Application of simulation in anesthesia Application of simulation in anesthesia

[object Object],[object Object],[object Object],Applications of Simulation in Anesthesiology

Why Use Patient Simulation? ,[object Object],[object Object],[object Object]

Why Use Patient Simulation? ,[object Object],[object Object]

Why Use Patient Simulation? ,[object Object],[object Object],[object Object],[object Object]

Diverse Applications of Patient Simulation in Anesthesiology ,[object Object],[object Object],[object Object],[object Object],[object Object]

Distinction Between “Education” and “Training” ,[object Object],[object Object],[object Object],[object Object]

Applications of Simulators in Anesthesiology EDUCATION ,[object Object],[object Object],[object Object],[object Object],[object Object]

Applications of Simulators in Anesthesiology EDUCATION ,[object Object],[object Object],[object Object],[object Object]

Applications of Simulators TRAINING ,[object Object],[object Object]

Applications of Simulators TRAINING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Applications of Simulators TRAINING ,[object Object],[object Object],[object Object],[object Object],[object Object]

Many Centers Run “Anesthesia Crisis Resource Management - ACRM” -- Why? ,[object Object],[object Object],[object Object]

Crisis management behaviors have been studied extensively in aviation Resulting in special training: Crew Resource Management (CRM)

Crisis Management ,[object Object],[object Object],[object Object]

Principles of Dynamic Decision Making and Teamwork ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],Principles of Dynamic Decision Making and Teamwork

Approach of Anesthesia Crisis Resource Management (ACRM) & Its Derivatives ,[object Object],[object Object],[object Object],[object Object]

Approach of Anesthesia Crisis Resource Management (ACRM) & Derivatives ,[object Object],[object Object],[object Object]

Approach of Anesthesia Crisis Resource Management (ACRM) & Derivatives ,[object Object],[object Object],[object Object],[object Object]

ACRM Simulation Scenarios ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Simulation Room -- VA Palo Alto

Scenarios are challenging medically, technically, and in terms of teamwork

A Picture of “Face Validity”

Debriefings with video allows discussion of alternatives and pros & cons of CRM behaviors & technical choices

Beyond ACRM: Expansion “Within” & “Without” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Crew Resource Management (CRM) Training Applies to Many Medical Domains ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Applications of Simulators RESEARCH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Applications of Simulators RESEARCH ,[object Object],[object Object],[object Object],[object Object],[object Object]

Applications of Simulators RESEARCH ,[object Object],[object Object],[object Object],[object Object]

Applications of Simulators RISK MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object]

Applications of Simulators PUBLIC RELATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object]

Video-link with HM, Queen Elizabeth II The video-conferencing set-up Dr. Gaba addresses Her Majesty Dr. Donovan introduces Dr. Gaba to Her Majesty

Key Challenges Ahead for Simulation in Anesthesiology and Health Care ,[object Object],[object Object],[object Object],[object Object],[object Object]

Key Challenges Ahead for Simulation in Anesthesiology and Health Care ,[object Object],[object Object],[object Object]

Unanswered Questions About Simulation Training and/or CRM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Does It Work? ,[object Object],[object Object],[object Object],[object Object],[object Object]

Obstacles to Investigating the Impact of Simulator Training on Performance ,[object Object],[object Object],[object Object]

Prototypical Experimental Design Chopra, et al; others 3x

A Definitive “Impact on Performance Experiment” Will Be Very Expensive ,[object Object],[object Object],[object Object],[object Object],[object Object]

at MDD/SD = 0.1, N=1944 Estimate of Required N (per cohort) for 80% power,  = 0.05 How Large Must the Cohorts Be? 0 50 100 150 200 250 300 350 400 450 500 Required N per Cohort 0 0.25 0.5 0.75 1 1.25 1.5 Minimum Detectable Difference / Std. Dev

Unanswered Questions Regarding Investigations of Impact on Performance ,[object Object],[object Object],[object Object],[object Object]

Should We Attempt to Perform Definitive Studies of Simulation Impact? ,[object Object],[object Object],[object Object],[object Object],[object Object]

Bottom Line ,[object Object],[object Object]

Application of simulation in anesthesia Application of simulation in anesthesia

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Application of simulation in anesthesia Application of simulation in anesthesia