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Withdrawn 11 August 2010

Plenary Session 1 - Are we all together yet?

Cate McIntosh - Opening remarks
Stewart Dunn / Paul Heinrich - 

Plenary Session 2 - Simulation on a large scale – a national and international update

Mark Cormack - Developing a national approach to clinical education: embedding a distributed simulation program
Mary Patterson - An international perspective - Accreditation and Certification of Simulation in Healthcare Programs

Chair: Brendan Flanagan

Panel: Nigel Lyons
Michael Seropian
Maggie Nicol
Patrick Crookes

107 Teaching clinical skills; why bother?

Michael Seropian: where to invest in simulation

109 To Infinity and Beyond in a SimVan

Meryl Altree: The Simulated Surgical Skills Program Mobile Simulation Unit (MSU)

49 Defining and assessing surgical competency: a systematic review

92 Can Virtual Reality Temporal Bone Simulator be used as a teaching aid to improve cadaver temporal bone dissection

10 Blending digital technology to enhance reflection and Continuous Professional Development (CPD) using simulation, podcasts and the Pebblepad e-portfolio

47 Simulated, stimulated and self efficacy measures: a pilot project evaluating the use of stimulus video clips in midwifery education

101 Interfacing the METI Emergency Care Simulator with Philips IntelliVue patient monitors

85 Size, shape and body scan data to improve biofidelity of patient simulators

53 Application and evaluation of a principled approach to designing realistic haptic drilling interaction in surgical simulators

16 Developing and evaluating an instrument to measure teamwork in healthcare

65 Predicting surgeons’ technical competence from NOTSS behaviour ratings

70 The use of communication probes to track information sharing within a team as an objective measure of team-working skills

87 Accuracy Of Assessment Of Team Performance By Team Members In Simulated Intensive Care Crises

Tracey Marshall: Wheezy way of learning

102 The use of Simulation for Cue-Based Learning of Diagnostic Expertise - Are We Teaching the Wrong Cues?

14 The Accuracy of Clinical Assessments made by Neonatal Resuscitation Team Leaders in Simulated Scenarios

Chair: Stuart Marshall

I Simon Cooper

21 Empowering the RNs of tomorrow – pre and post simulation analysis of clinical skill parameters related to deteriorating patients

74 Development of a Course for Patient Safety with Integration of Story-Telling and Simulation to Promote Rapid Response in Pediatric Wards

Chair: Brian Robinson

Panel: John Shatzer, Brian Jolly and Dan Raemer

38 Use of simulation tools for assessment and skill development during a two-day post-graduate course on manual therapy skills

76 "Undertaking an Evaluation of Learning through Observational Simulation, using Kirkpatrick’s Model."

106 Open Disclosure (OD), medication error, medical simulation and debriefing - Research in progress

Plenary Session 5: Chair Marcus Watson

1. Jeffrey Cooper - Teamwork in healthcare and among simulation professionals: Do you practice what you preach?
2. René Amalberti - Four steps and four challenges for making healthcare safer

1. A/Prof. Dan Raemer - Research Using Simulation as a Laboratory Technique: A Current Challenge
2. Dr Cate McIntosh - Closing Remarks

This session illustrates these problems with concrete examples and suggests a series of simple solutions, including the use of simulations, manageable at ward and general practice level.

• Develop good ideas for patient safety
• Develop better safety measurement
• Develop scenarios based on the solutions developed in the workshop that may be useful in training people
• Design more effective safety recommendations
• Learn to manage crisis conditions in wards and offices that threaten safety, such as distractions and production pressure

The 'pause and discuss' technique, as compared to video assisted debriefing, is particularly suited to novice learners in that it provides a forum where the presence of the facilitator can provide a degree of psychological safety and support for the learner. 

'Pause and discuss' scenarios are also less resource intensive and do not require the use of video to stimulate discussion. This potentially makes the 'pause and discuss' technique a more viable option to clinical educators who do not have access to large scale resources. An added bonus is that the technique is very portable allowing simulation scenarios to be conducted in a variety of clinical and non-clinical settings. 

This workshop will allow participants to practice facilitator-led discussion techniques to explore the learners' situational awareness, stimulate 'reflection-in-action' and develop clinical reasoning skills.

