Publications

Simulation in Acute Care Pediatrics: New paradigms in care

Simulation offers tremendous promise to improve health care delivery especially in acute care areas. It can be an effi cient mode to learn, probe and improve crisis resource management, unit risk assessment, establish an environment for discussing error without punishment, investigating human performance, assessing situation readiness, implement new protocols, test run new instruments, improve interdepartmental coordination, learn new concepts or procedural skills and also in establishing systems and usability of a new unit.Simulation based learning relies heavily on refl ective practice,a key foundational concept of adult learning. PediSTARS India is actively working towards addressing the challenges of implementing simulation based interventions to better the care of sick children in India.
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Pediatric Advanced Life Support (PALS) and Simulation

Pediatric Advanced Life Support (PALS) course is a very popular course directed towards Pediatricians aimed towards improving the outcomes of sick children. However, despite the popularity of the course, translation of this knowledge to the bedside has been far from satisfactory due to variety of reasons. Few strategies have been employed to make the course more effective. Modular training by delivering PALS components in a staggered fashion over a defi ned time period, self-directed interactive web based learning, use of high fi delity simulators to deliver realistic scenarios, conducting the course in the provider’s workplace using his resources and team and using refl ective practice based debriefi ng technique to enhance learning from real life events have shown some promise.
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Contextualising Simulation in Emergency Medicine Department and Pediatric Intensive Care Unit in India

Emergency Department and Pediatric intensive care units are acute Pediatric care areas with high risk and require quality and safe care to deliver good outcomes to children. Simulation appears to be adapted well in many Emergency Departments as well as PICUs across the world to understand and optimise the delivery of acute care. We have little data on the adaptability and application of simulation methods into acute Pediatric care provision in India. Simulation is currently limited to a few task-training workshops and is yet to become an integral part of healthcare in day-to-day practice. There is a lot of room to expand the scope of simulation in Emergency Departments and PICUs across the country. There is a need to expand the expertise and numbers of simulation trainers to facilitate the wider application. Further studies are needed to understand the impact on patient outcomes and understand the challenges in wider application to patient care.
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Simulation Training in Neonatology - Setting the context

Appropriate management of neonatal emergencies not only requires knowledge and skills but also effective teamwork. Adults are experiential learners who learn by refl ecting on the clinical situation they were involved with. Simulation is an effective tool to train as a team and also learn by refl ection in a safe environment. Simulation brings out the human factors, which signifi cantly contributes to medical errors and helps train in crisis resource management. Simulation based training is now recommended by resuscitation councils worldwide. In neonatal training, simulation can be used as a tool in many contexts – learning psychomotor skills, identifying knowledge gaps, communication skills and teamwork. In situ simulation will also help test the systems. We describe some key contexts wherein simulation based training can be used effectively as a tool to improve clinical care and enhance quality in neonatal medicine.
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Debriefing –What, why and how?

Debriefi ng is a critical part of a simulation exercise in order to foster refl ection and enhance clinical reasoning. Without a proper understanding of how to debrief simulation based trainings or real life events can be ineffective and inconsistent. In this article we provide an overview to the necessary elements of debriefi ng. We describe a three-stage approach to debriefi ng; reactions, descriptive and summary and review different forms of questioning that can be used in the descriptive phase. It is important for educators in simulation to train and understand how to effectively lead learners through simulation and debriefi ng in order to be successful.
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A Road Map to Planning a Pediatric Simulation Session

Medical education has increasingly focused on patient safety in the last few decades. Awareness of and emphasis on adult learning principles have made simulation training a novel method. Creating a realistic case scenario experience is very important for the active engagement of the participant to facilitate refl ection during debriefi ng. Designing a simulation session in order to recreate a realistic clinical experience requires rigorous research and meticulous planning. Poor preparation may cause the whole experience of simulation to be counter-productive. These insights are simplifi ed into a step by step approach in this article where the importance of a thorough Needs-Assessment, clear aims, SMART learning Objectives and a well-designed scenario is elucidated thus demystifying the intricate process of planning a simulation session.
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