Debriefing. Simulation. Education.

One of the main principles of medical simulation is that deliberate practice is essential. This practice can come in many forms. It can range from simple skills, like practising IV insertion on a plastic limb model, to complex scenarios, like running a multidisciplinary resuscitation.

Simulation is particularly relevant to emergency medicine, where a broad range of skills and knowledge are required. Low frequency, high stakes situations arise in the clinical setting, and the emergency practitioner may not have time to prepare. Both skillsets and knowledge need to be established before the event. Medical simulation allows the emergency medicine provider to prepare for these events adequately.

The goal of the materials provided by the EM Network is to allow practitioners across BC to create and maintain their local simulation programs. On the SIM Cases webpage you will find:

• A bank of simulation cases relevant to emergency medicine practice.
• Information on SIM facilitation and debriefing courses.
• Links to external resources.

The EM Network SIM cases are peer-reviewed and periodically updated. We believe they align with the EM Network vision: Exceptional emergency care. Everywhere. No matter how large or small your health care facility is, you can incorporate medical simulation into your practice. We hope to provide the tools to enable this.

Video Resources

• How to Debrief a Simulation Using PEARLS.

Literature

The Theory of Simulation

• Establishing a safe container for learning in simulation.
  Rudolph, J. W., Raemer, D. B., & Simon, R. (2014). Establishing a safe container for learning in simulation: the role of the presimulation briefing. Simulation in healthcare: journal of the Society for Simulation in Healthcare, 9(6), 339–349.

Strategies

• Promoting Excellence and Reflective Learning in Simulation (PEARLS).
  Eppich, W., & Cheng, A. (2015). Promoting Excellence and Reflective Learning in Simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing. Simulation in healthcare: journal of the Society for Simulation in Healthcare, 10(2), 106–115.
• Reconsidering fidelity in simulation-based training.
  Hamstra, S. J., Brydges, R., Hatala, R., Zendejas, B., & Cook, D. A. (2014). Reconsidering fidelity in simulation-based training. Academic medicine: journal of the Association of American Medical Colleges, 89(3), 387–392.
• Establishing a Safe Container for Learning in Simulation. (Sim Healthcare 9:339–349, 2014)
• Crisis Resource Management. Goldhaber-Fiebert, S., McCowan, K., Harrison, K., Fanning, R., Howard, S., Gaba, D.
• Simulation Pre-Brief Checklist. Allen, J. Skinner, J.

Debriefing

• There’s no such thing as “nonjudgmental” debriefing.
  Rudolph, J. W., Simon, R., Dufresne, R. L., & Raemer, D. B. (2006). There’s no such thing as “nonjudgmental” debriefing: a theory and method for debriefing with good judgment. Simulation in healthcare: journal of the Society for Simulation in Healthcare, 1(1), 49–55. 

PEARLS

• The PEARLS Healthcare Debriefing Tool.
  Bajaj, K., Meguerdichian, M., Thoma, B., Huang, S., Eppich, W., & Cheng, A. (2018). The PEARLS Healthcare Debriefing Tool. Academic medicine: journal of the Association of American Medical Colleges, 93(2), 336. 
• Promoting Excellence and Reflective Learning in Simulation (PEARLS). (Sim Healthcare 10:106–115, 2015)
• PEARLS Scripted Debriefing Tool. Walter Eppich, MD, MEd., Adam Cheng, MD.

EDI

• Equity, Diversity, and Inclusion in Simulation – A Reflexive Tool for Simulation Delivery Teams. SIM-EDI is a tool for SIM team reflexivity. It aims to ensure there is meaningful, non-tokenistic, representation of various groups in existing simulation content. Via The Royal College of Physicians and Surgeons of Canada Ice Blog.
• Recommendations and Guidelines for the Use of Simulation to Address Structural Racism and Implicit Bias. (Sim Healthcare 16:275–284, 2021)

Courses

Simulation Canada – Keystone Apex Training & Certificate 
The Keystones Apex program covers planning, developing, facilitating and debriefing simulation-based learning in healthcare. Keystones Apex courses are online and interactive.

The Debriefing Academy – The Master Debriefer Course
The Master Debriefer Course (Virtual Edition) provides the advanced content, strategies and tools necessary to transform debriefing conversations into vehicles of change within healthcare environments. This immersive 7-week virtual on-line course focuses on improving debriefing skills by weaving through several important elements of debriefing and feedback practice.

Useful Websites

Debrief2Learn
Debrief2Learn aims to improve healthcare outcomes by fostering effective feedback and debriefing practices.

Center for Medical Simulation
Simulation training at CMS gives healthcare providers a new and enlightening perspective on how to handle real medical situations. Through high-fidelity scenarios that simulate genuine crisis management situations, the CMS experience can open new chapters in the level of healthcare quality that participants provide.

Simulation Canada
Simulation Canada (formerly SIM-one and the Canadian Network for Simulation in Healthcare) is Canada’s interprofessional, cross-sector network for the advancement of simulation in healthcare. We are a not-for-profit organization that connects the simulation community, facilities, and resources across Canada and beyond. We advocate for and advance simulated learning in health professions education for the benefit of patient care and safety.

BC Simulation Network
The BC Simulation Network (BCSN) is a community of practice that provides British Columbia’s health care simulation centres, programs and enthusiasts with a forum in which to discuss and advance ideas at the intersection of health professions education, simulation practice, technologies, ongoing competency and delivery of health services.  It provides an opportunity to share resources and align operations in an effort to improve access and use of simulation provincially.

Simulation Literature
Various resource links on amazing academic work that has been done in the simulation world over the years as a foundation to how and why we sim.

Teaching With Simulation Lessons
Are you intimidated by the word “simulation”? Teaching with simulation has gained in popularity due to its positive impact on student outcomes. Our simulation lessons will train you how to teach effectively with simulation. They cover the basics of advanced applications. There are also tools to help you plan your simulations, develop your simulation scenarios, and track students’ outcomes.

EM Sim Cases
Peer-reviewed simulation cases for Emergency Medicine programs available in FOAMed spirit.

UBC CPD Real-Time Virtual Support Education (RTVS)
UBC CPD offers RTVS support for simulations in your community, virtual facilitators to help your community plan and run simulations, and RTVS support for residency simulations.