• Advantages and disadvantages of using simulation (briefly - also addressed in plenary session)
• Getting clinical skills into the curriculum
• Managing large numbers of students
• Deciding what to teach and when
• Using simulation for assessment of learning

The use of SP enables simulation to go beyond skills based education and to encompass a more holistic approach to the learning experience.

Reference: Barrows, H. (1987). (Standardized) Patients and other Human Simulations. Retrieved December 22, 2008 from Association of Standarized Patient Educators at www.aspeducators.org/sp_info.htm

• Demonstrate how to develop templates for creating scenario based improvisation scripts to guide actors and SP in the simulation environment.
• Outline techniques for facilitators to work/direct actors and the SP to define the parameters and action of the scene to be improvised.
• Provide facilitators with technical skills to undertake pre and post production management processes.
• Provide direction on design and production requirements to ensure the illusion of reality is maintained.

The aim of this session is to give you new ideas, tools and techniques to put to work to make your simulation efforts more successful. 

The session will include story-telling and discussion around examples of success and failure in the effective uses of simulation from the speaker and the audience. The audience will be asked to explore their own successes and failures in using simulation and what they learned from them.

1. Describe how simulation can be used as a patient safety tool
2. Develop effective communication strategies & tactics to engage clinicians and managers in conversations about safety
3. Identify at least one area of improvement for their own leadership or teaching style or safety behaviour and how they will actually alter it.

• Patient safety 
• Leadership 
• Self improvement 
• Behaviour change

1. Participants will learn about the elements and topics that are most important when writing a proposal for management.
2. How do you develop a project time line?
3. What kind of design plan is required?
4. What sort of equipment selection criteria is important?

The workshop will investigate the program as a whole and the individual parts of a program and how they blend together to odder an educationally sound learning activity. 

By the end of this workshop, participants should be able to:

• Demonstrate an understanding of the relevance of some common teaching and learning theories to simulation training
• Design and develop an idea for a program into a sequential program
• Design and develop individual learning experiences that utilize simulation as part of an overall program
• Identify many of the pitfalls of designing a simulation based education program

• Educational understanding of simulation 
• Learning preferences 
• Learning theory 
• Stages to course development 
• Scenario writing

• Simulation instructors 
• Clinical educators 
• Health educators

This workshop focuses on the difficult task of breaking bad news to patients. The presenters of this workshop will share their extensive experience of teaching health professionals to BBN to patients with the use of highly interactive methods and actors. 

In addition they will describe research findings which identify different styles of BBN and the impact these varied styles has on the person delivering the news. The workshop is very interactive. Participants will observe example videos from the research and experience the simulation first-hand with a professional actor. They will contribute ideas on incorporating these findings to provide a more evidence-based approach to teaching skills like BBN.

• Teaching & learning with standardized patients
• Effective use of stress in difficult communications
• Research in simulations
• Communication skills

• Medical and nursing teachers
• Simulation trainers
• Researchers

1. Jennifer Keast
2. Mary Patterson
3. Dan Raemer
4. Dylan Campher
5. Cobie Rudd

A large panel of international and National experts in the field will be there to answer your questions and give their views on this important area.

1. Patrick Crookes
2. Nigel Lyons
3. Michael Seropian
4. Marcus Watson
5. Andrew Smith
6. Nigel Chong
7. Cobie Rudd

Some have described partnership as the "suppression of mutual loathing in pursuit of government money" (attributed to Ivan Lewis MP, Parliamentary Under Secretary of State for Care Services, 15 June 2006, in a speech to the NHS Confederation). 

Through an onstage simulation, we will explore the following issues:

1. Who should lead a partnership or collaboration and how is this decided?
2. What are some of the issues that arise when collaborations are formed?
3. What are the decision-making processes within collaborations?

Evidence on the effectiveness of educational initiatives is often limited to participant satisfaction. Ideally we should be measuring change in workplace behaviours and improved outcomes. While this is possible to do in a simulated learning environment, observation of workplace performance to evaluate change in behaviour is problematic. One approach is to seek concrete examples from the learners on actual changes they have made to their practice subsequent to an intervention. 

Have you changed your GENERIC safety behaviours, i.e., changed some behaviours without having had to have the real, specific event? How do we get people to do the equivalent of putting on seat belts and doing REALLY good teamwork without hurt or getting hurt first? Aims and learning objectives 

The purpose of this workshop is to identify factors that can be learnt in simulated learning environments that have a powerful effect on behaviour and performance. From this exploration, participants will have an opportunity to share important lessons, and to share how these were learnt, and therefore how they could be taught to others. 

