Characteristics of Real-Time, Non-Critical Incident Debriefing Practices in the Emergency Department.

INTRODUCTION: Benefits of post-simulation debriefings as an educational and feedback tool have been widely accepted for nearly a decade. Real-time, non-critical incident debriefing is similar to post-simulation debriefing; however, data on its practice in academic emergency departments (ED), is limited. Although tools such as TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) suggest debriefing after complicated medical situations, they do not teach debriefing skills suited to this purpose. Anecdotal evidence suggests that real-time debriefings (or non-critical incident debriefings) do in fact occur in academic EDs;, however, limited research has been performed on this subject. The objective of this study was to characterize real-time, non-critical incident debriefing practices in emergency medicine (EM). METHODS: We conducted this multicenter cross-sectional study of EM attendings and residents at four large, high-volume, academic EM residency programs in New York City. Questionnaire design was based on a Delphi panel and pilot testing with expert panel. We sought a convenience sample from a potential pool of approximately 300 physicians across the four sites with the goal of obtaining \u3e100 responses. The survey was sent electronically to the four residency list-serves with a total of six monthly completion reminder emails. We collected all data electronically and anonymously using SurveyMonkey.com; the data were then entered into and analyzed with Microsoft Excel. RESULTS: The data elucidate various characteristics of current real-time debriefing trends in EM, including its definition, perceived benefits and barriers, as well as the variety of formats of debriefings currently being conducted. CONCLUSION: This survey regarding the practice of real-time, non-critical incident debriefings in four major academic EM programs within New York City sheds light on three major, pertinent points: 1) real-time, non-critical incident debriefing definitely occurs in academic emergency practice; 2) in general, real-time debriefing is perceived to be of some value with respect to education, systems and performance improvement; 3) although it is practiced by clinicians, most report no formal training in actual debriefing techniques. Further study is needed to clarify actual benefits of real-time/non-critical incident debriefing as well as details on potential pitfalls of this practice and recommendations for best practices for use

An overview of decision table literature 1982-1995.

This report gives an overview of the literature on decision tables over the past 15 years. As much as possible, for each reference, an author supplied abstract, a number of keywords and a classification are provided. In some cases own comments are added. The purpose of these comments is to show where, how and why decision tables are used. The literature is classified according to application area, theoretical versus practical character, year of publication, country or origin (not necessarily country of publication) and the language of the document. After a description of the scope of the interview, classification results and the classification by topic are presented. The main body of the paper is the ordered list of publications with abstract, classification and comments.

Transferring simulation skills from other industries to nuclear

Engineering analysis and simulation has always played a significant role in the nuclear sector and its use continues to increase across all branches of industry. To remain competitive in an increasingly global environment and to ensure the safety and reliability of designs, the nuclear industry must take advantage of the new engineering simulation technologies. Concerns surrounding the inappropriate use of simulation by staff without the appropriate competency persist, as analyses become more advanced, increasingly embracing more complex physical phenomena, often in an effort to model reality more faithfully. Furthermore, the age profile of the skilled staff in the nuclear sector in the UK is such that the skills shortage is likely to increase in future. These trends emphasize the need for life-long learning and continual staff development along with transfer of skills from other industry sectors to the nuclear sector. The nuclear industry has taken some initiatives to address skill shortages through the National Skills Academy for Nuclear and Nuclear Energy Skills Alliance (NESA) but these are mostly focused on manufacturing and R&D skills. The recently completed EU funded EASIT2 project is directly aimed at addressing the engineering analysis and simulation skills. This paper gives a brief overview of the EASIT2 project and its deliverables and points out how it can help the skills issues being faced by the nuclear industry. INTRODUCTIO

Crossing the death valley to transfer environmental decision support systems to the water market

