The Impact of a Distributed Battery Energy Storage System on Transmission and Distribution Power Grids

This thesis reports on an investigation of the impact of battery energy storage systems (BESS) on the voltage and frequency stability of a transmission system. It also explores an application of a BESS into an active distribution system which delves the realm of smart grids. Power quality and system stability are two major concerns in the transportation and distribution of electrical energy. It has long been recognised that energy storage is a possible way forward to improve on these parameters; but the battery technology and the ancillary power electronics had not been developed sufficiently, until quite recently; to meet such expectations. Current battery energy storage challenges the paradigm of instantaneous usage of electrical energy. Intermittent renewable energy production has the potential to improve the quality and efficiency of energy production. The thesis gives an explanation of the battery working principles and includes a com-parative study of battery technologies and the main advantages and disadvantages of batteries in comparison to other electrochemical energy storage technologies. Besides, the thesis addresses the all-important issue of power electronic converters. Battery con-verters are responsible for controlling the power exchange between the grid and the BESS. The link between the battery and the DC bus, i.e., DC-DC converter, and the link between the DC bus and the grid, i.e., DC-AC converter, are covered in depth. It has been found that using a BESS in a transmission system significantly improves frequency stability. The damping of oscillations following a transient event is much improved. The BESS can be seen as additional spinning reserve in the system. On the other hand, when a BESS is applied in an active distribution system, the power, deliv-ered by an intermittent energy source is of much higher quality. In particular, it is shown that the BESS has the potential for turning a part of the distribution system with intermittent generation, self-reliable from the energy perspective In brief, the outcome of this thesis shows the positive influence of the BESS in electrical powers grid. Further research is required to develop a more detailed model of the battery which would include battery ageing and temperature dependency

Evolution de l'enseignement par la simulation

Présentation de l'évolution de la simulation avec un focus sur la pédagogie utilisée ainsi que sur les facteurs humains et l'impact sur la qualité des soins et la sécurité des patient

Implémentation d’un programme de débreffage clinique à distance des étudiants : DISCERN-STUDENT

Introduction : En Europe (Belgique), les étudiants infirmiers prestent 2 300 heures de stage auprès du patient. Il a été démontré qu’une rétroaction par un professionnel ou un formateur améliore les apprentissages. Or, les étudiants sont peu accompagnés. La COVID-19 a engendré une diminution voire l’arrêt des supervisions par des formateurs. Afin de faire face à cette situation, un programme de débreffage clinique à distance intitulé DISCERN-STUDENT a été développé. Méthodes : L’objectif de cette étude était d’identifier les compétences (techniques et non techniques), les évènements indésirables et les presque incidents ainsi que les pratiques pédagogiques (p. ex. questions réflexives) abordés lors des débreffages. Une analyse de contenu des rapports de débreffage (n=115) a été réalisée. Résultats : Seuls six rapports (5,2%) n’ont pas abordé de compétences non-techniques alors que les compétences techniques ont toujours été discutées. Parmi celles-ci, les procédures et médications (n=52;45,2%) sont les plus fréquemment discutées. Au niveau des compétences non-techniques, les problèmes de communication (n=73;63,5%), le stress (n=42;36,5%), la prise de décision (n=32;27,8%), la collaboration avec l’équipe (n=26;22,6%) ainsi que la conscience situationnelle (n=25;21,7%) sont les thèmes récurrents. Durant les débreffages, 64 évènements indésirables (55,6%) et 42 presque incidents (36,5%) ont été découverts. Les questions réflexives (n=111;96,5%), les rétroactions par l’enseignant (n=66;57,4%) et la discussion sur les émotions ressenties par les étudiants (n=50;34,8%) constituent la majorité des pratiques pédagogiques. Discussion et conclusion : DISCERN-STUDENT a permis de découvrir des évènements indésirables ou des presque incidents alors que tant les compétences techniques que non-techniques peuvent être discutées. Cette modalité pédagogique pourrait compléter les pratiques d’accompagnement en stages cliniques. Des études ultérieures sont nécessaires pour la valider et analyser les éléments découverts.Introduction : En Europe (Belgique), les étudiants infirmiers prestent 2 300 heures de stage auprès du patient. Il a été démontré qu’une rétroaction par un professionnel ou un formateur améliore les apprentissages. Or, les étudiants sont peu accompagnés. La COVID-19 a engendré une diminution voire l’arrêt des supervisions par des formateurs. Afin de faire face à cette situation, un programme de débreffage clinique à distance intitulé DISCERN-STUDENT a été développé. Méthodes : L’objectif de cette étude était d’identifier les compétences (techniques et non techniques), les évènements indésirables et les presque incidents ainsi que les pratiques pédagogiques (p. ex. questions réflexives) abordés lors des débreffages. Une analyse de contenu des rapports de débreffage (n=115) a été réalisée. Résultats : Seuls six rapports (5,2%) n’ont pas abordé de compétences non-techniques alors que les compétences techniques ont toujours été discutées. Parmi celles-ci, les procédures et médications (n=52;45,2%) sont les plus fréquemment discutées. Au niveau des compétences non-techniques, les problèmes de communication (n=73;63,5%), le stress (n=42;36,5%), la prise de décision (n=32;27,8%), la collaboration avec l’équipe (n=26;22,6%) ainsi que la conscience situationnelle (n=25;21,7%) sont les thèmes récurrents. Durant les débreffages, 64 évènements indésirables (55,6%) et 42 presque incidents (36,5%) ont été découverts. Les questions réflexives (n=111;96,5%), les rétroactions par l’enseignant (n=66;57,4%) et la discussion sur les émotions ressenties par les étudiants (n=50;34,8%) constituent la majorité des pratiques pédagogiques. Discussion et conclusion : DISCERN-STUDENT a permis de découvrir des évènements indésirables ou des presque incidents alors que tant les compétences techniques que non-techniques peuvent être discutées. Cette modalité pédagogique pourrait compléter les pratiques d’accompagnement en stages cliniques. Des études ultérieures sont nécessaires pour la valider et analyser les éléments découverts