Format: We will begin by an exploration of participants' own experiences that changed their practice following exposure to simulated learning environments. We will explore the evidence on effectiveness of simulation-based educational interventions from the literature, from our own experience and that of our colleagues. Themes will be brought together to guide recommendations for education and research in simulation-based interventions to improve practice. 

Target group: Audience size maximum ~20. 

Participants should have an interest in patient safety, cognition and/or teamwork, and have experience as teachers and/or learners in simulated learning environments.

Format of Session and Outline of Intended Activities: 

Introduction - methodologies for developing scenario-based role plays in a virtual world environment 

Demonstration - video of scenario-based role plays pertinent to health issues 

Setting the scope of the scenario - the whole group the back ground and possible outcomes for the scenario will be set 

Group work - each group will be assigned a character role, the group will be responsible for outlining the background of the character, influencing factors, social background, needs and desires, ethical values, and any external factors influencing factors 

Performing the scenarios - each group will select a member to perform the character they have constructed. The scenario will be performed in a virtual environment, with the rest of the group watching and listening the performance from the projected image. 

Debriefing - The group will participate in a debriefing session about the process of writing scenario-based role plays and the scenario that was performed. Debriefing will highlight the communication skills and ethical values that were demonstrated in the performance. 

Questions - The workshop will finish will a question time and an evaluation about the workshop. 

Aims and leaning objectives: The aims of this session it to:

• Introduce health professionals to scenario-based role play construction in a virtual world environment.
• Give the participant a chance to experience an online methodology in practice using an online teaching model.
• Allow participants to develop basic scenario building skills. 

Target group: Health professionals who are required to communicate with others, no prior experience necessary.

Reference:

1. Garrison, R., Anderson, T., & Archer, W. (2000). Critical inquiry in a text-based environment: Computer conferencing in higher education. The Internet and Higher Education, 2(2-3), 87-105.

Like other aspects of trauma and emergency care, simulation training provides an opportunity to rehearse challenging clinical situations. It is enhanced by realistic moulage but this may be neglected if educators lack knowledge of moulage techniques and materials. The presenters have developed a method of moulage for escharotomy skin which realistically replicates all the visual cues encountered when performing an echarotomy in a clinical situation. 

This workshop will provide participants with an interactive learning experience in the construction of a realistic mannequin skin for a child with full thickness circumferential burns to the chest. The techniques they learn from this workshop will enable them to reproduce the burns skin in their own workplace. By exposing staff to this challenging situation we hope to provide participates with not only the technical knowledge they may require but also the mental strength to cope with such a difficult event. 

Although this simulated skin was developed for a paediatric mannequin the technique can easily be modified and applied to an adult mannequin. 

Target audience: This workshop is intended for not only people already working in the field of medical simulation such as simulation coordinators, nurse educators and instructors but also medical staff whose centres would benefit from exposing their staff to such a realistic and confronting simulation. 

Experience level: This workshop can be attended by anyone interested in medical simulation ranging from the complete novice to experts in the field wishing to learn new techniques.

Outline: 

Suitable for: All participants interested in:

1. Improving debriefing skills
2. Conducting research into debriefing 

Expertise level: Some experience with debriefing desirable but not essential 

Maximum participants: No maximum

Description: The workshop will start with a brief overview of eportfolios in medical education. Personal development planning (PDP), reflection and multisource feedback (MSF) are increasingly being used for registration and revalidation. During this time attendees with laptops will be given PebblePad eportfolio accounts. 

The hands-on element of the workshop will focus on demonstration of eportfolio tools to capture evidence of learning, capability and confidence and to scaffold reflection. Whilst we will be using PebblePad, the lessons are applicable to any eportfolio. Attendees who bring their own laptop will be given a demonstration PebblePad account and access to several example forms and profiles. 

Target audience: This workshop is aimed at those who design or deliver training courses, assess competency and those responsible for investigating new technologies. Those interested in certification of health simulation professionals are encouraged to attend. 

Experience level: This workshop can be attended by anyone interested in effective training, ranging from the complete novice to experts in the field wishing to learn new techniques.

A major challenge for both foundation healthcare training and continuing professional development is transferring what has been leaned through simulation into clinical practice. 

