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• W3086639554 abstract "We read with great interest the article “Rethinking Residency Conference in the Era of COVID-19” by Gottlieb et al.1 which highlighted suggested methods for continuing residency didactics. This is a challenging time and has required residency programs to develop creative solutions to continue delivering quality education. While the article did recommend the continuation of simulation and case-based learning, the article did not provide specific guidelines on how to accomplish this. We at Cook County Emergency Medicine (CCEM) would like to detail a method we have successfully used to conduct virtual simulation. To maintain social distancing measures during the COVID-19 pandemic, CCEM also transitioned to Zoom-based lectures. Fortunately, we were also able to continue simulation based learning on this platform. Using the breakout feature we split residents by class for an hour-long virtual simulation session. Each class was then split into two smaller groups and then placed in two separate breakout rooms. This allowed for approximately eight residents per session. There was a faculty facilitator assigned to each breakout room. The same case was used for each group and was performed over approximately 40 minutes, leaving the remaining 20 minutes for debrief. To increase fidelity and create a sense of urgency a patient monitor was displayed via the “share screen” option on Zoom. In our initial sessions we utilized the SimMon software to simulate the monitor. The SimMon software cannot be shared from a laptop or computer and has to be shared via a second device, requiring the facilitator to use a tablet or a cellphone that is then plugged in to the computer. SimMon cost is approximately $20. In later sessions, we used Simpl (Simulated Patient Monitor) software, which allows learners to view the monitor in real time on their personal devices without the facilitator having to utilize the share screen function. This seemed to be more advantageous because it is a significantly lower cost. It only costs $2 for the facilitator and is free for the learner. It does, however, require a second device for the learner, one for the Zoom platform and one for the monitor that is displayed through the Simpl application. We found that having this system allowed learners to have a constant stream of vitals without the interruption of stimuli that occurred with the share screen method. Stimuli such as labs, ECGs, imaging, or pertinent components of the patient’s physical examination were organized into PowerPoint. Each stimulus was placed on a separate slide. If a second faculty member or facilitator was available he or she would serve as a simulated patient. If a second person was not available, the facilitator would give verbal feedback from the patient in a manner similar to oral boards. Virtual simulation in this method is advantageous in being able to link in video streams of unique physical examination findings or ultrasound results that are difficult to incorporate seamlessly into traditional in-person simulation. Each facilitator was encouraged to have a printed copy of the clinical scenario to eliminate the need to shift between case details and other software being used during the case. The limitation of the Zoom screen share function is that the entire facilitators screen is viewed by the learners. Therefore, it was important that as the facilitators we limited the labels on our documents and stimuli slides so as to not alert learners to content. For example, if the facilitator navigates through PowerPoint it is possible for learners to see information contained on other slides, which may give clues as to which labs or imaging to order. To combat this, we reduced the preview pane in PowerPoint. Additionally, each slide was titled so as not to alert learners to content. Rather than naming a slide ECG, CBC, or BMP the slides would be named “Stimulus 1,” etc. A key for stimuli and their corresponding slide should be printed along with the clinical scenario. PowerPoint should be shared while in “presentation mode” and the facilitator can then navigate by right clicking and then selecting the desired stimulus number. This method has been utilized at the CCEM Residency Program for a total of 8 hours of didactics and was felt to be a valued part of our curriculum. This format was also used as a part of didactics for emergency medicine residents at Rush University, with rotating fourth-year medical students, second-year medical students participating in a summer enrichment program, and physician assistants at Cook County Health. Our method of conducting virtual simulation is easily accomplished and inexpensive and can be administered across multiple levels of learners. This method also requires little faculty buy-in because the cases can be run without difficulty by an individual. We hope that our contribution allows others to continue simulation-based learning as a part of routine didactics for not only residency programs, but also in physician assistant, medical student, and nursing education." @default.
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• W3086639554 date "2020-10-13" @default.
• W3086639554 modified "2023-10-18" @default.
• W3086639554 title "In Reply to Rethinking Residency Conference in the Era of COVID‐19 by Gottlieb et al" @default.
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• W3086639554 doi "https://doi.org/10.1002/aet2.10531" @default.
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