Inblick, utblick och vision - lärande idag och imorgon

Transkript

1 Inblick, utblick och vision - lärande idag och imorgon Li Felländer- Tsai, Professor, Karolinska Universitetssjukhuset i Stockholm Föreståndare: Centrum för avancerad medicinsk simulering och träning (CAMST)

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4 Vad har förändrats? Jacobaeus tal - Kjellin tal

5 RISK

6 Risker i sjukvården

7 Risker i sjukvården

8 Misslyckad design

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10 TILLBAKABLICK

11 Simulering SimulaKon is the imitakon of the operakon of a real- world process or system over Kme Suspension of disbelief Horse simulator during WW1

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13 Då seklet var ungt The Center for Advanced Medical SimulaMon at Karolinska was establshed in The inimamve was taken by the CEO at Huddinge University Hospital Björn Rosén and Associate professor Kjell Thor, MD, PhD, FACS. The start was co- financed by Huddinge University Hospital, Karolinska InsMtutet and the Wallenberg FoundaMon When Huddinge University Hospital was merged with Karolinska Hospital in 2004 to Karolinska University Hospital the acmvimes at Solna were merged into the same organizamon. mars 13, 2013 Li Felländer- Tsai 13

14 Invigning av Simulatorcentrum (Centrum för avancerad medicinsk simulering och träning, CAMST) 20 mars 2002 av Socialstyrelsens generaldirektör KersMn Wigzell Mål och vision A] skapa en ny säkerhetskultur där avancerad simulering som träningsmetod implementeras i sjukvård och utbildning Validering SystemaMsk träning för dagens och morgondagens sjukvårdspersonal mars 13, 2013 Li Felländer- Tsai 14

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16 mars 13, 2013 Li Felländer- Tsai 16

17 Utveckling av virtuella världar för träning Wallenberg Global Learning Network Projects

18 WGLN CollaboraKon: Development of Virtual ED SimulaKon Systems Improving deliberate pracmce repemmons Distributed learning possible RepeMMons NaMonal and global collaboramon Reduced costs for technical equipment Reduced costs for staff

19 Design, Development & EvaluaMon of Emergency Medicine Cases for the HPS & Virtual ED SimulaMon Systems Wm. LeRoy Heinrichs, MD, PhD Principal InvesMgator- Stanford University Patricia Youngblood, PhD SakM Srivastava, MD Robert Cheng Kingsley Willis Phillip Harter,MD- EM Consultant Li Felländer- Tsai, MD, PhD Principal InvesMgator- Karolinska InsMtutet Carl- Johan Wallin, MD, PhD, DEAA Leif Hedman, PhD Lisbet Meurling, MD Lars Särnå Kai Mäkinen WGLN Symposium Fall 2004

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21 mars 13, 2013 Li Felländer- Tsai 21

22 Virtuell akutmo]agning Mdigt tal Observer WGLN Symposium Fall 2004

23 Ljud i realmd med Talkspace WGLN Symposium Fall 2004

24 "/&+3188#!41&0+9;!?_E`!L9>U=,/3>!! F#88!CDDY!

25 Scenarios 1. M: bicycle rider falls from bike, suffers spleen rupture* 2. M: with pneumothorax & femur fracture aier auto collision 3. M: car driver with hypoglycemia & femur fracture 4. M: ethanol- induced fall with head injury & obstructed airway 5. F (2 nd trimester): renal laceramon aier auto collision 6. M: construcmon worker fall, liver rupture, fractured femur** WGLN Symposium Fall 2004 *used for pretest ** used for pos]est

26 Avatarer och användarkontroller WGLN Symposium Fall 2004

27 Lessons Learned SoVware Development & TesKng Visual realism is not necessary for effecmve team training Simple programming of physiologic responses is adequate for learning team skills Audio connecmon is crimcally important Third party server (not under our control) was unreliable WGLN Symposium Fall 2004

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29 SiMErgency A WGLN project Virtual Medical Emergencies Simulations of For Training High School Students Li Felländer-Tsai and Johan Creutzfeldt Karolinska Institutet Leif Hedman Umeå University Wm. LeRoy Heinrichs, Patricia Youngblood, Sakti Srivastava Stanford University Medical Media and Information Technologies Laura Kusumoto Forterra Systems, Inc. h]p:// mars 13, 2013 Li Felländer- Tsai 29