Resuscitation training: There have been several reports from Australia, the US and Europe, of many new medical graduates not having the competence or confidence to manage clinical emergencies. Acute care knowledge and skills were taught in the Flinders curriculum but anecdotal feedback from local hospitals indicated that some of our students were not work ready. 

Clearly we needed to ensure that all our students were appropriately prepared for the workplace and able to care for patients who are seriously ill. The Flinders GEMP (Graduate-entry Medical Program) students are taught at several locations throughout South Australia and Northern Territory. Some may not physically attend the main campus for a whole year. In the final year of the GEMP (Year 4), students can be studying anywhere in the world. The assessment process for this would have to be comprehensive yet efficient and show they were competent life support providers equipped to be life-long learners. This included showing they could identify their own learning needs and actively seek out opportunities to improve knowledge and skills as well as demonstrate they could provide emergency care safely and effectively when required. 

Traditionally, medical education has focused on the fundamentals of medical knowledge with most clinical training taking place after graduation. Medical assessment has until quite recently relied mostly on knowledge displayed through written examinations and a small number of highly structured and brief clinical skills examinations. An aggregate pass mark set by university policy meant that we could not be sure that any particular student actually had all the essential clinical skills and knowledge. For example, Basic Life Support (BLS) and Advanced Life Support (ALS) are essential clinical skills. They are included in the curriculum but teaching was fragmented and assessment was inconsistent. Content of BLS and ALS courses is recommended by peak resuscitation organisations but it is generic with teaching recommended as a single block. Learning from such courses has been shown to be poorly retained. 

We investigated educational technologies that could usefully contribute to both documenting student achievement and becoming a competent and reflective practitioner. It quickly became clear that an eportfolio would be ideal but we could not find an existing model of this for acute clinical care. The usual approach to managing a perceived knowledge gap is to introduce more teaching or a new course. Our initiative has been to give students a means to collate and connect information. (see figure 1 below) 

We have provided a set of webfolios, forms and profiles that provide a scaffolding that students can use to organise their BLS/ALS learning. After each training session, students are encouraged to reflect on concepts covered by completing a form specific to that session. Video recordings are made available to students to use as evidence of their performance. Throughout their medical education, students are encouraged to update their self-assessed Life Support skills profile and seek out opportunities for learning in these areas. Upon completion of the GEMP, students have an eportfolio with numerous reflections on simulated and real medical emergencies and evidence to demonstrate their competence in the form of video and 360° feedback. 

Stakeholders in the Flinders 'Life Support Provider' initiative:

• The University provided seed funding for a pilot study through a Teaching and Learning Innovation Grant in 2007.
• The GEMP Course Committee and Executive needed to approve the proposed change in assessment. Some of their members were aware of eportfolio use in UK medical schools and were very supportive. Using an eportfolio for logging activities and evidencing achievement over time and planning further study for performance improvement is very sound educationally.
• Student engagement for the pilot was initially obtained through an information session and word of mouth. The Life Support eportfolio is now a part of the 'Doctor and Patient Theme' of the GEMP.
• National and international peak resuscitation organisations have not been engaged yet. 

These bodies can approve specific BLS and ALS courses but this eportfolio-based accreditation of Life Support Providers is a significant departure from what they currently recommend. 

Figure 1 Screen grab from the Flinders Life Support ePortfolio showing part of the skill set of section 4: Advanced Life Support. Users can move through the profile using the navigation buttons. The self-rating scale is shown on every page. A wide range of evidence of knowledge and skills can be added, eg description of a clinical event (real or simulated), personal reflection, feedback from a supervisor, video of a simulated emergency, scan of an ECG, comments by a colleague, etc, etc. 

ePortfolio training: The hands-on element of the workshop will focus on demonstration of eportfolio tools to capture evidence of learning, capability and confidence and to scaffold reflection. Whilst we will be using PebblePad, the lessons are applicable to any eportfolio. Attendees who bring their own laptop will be given a demonstration PebblePad account and access to several example forms and profiles. 

The eportfolio can be used to inform students of the explicit curriculum and minimum requirements but it also allows students to demonstrate superior performance and the pursuit of excellence.

Target audience / Experience level: This workshop is aimed at new and current reviewers, but is also equally relevant for potential authors. 

