tech FILES
BY Michelle Lindstrom
Practise Makes Perfect PHOTO: NICKI WOHLAND
Pediatric simulation is improving the training experience for health-care professionals and outcomes for patients
WHAT A DOLL: Dr. Jonathan Duff poses with HAL®(Hybrid Assistive Limb®), a child-sized mannequin which helps health care workers hone their skills.
DR. JONATHAN DUFF, PEDIATRIC INTENSIVIST at the Stollery Children’s Hospital and associate professor with the faculty of medicine and dentistry in the department of pediatrics, says health care education is changing. “If you look at the aviation industry, you would never get on a plane with a pilot who has not been through a flight simulator in the past year,” he says. “Simulation is going to become part of the health care culture where you’ve already mastered some of the skill in a simulated environment before coming on and seeing patients in the real world.” As one of a team of critical care physicians at the Stollery, Dr. Duff shares a role of being the physician-in-charge of the pediatric intensive care unit (PICU) when he’s on 22
HEROES | S P R I N G 2 0 1 4
HEROES_Spring2014_pg22-24.indd 22
service in the hospital. He also co-facilitates the Stollery’s pediatric simulation program. Pediatric simulation can include the use of actors that allow doctors to practise communication skills and techniques in different scenarios – for instance, to inform families of bad news. It can also involve pediatric specialists gathering together to run through a complicated emergency situation and check that everyone knows the proper skills and protocols. This enables staff to be trained on the necessary, non-technical skills – such as communicating effectively, using resources appropriately and coordinating a roomful of medical staff efficiently – as well as the technical, hands-on skills required for management of critically ill patients. “We often work in high-risk, high-stress, high-impact environments,” Dr. Duff says. “It makes sense to allow people to practise those skills before they have to do it in the ICU with a real baby.” Small mannequins – infant and child-sized – are also part of the simulation training. These dolls can breathe, cough and move slightly to mimic what a real patient might do. “If we have a trainee in the ICU, they can practise resuscitating a sick baby and, at the end, we give him or her feedback about what went well and what didn’t,” Dr. Duff says, adding that if something does go wrong, better there than in the emergency room considering the mannequins can be rebooted and the skill can be practised again. For about seven years, as long as Dr. Duff has been on staff, the Stollery has run pediatric simulation training for nurses, respiratory therapists and already well-trained attending physicians who want to hone their skills through peer feedback. “We’re slowly moving forward,” Dr. Duff says. “Every year, we train more people.” The biggest struggle is the lack of dedicated training space in the Stollery, as most rooms are used for direct patient care. Still, the hospital sees an impressive draw of eager trainees, purposely seeking out positions at the Stollery because of its simulation training. “It’s nice to see there’s more research happening in simulation to show improvement in patient outcomes versus how we used to train people,” Dr. Duff says. “The idea that once you’ve seen me do it, now you go do it on someone’s baby – we’re not doing that anymore. Simulation allows us to practise.” S TO L L E RY C H I L D R E N ’ S H O S P I TA L F O U N DAT I O N
2014-04-28 3:28 PM