When COVID-19 began, teaching simulations at the Island Medical Program needed to stop to keep students safe.
Normally held in-person, a simulation allows medical students to learn clinical skills in a realistic, hands-on setting using high-fidelity mannequins. It’s an effective tool for medical education – so much so that Riley Reel and Kevin Gunther (IMP Class of 2023) felt that stopping it could be detrimental to their pre-clinical peers’ learning.
L-R: Kevin Gunther and Riley Reel (IMP Class of 2023) with a high-fidelity simulation mannequin.
So, the pair of second-year students, who run the IMP Simulation Program as an extracurricular project, found a way to continue the activity while following public health orders.
Their solution: hybrid simulations.
In this adapted model, IMP students use Zoom to virtually enter the simulation centre at Victoria’s Royal Jubilee Hospital. Though the participants are not physically in the room, multiple camera angles, and two in-person simulation assistants allow the students to interact with the centre’s mannequin, cardiac monitors, and other medical equipment.
“Participants are able to request the simulation assistants to carry out anything they would typically do themselves if they were in-person,” Riley and Kevin explain. The pair are also the in-person assistants and they follow a strict COVID-19 safety plan approved by WorkSafeBC and Island Health when fulfilling that role.
To ensure their hybrid model offers the same level of learning and knowledge application as a normal simulation, Riley and Kevin ask student participants to be as detailed with their instructions as possible and to interpret all the information themselves. The in-person assistant cannot provide any additional assistance.
After each simulation, a local internal medicine or emergency resident joins the student participants via Zoom to facilitate a comprehensive debrief.
Riley and Kevin say they had the option to develop a virtual simulation model in which student participants would meet a “patient” on Zoom to take a history and use other virtual tools to manage them medically. However, they didn’t find this model realistic enough.
“Visualizing a realistic clinical environment, directing an in-person simulation assistant, and observing the assessment and interventions being performed in real-time better approximates an in-person simulation than a fully virtual approach,” Riley and Kevin explain.
Riley and Kevin also see this hybrid model being of use after the pandemic. “Hybrid simulations would be a great option for rural healthcare students and professionals who may not have access to a simulation lab to participate in more realistic simulations,” they explain.
“Hybrid simulations require participants to use advanced communication skills to direct the simulation assistant, so this model could also be adapted to train urban specialists how to communicate with rural healthcare professionals to support them in providing care to complex or critically ill patients.”
Riley and Kevin recently published their findings in the Canadian Medical Education Journal. The paper’s four other co-authors are UBC medical students from across the province.
For a visual representation of how hybrid simulations are run, check out this video.