Outcomes: Participants who attend will gain a better understanding of expectations for:

1. Reviews in general
2. Reviews of different types of papers
3. Feedback to authors and editors. 

Potential authors who attend will gain a better understanding of what reviewers expect in a manuscript and what typical problems to avoid. Reviewers who attend will not only gain a better understanding of the expectations of authors and the editors, but will learn how to write better papers themselves.

• To discuss innovative techniques in obstetric simulation
• To describe simulation based nursing and midwifery research
• To simulate maternal deterioration using a simulated patient and a pregnancy suit (demonstration)
• Prepare equipment and simulated patients for obstetric simulation
• Develop and run a scenario using applicable roles (e.g. scenario lead and candidate) 

Rationale: Obstetric simulation based research has been used to address issues related to teamwork [1], team performance [2,3], the identification of clinical errors [4], the reduction of clinical risks [5] and the improvement of clinical outcomes [6]. Simulation has been found to improve midwifery and obstetric students' decision making and confidence [7], whilst simulated vaginal breech delivery has been shown to enhance medical residences' performance [8]. However, Ellis et al [9] concluded that neither simulation training nor teamwork training contributed to improved management of eclampsia over and above standard in-hospital training. 

Learning through simulation can be conducted via simple retrospective patient chart review [10] or a range of clinical simulators from 'part task' trainers with individual workstations to integrated 'whole patient simulation'[11]. These approaches have varying degrees of fidelity; however, a particular strength of simulation lies in the ability to present critical incidents 'at will' whilst also allowing prospective data collection [12]. 

In this workshop we will present, discuss and develop a new and innovative approach to maternal simulation using a simulated patient (actress) and a pregnancy suit. 

Target Audience: All interested parties 

Experience level: Beginners to advanced 

Timetable:

• Introductions - 5 mins
• Innovative techniques in obstetric simulation
• presentation and summary - 5 minutes
• Simulation based nursing and midwifery research
• presentation and video 15 minutes
• Scenario demonstration (educator, patient actress, student) - 15 minutes
• Equipment preparation and obstetric simulation - 20 minutes
• Group work - developing and running a scenario - 30 minutes 

References:

1. Johanson RB, Menon V, Burns E, et al. Managing obstetric emergencies and trauma (MOET) structured skills training in Armenia, utilising models and reality based scenarios. BMC Med Educ 2002; 2(5).
2. Freeth D, Ayida G, Berridge EJ, et al. MOSES: Multidisciplinary Obstetric Simulated Emergency Scenarios. J Interprof Care 2006;20(5):552-4.
3. Morgan PJ, Pittini R, Regehr G, et al. Evaluating teamwork in a simulated obstetric environment. Anesthesiology 2007;106(5):907-15.
4. Maslovitz S, Barkai G, Lessing JB, et al. Recurrent obstetric management mistakes identified by simulation. Obstet Gynecol 2007;109(6):1295-300.
5. Sorensen SS. Emergency drills in obstetrics: reducing risk of perinatal death or permanent injury. JONAS Healthc Law Ethics Regul 2007;9(1):9-16.
6. Draycott T, Sibanda T, Owen L, et al. Does training in obstetric emergencies improve neonatal outcome? BJOG 2006;113:177-82.
7. Cioffi J, Purcal N, Arundell F. Apilot study to investigate the effect of a simulation strategy on the clinical decision making of midwifery students. J Nurs Educ 2005; 44(3):131-4.
8. Deering, S., Brown, J., Hodor, J., & Satin, A. J. Simulation training and resident performance of singleton vaginal breech delivery. Obstetrics and Gynecology,2006. 107(1), 86-89)
9. Ellis, D., Crofts, J. F., Hunt, L. P., Read, M., Fox, R., & James, M. Hospital, simulation center, and teamwork training for eclampsia management: a randomized controlled trial. Obstetrics and Gynecology, 2008, 111(3), 723-731.
10. Nackman GB, Bermann M, Hammond J. Effective use of human simulators in surgical education. Journal of Surgical Research 2003; 115: 214-18
11. Rogers PL, Jacob H, Rashwan AS, Pinsky MR. Quantifying learning in medical students during a critical care medicine elective: a comparison of three evaluation instruments. Crit Care Med 2001; 29: 1268-73
12. Gaba D, Howard SK, Small SD. Situational awareness in anaesthesiology. Human Factors 1995; 37(1): 20-31

Summary of Workshop: Moulage is currently used to simulate injuries for the Pre-Hospital Trauma Life Support courses as well as ‘in-house’ courses delivered at the Queensland Health Skills Development Centre. Through the increased awareness and participation in simulation based training the need for moulage skills and techniques has also increased.