30 MOS based K- 12 Training Peninsula High School CPR Training for US and Swedish High School students and Swedish Medical students mars 13, 2013 Li Felländer- Tsai 30

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33 2011

34 INBLICK

35 Learning Curve (total score) Learning curve totalresultat Resultat, max= Test

36 Simulering inom teamträning

37 Simulering inom intravaskulär intervenkon

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39 Simulering inom laparoskopi

40 Visualisering och simulering inom ryggkirurgi

41 Artroskopisimulering

42 F&#>M$1*,!,+3$1*+!

43 FramMdens kirurg

44 FORSKNING OCH VALIDERING

45 Avhandling Linköping 2004 Ericka Johnson, PhD Fältstudier

46 Två avhandlingar inom området avancerad simulering vid Karolinska InsMtutet 2005 mars 13, 2013 Li Felländer- Tsai 46

47 Avhandling inom medicinsk simulering vid KTH 2012 Magnus Eriksson, PhD

48 Planerade disputamoner 2013 Centrum för avancerad medicinsk simulering och träning (CAMST) Ulf Jensen (kardiolog) Johan Creutzfeldt (anestesiolog) Lisbet Meurling (anestesiolog) Liv Ahlborg (gynekolog) Marcus Schlickum (AT läkare)

49 Exempel på internamonella samarbeten L Felländer- Tsai, LeRoy Heinrichs Ma] Ri]er and Dan Smith together with Lars Enochsson David Gaba, Johan Creutzfeldt mars 13, 2013 Marcus Schlickum, LeRoy Heinrichs Rhona Flin, CJ Wallin 49

50 UTBLICK

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56 Verbal and Visual Working Memory (RoboMemo) Input Module (Verbal) Rotating Datalink (Visual) 2006 MMVR Li Felländer- Tsai 56

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59 59 Materials and methods: SystemaMc video game training: 30 min 5 days/week for 5 weeks RandomizaMon

60 V=,+G+&#/*/*;!+1,+! H=+#8!,:=&1![7XLHG".\!4,!FVL!m!`=*GFVL!;#>1!+&#/*/*;! [UpDQDj\!

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64 SCENARIOBASERAD IN SITU - SIMULERING 2 EXEMPEL

65 Scenariobased In situ simulakon - ICU Karolinska Huddinge and Solna Systema<c simula<on- based team training in a Swedish ICU - a diverse response among cri<cal care professions Lisbet Meurling Disputa<on 31 maj 2013

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67 Flow chart for the study. Meurling L et al. BMJ Qual Saf doi: / bmjqs Copyright BMJ Publishing Group Ltd and the Health Foundation. All rights reserved.

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69 Percentage of each profession reporting high or very high level of collaboration/ communication with other members of the intensive care team before simulation-based team training. Meurling L et al. BMJ Qual Saf doi: / bmjqs Copyright BMJ Publishing Group Ltd and the Health Foundation. All rights reserved.

70 Percentage of each profession reporting high or very high level of collaboration/ communication with other members of the intensive care team after the intervention. Meurling L et al. BMJ Qual Saf doi: / bmjqs Copyright BMJ Publishing Group Ltd and the Health Foundation. All rights reserved.

71 In situ träning på en autenmsk akutmo]agning

72 In situ simulakon - ER Dr Karl- Johan Lidefelt, MD, PhD Senior consultant in pediatrics Does high- or low fidelity equipment make a difference for parkcipants and trainers during paediatric simulakons? Meurling L et al

73 Meurling L et al

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76 Hybrid simulakon: Bringing momvamon to the art of teamwork training in the operamon room, in press Sc J Surg Self- efficacy Before Aier Hybrid- simulamon is feasible and has the possibility to train an authenmc operamng team in order to improve individual confidence (self- efficacy and momvamon).

77 FRAMTID

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80 Visualisering

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82 Rh1>U18!

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85 Fortsa] utveckling av intraoperamv navigamon och visualisering

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87 Simulator då

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89 FramMden är ljus Riskhantering.

90 Sammanfa]ande riskbedömning Simulering är e] kraifullt redskap Det finns risker vid felanvändning False training NegaMva beteenden kan befästas NegaMva känslor kan uppstå som förhindrar effekmv inlärning Systema3sk träning måste gå hand i hand med utvärdering och validering

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92 Vision utan akmon är enbart hallucinamon