Efficacy of a Short Role-Play Training on Breaking Bad News in the Emergency Department

Introduction: Breaking bad news (BBN) in the emergency department (ED) represents a challenging and stressful situation for physicians. Many medical students and residents feel stressed and uncomfortable with such situations because of insufficient training. Our randomized controlled study aimed to assess the efficacy of a four-hour BBN simulation-based training on perceived self-efficacy, the BBN process, and communication skills.Methods: Medical students and residents were randomized into a 160-hour ED clinical rotation without a formal BBN curriculum (control group [CG], n = 31) or a 156-hour ED clinical rotation and a four-hour BBN simulation-based training (training group [TG], n = 37). Both groups were assessed twice: once at the beginning of the rotation (pre-test) and again four weeks later. Assessments included a BBN evaluation via a simulation with two actors playing family members and the completion of a questionnaire on self-efficacy. Two blinded raters assessed the BBN process with the SPIKES (a delivery protocol for delivering bad news) competence form and communication skills with the modified BBN Assessment Schedule.Results: Group-by-time effects adjusted by study year revealed a significant improvement in TG as compared with CG on self-efficacy (P < 0.001), the BBN process (P < 0.001), and communication skills (P < 0.001). TG showed a significant gain regarding the BBN process (+33.3%, P < 0.001). After the training, students with limited clinical experience prior to the rotation showed BBN performance skills equal to that of students in the CG who had greater clinical experience.Conclusion: A short BBN simulation-based training can be added to standard clinical rotations. It has the potential to significantly improve self-efficacy, the BBN process, and communication skills

Development and implementation of an end-of-shift clinical debriefing method for emergency departments during COVID-19.

BACKGROUND: Multiple guidelines recommend debriefing after clinical events in the emergency department (ED) to improve performance, but their implementation has been limited. We aimed to start a clinical debriefing program to identify opportunities to address teamwork and patient safety during the COVID-19 pandemic. METHODS: We reviewed existing literature on best-practice guidelines to answer key clinical debriefing program design questions. An end-of-shift huddle format for the debriefs allowed multiple cases of suspected or confirmed COVID-19 illness to be discussed in the same session, promoting situational awareness and team learning. A novel ED-based clinical debriefing tool was implemented and titled Debriefing In Situ COVID-19 to Encourage Reflection and Plus-Delta in Healthcare After Shifts End (DISCOVER-PHASE). A facilitator experienced in simulation debriefings would facilitate a short (10-25 min) discussion of the relevant cases by following a scripted series of stages for debriefing. Data on the number of debriefing opportunities, frequency of utilization of debriefing, debriefing location, and professional background of the facilitator were analyzed. RESULTS: During the study period, the ED treated 3386 suspected or confirmed COVID-19 cases, with 11 deaths and 77 ICU admissions. Of the 187 debriefing opportunities in the first 8-week period, 163 (87.2%) were performed. Of the 24 debriefings not performed, 21 (87.5%) of these were during the four first weeks (21/24; 87.5%). Clinical debriefings had a median duration of 10 min (IQR 7-13). They were mostly facilitated by a nurse (85.9%) and mainly performed remotely (89.8%). CONCLUSION: Debriefing with DISCOVER-PHASE during the COVID-19 pandemic were performed often, were relatively brief, and were most often led remotely by a nurse facilitator. Future research should describe the clinical and organizational impact of this DISCOVER-PHASE

Some novel applications of VR in the domain of health

Recent progress in virtual reality (VR) technologies make immersion more accessible to everyone, and, in particular, developments aimed at the entertainment industry are being brought into to the domain of health. The main uses of VR in health are of two forms. First, it is a new method to diagnose and to treat patients; second, it is a new method to train and/or teach healthcare and emergency-response professionals. There are several reasons for using VR in healthcare. First, virtual environments (VE) are fully under control, so that the user (patient or professional) is then safe from any harm and the session can be interrupted if necessary. Second, there are many instances where placing the user in a real environment would be very hard to do and/or very costly. A major advantage of VR is that this user can instead be immerged in an equivalent artificial/virtual environment through the use of immersive technologies. Third, with regard to teaching, a significant advantage of VR is that it allows one “to bring the body to learning”, thereby effectively embedding new knowledge into the muscles. Below, we describe several uses of VR at our university in the domain of health. © Springer Nature Switzerland AG 2019