The aim of this workshop is to provide participants an opportunity to explore and create visual clues which would enable diagnosis in a simulated environment through the process of abstraction. The workshop content will be informative and relevant to simulation based training. Some specialised moulage will be shared with participants. This will be a great opportunity for workshop participants to discuss techniques, applications and new ways of using materials.

Topics Covered

• Introduction to moulage materials and tools
• Basic colour theory
• Create minor wounds, scratches, abrasions, minor lacerations and burns
• Observe development of major limb fracture
• Free time to develop simulated injuries to meet specific needs of individual participants

Participants will also be given handouts containing recipes and tips on simulation mixtures and fluids

Target Audience: Target audience would include all who use simulated injury for the successful running of simulation scenarios: PHTLS instructors, Ambulance and medical evacuation teams, Crisis Resource management course instructors and participants.

Bios of Facilitators: Julie-Ann Barker is a graduate from the Sydney College of Visual Arts, with a Bachelor of Visual Arts. 

Tracey Beacroft is a Registered Nurse with qualifications in A&E, Trauma and ICU Experience in medical aviation simulation and trauma training.

Aims and Learning Objectives: Participants in this workshop will practice identifying behaviours which detract from effective debriefing in live simulated debriefs of a pre-recorded simulation event. They will develop and try out strategies to mitigate or reverse these behaviours. 

Target group (size and experience level): The workshop is open to 20 participants. 

Previous experience debriefing scenarios would be desirable although not essential. 

Format of the session / Outline of intended activities: The participants will work in groups of 4 to assess staged debriefs. They will watch a purpose-filmed simulation of a cardiac resuscitation and the participants in the film will be debriefed for 2-5 min by members of a group. This roleplay will be videoed. The group will be asked to identify specific behaviours and come up with strategies to work through the particular problem demonstrated. 

The 2-5min debrief process will be repeated as time allows. Each time, different challenging behaviours will be demonstrated and subsequently discussed. The aim will be to allow each of the 5 groups to experience and manage a different critical debriefing event while observed by the other groups. 

A faculty member will summarise and wrap-up the session, inviting feedback with a written questionnaire. Participants will be asked to sign a release allowing the video of the simulated debriefs to be used for train-the-trainer purposes in similar workshops.

The requirement of the Australian Council on Healthcare Standards to develop a simulation-based model to meet the educational needs of healthcare professionals to improve recognition of the early signs of the deteriorating patient has highlighted the need for in-situ simulation education within the healthcare settings. 

During this workshop we will demonstrate the fidelity that can be achieved through in situ simulation to meet the challenges of maintaining quality and safety in healthcare. 

Format of the Session: An interactive 90 minute workshop using the latest mannequin technology will engage participants in the concept, development and delivery of this new and innovative approach to simulation based education. Participants shall be given an example of footage of an in-situ simulation, which will be complimented by interacting directly with the latest high fidelity simulation patient mannequin. The workshop will highlight the possibilities for the participants interested in developing this form of simulation through sharing our own experience using in-situ simulation and by engaging participants in a demonstration of the technique. 

The intended activities shall comprise interaction with a high fidelity mannequin, video evidence, group discussions, brain storming exercises and sharing ideas. 

Aims and Learning Objectives: The aim of our workshop is to stimulate discussion and an exchange of ideas around the possibility of implementing this type of simulation in the participants' individual environments. Participants will gain an appreciation of in-situ simulation capability outside the normal simulation laboratory. 

Target group (size and experience level): The target group size ideally will be 40 participants with experience in scenario development and simulation delivery using high fidelity mannequins.

Summary of Workshop: Moulage is currently used to simulate injuries for the Pre-Hospital Trauma Life Support courses as well as ‘in-house’ courses delivered at the Queensland Health Skills Development Centre. Through the increased awareness and participation in simulation based training the need for moulage skills and techniques has also increased.

The aim of this workshop is to provide participants an opportunity to explore and create visual clues which would enable diagnosis in a simulated environment through the process of abstraction. The workshop content will be informative and relevant to simulation based training. Some specialised moulage will be shared with participants. This will be a great opportunity for workshop participants to discuss techniques, applications and new ways of using materials.

