institutional leaders (7 total) were identified and interviewed as “key informants” regarding their perceptions of the feasibility of a simulation program in the domains of acceptability, demand and practicality. Preliminary descriptive data analysis has been completed for the qualitative responses. The simulations followed by surveys are on-going, as is an iterative approach to the qualitative data analysis searching for sufficiency of overarching themes. IRB granted for the study by Seattle Children’s Hospital and Yukon-Kuskokwim Health Corporation (YKHC).
Results: : Key informants:
Community Health Aides:
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Discussion/Conclusions: : Simulation is feasible – in the realms of acceptability, demand, implementation and practicality - in this geographically remote hospital in Southwest Alaska, according to key informant leaders and simulation participants. Acceptability themes include: the potential to enhance confidence, competence, efficiency, and standardize care with potential to thereby improve patient care and quality. There is demand given the high staff turnover rate, with simulation acknowledged as a tool to standardize care. In terms of the practicality, participants highlighted that they enjoyed the simulations and would be more likely to attend if future simulations were held during their standard work day and if the simulations were brought to them where they work (opposed to a separate training center). Key-informants highlight the need for institutional buy-in and the need for a champion(s) with protected professional time to facilitate the simulations. Barriers to implementation include limited resources of time, schedules, money, and simulation equipment. This study is limited by the small sample size.
Next steps are to continue running the simulations through the upcoming calendar year with this population and continue the qualitative data collection and analysis. In addition, outside simulation experts will train local staff in simulation facilitation, with the intention to develop a sustainable simulation program in the region.