There's a growing application of simulation to identify latent safety threats e.g. equipment, interpersonal & physical space issues especially during #covid19
Typically data is gathered via debriefing (i.e. feedback from participants after simulation)
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We observed that even when explicitly asked about challenges posed by the physical space & equipment, the discussions veered back towards teamwork/communication. Even our follow up questions gravitated away from the physical space/equipment issues
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This is an IMPORTANT finding since most of us #simulation folks rely heavily on debriefing (rather than other data, like observational, movement tracking etc)
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It's likely that people are not accustomed at providing feedback about their clinical space. We blindly accept that equipment & environment issues in healthcare are "just how it is". Almost like a bit of learned helplessness
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Our work suggests that we need to tailor our data collection efforts to align with the type of information we are seeking. Debriefing for system issues is great but there are also limitations. Alternative data collection processes may be required to account for these gaps.
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I'll briefly mention the techniques that I utilize and teach
1. Distributed practice - spreading out study activities over time
- far more effective to study 1hr for 5 nights than 5hrs on 1 night
- this approach benefits long term retention
- basically cramming doesnt work!
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In one study, spaced practice where students had 1 or 30 day between sessions produced better results than 0 days betw sessions when evaluated on the final test
Notably, 30d betw sessions was worst at the beginning but overtime was best strategy
Make no mistake the recent words of the premier touting the strength of our healthcare system are not anchored in reality.
The many amazing healthcare workers battle a dysfunctional system to continue to deliver care despite the govt
Let me help the premier understand better 1/
Working in our current healthcare system is like running on treadmill with no end, no food, no water and the pace continues to increase. It’s not sustainable and eventually bad things happen.
A summary
- there aren’t enough nurses
- rural EDs close regularly (that’s crazy)
- EMRs aren’t compatible across institutions and govt is complicit in this - wasting money, time and harming pts
- there aren’t enough family physicians and those remaining want out
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First, we pulled off one of the largest randomized trials looking at practice in the #meded literature.
We enrolled 176 emergency medicine residents across North America at 5 sites. It was a huge undertaking and not an easy study to complete, esp the retention testing.
Key to this conversation is, what is deliberate practice & mastery learning?
Deliberate practice, long studied by Ericcson requires several elements with a primary goal of improving.
Also referred to as 10,000hr rule (from Gladwell) but this is rather a misrepresentation
Starting March 31st @ONThealth announced they will purposefully & systematically reduce healthcare access to those who are marginalized or under resourced.
Ont govt will end a program that provided healthcare access to the uninsured.
Here’s a 🧵 on what this means.
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At first glance, this might seem to only affect visitors or travellers (which it will) however it will deliberately negatively impact many Ontario residents who have lost, can’t renew or have an expired OHIP card.
These are people who are in fact OHIP-eligible.
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At our hospital, this will represent 1000s of pts per year.
The vast majority are patients who lack the resources to sort out the process required to apply for or renew an OHIP card.
A process made easier with a drivers licence, home address or collateral forms of ID.
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In honour of upcoming St. Patrick’s Day and the luck of the Irish, here’s a post on the importance of luck in decision making.
What is luck? Well, it can be either good or bad and it’s the result of chance. By definition it's out of our control.
Here's a thread: 🧵 1/
Luck is a funny thing when it comes to decisions and our interpretation changes depending on who made the decision.
This week we saw an example of bad luck for clients of SVB. The bank run was completing out of their control.
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It wasn’t an unreasonable decision to have money deposited there, at least based on all available information. Its easy to criticize others for putting all their money there without diversifying (not luck but bad decison) which unreasonable...as this isn't an investment!.
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