Environmental decision support systems (EDSSs) are attractive tools to cope with the complexity of environmental global challenges. Several thoughtful reviews have analyzed EDSSs to identify the key challenges and best practices for their development. One of the major criticisms is that a wide and generalized use of deployed EDSSs has not been observed. The paper briefly describes and compares four case studies of EDSSs applied to the water domain, where the key aspects involved in the initial conception and the use and transfer evolution that determine the final success or failure of these tools (i.e., market uptake) are identified. Those aspects that contribute to bridging the gap between the EDSS science and the EDSS market are highlighted in the manuscript. Experience suggests that the construction of a successful EDSS should focus significant efforts on crossing the death-valley toward a general use implementation by society (the market) rather than on development.The authors would like to thank the Catalan Water Agency (Agència Catalana de l’Aigua), Besòs River Basin Regional Administration (Consorci per la Defensa de la Conca del Riu Besòs), SISLtech, and Spanish Ministry of Science and Innovation for providing funding (CTM2012-38314-C02-01 and CTM2015-66892-R). LEQUIA, KEMLG, and ICRA were recognized as consolidated research groups by the Catalan Government under the codes 2014-SGR-1168, 2013-SGR-1304 and 2014-SGR-291.Peer ReviewedPostprint (published version

The development of a competence framework for engineering analysis and simulation

Engineering analysis and simulation has always played a significant role in the nuclear sector and its use continues to increase across all branches of industry. To remain competitive in an increasingly global environment and to ensure the safety and reliability of products, companies must prepare effectively for the challenges that new engineering simulation technologies will bring. Concerns surrounding the inappropriate use of simulation by staff without the appropriate competences persist, as analyses become more advanced, increasingly embracing more complex physical phenomena and interactions, often in an effort to model reality more faithfully. These trends and the associated competencies required, emphasize the need for life-long learning and continual staff development. Organisations clearly require a sufficient and ongoing supply of well-qualified engineers and the recently funded EASIT2 project is directly aimed at addressing and managing these issues

Querying a regulatory model for compliant building design audit

The ingredients for an effective automated audit of a building design include a BIM model containing the design information, an electronic regulatory knowledge model, and a practical method of processing these computerised representations. There have been numerous approaches to computer-aided compliance audit in the AEC/FM domain over the last four decades, but none has yet evolved into a practical solution. One reason is that they have all been isolated attempts that lack any form of standardisation. The current research project therefore focuses on using an open standard regulatory knowledge and BIM representations in conjunction with open standard executable compliant design workflows to automate the compliance audit process. This paper provides an overview of different approaches to access information from a regulatory model representation. The paper then describes the use of a purpose-built high-level domain specific query language to extract regulatory information as part of the effort to automate manual design procedures for compliance audit

Developing an agent-based simulation model of software evolution

Context In attempt to simulate the factors that affect the software evolution behaviour and possibly predict it, several simulation models have been developed recently. The current system dynamic (SD) simulation model of software evolution process was built based on actor-network theory (ANT) of software evolution by using system dynamic environment, which is not a suitable environment to reflect the complexity of ANT theory. In addition the SD model has not been investigated for its ability to represent the real-world process of software evolution. Objectives This paper aims to re-implements the current SD model to an agent-based simulation environment ‘Repast’ and checks the behaviour of the new model compared to the existing SD model. It also aims to investigate the ability of the new Repast model to represent the real-world process of software evolution. Methods a new agent-based simulation model is developed based on the current SD model's specifications and then tests similar to the previous model tests are conducted in order to perform a comparative evaluation between of these two results. In addition an investigation is carried out through an interview with an expert in software development area to investigate the model's ability to represent real-world process of software evolution. Results The Repast model shows more stable behaviour compared with the SD model. Results also found that the evolution health of the software can be calibrated quantitatively and that the new Repast model does have the ability to represent real-world processes of software evolution. Conclusion It is concluded that by applying a more suitable simulation environment (agent-based) to represent ANT theory of software evolution, that this new simulation model will show more stable bahaviour compared with the previous SD model; And it will also shows the ability to represent (at least quantatively) the real-world aspect of software evolution.Peer reviewedFinal Accepted Versio