Topics Covered

• Introduction to moulage materials and tools
• Basic colour theory
• Create minor wounds, scratches, abrasions, minor lacerations and burns
• Observe development of major limb fracture
• Free time to develop simulated injuries to meet specific needs of individual participants

Participants will also be given handouts containing recipes and tips on simulation mixtures and fluids

Target Audience: Target audience would include all who use simulated injury for the successful running of simulation scenarios: PHTLS instructors, Ambulance and medical evacuation teams, Crisis Resource management course instructors and participants.

Bios of Facilitators: Julie-Ann Barker is a graduate from the Sydney College of Visual Arts, with a Bachelor of Visual Arts. 

Tracey Beacroft is a Registered Nurse with qualifications in A&E, Trauma and ICU Experience in medical aviation simulation and trauma training.

This workshop will discuss the problem of violations in health care, as well as the transfer of knowledge about violations from other fields to health care. The workshop proposes a rephrasing of the concept of violations, firstly by introducing existing models explaining violations, then suggesting a general framework for understanding the evolution of deviations from normal procedures at work and finally, by searching for solutions to contain the problem at an acceptable level.

Suitable for: All those interested in gaining a deeper understanding of current models of safety; suitable for those with an interest in human factors

Expertise level: All

Maximum numbers: No maximum

Recommended background reading

1. Amalberti A, Vincent C, Auroy Y, de Saint Maurice G. Violations and migrations in health care: a framework for understanding and management. Qual Saf Health Care 2006; 15 (Suppl 1): i66-i71

Maximum numbers:Up to 25 participants

Learning outcomes for participants include:

• Why simulation? - be sure in your own mind
• Getting started: know what you need
• Stakeholder engagement: who do you need to convince?
• How to get funding and staying within budget
• Dealing with the dark side: manage your operational managers
• Simulation technicians: everyone should have one
• How to get students through the doors
• Ground rules: simulation and debrief with proud professionals
• Culture change: getting rid of the fear of failure
• Patient safety: linking learning outcomes to the 'real world' 

Rationale for workshop: Ambulance services are driven by operational priorities. It can be tough trying to get time and money for training. It can be difficult to persuade students as well as managers of the value of simulation. This workshop will show how with vision and motivation it is possible to overcome obstacles and establish a simulation facility and integrated simulation training programme for paramedics. It will help you to develop a strong rationale for your vision and plans, and will go on to explore how simulation can be used to help create a learning culture within your organisation. 

Target Audience: Anyone who is keen to establish a pre-hospital care simulation facility and training programme, or who has set up a simulation facility and is looking for ways to utilise its full potential. 

Optimal experience level: Some knowledge of the principles and practice of simulation, but enthusiasm is more important than experience. 

Timetable: 

Introduction: the Wellington story 

Group exercise 1: Getting Started

• List the components required for a good pre-hospital simulation facility
• Work out how much it will cost you
• Decide who is going to pay for it and how you will persuade them to do so 

Group exercise 2: Making learning happen

• List the learning outcomes you want from a simulation programme
• What factors will hinder your students from achieving these outcomes?
• What factors will help your students to achieve these outcomes? 

Group Exercise 3: Wider benefits What differences do you expect simulation to make to your:

• Service delivery?
• Organisational culture?
• Patient outcomes? 

Debrief and summary 15 mins

This workshop will use video-recordings to identify issues in the appropriate use of rating scales and other methods and discuss common sources of error in judgements based on the analysis of live or recorded simulation activity. This will be informed by recent developments about assessor training discussed at the Ottawa Conference on Clinical Competence, Miami, May 2010.

• network
• share ideas
• discuss rural issues and
• address practical problems from a rural perspective.

• Brendan Flanagan
• Marcus Watson

• Cyle Sprick
• Daniel Host
• Julian van Dijk
• Tess Vawser
• Jennifer Keast
• Chris Carpenter

This session, with a panel of audiovisual experts, will provide the platform for an interactive discussion on the pros and cons, benefits and limitations of what is available in the market place at the moment to help you determine the best system to meet your needs. There will be a moderated discussion between the experts and time to answer all of your AV queries.

Speaker: Professor Cliff Hughes, CEO, Clinical Excellence Commission, New South Wales.

Research Awards