Enhancement of plastic surgery training by including simulation in education and training programmes

Background. This research investigated the possibility of integrating simulation in plastic surgery residency training. The problem addressed was the lack of knowledge about using simulation as a teaching method to enhance the training of plastic surgeons. There was a lack of empirical evidence regarding learning outcomes that could be mastered by simulation-based education and training and their specific cognitive levels.Objectives. To identify and describe: (i) learning outcomes for plastic surgery education and training for which simulation might be an important (essential and useful) training method; and (ii) simulation modalities, linked to specific cognitive levels, to establish the influence of simulation on plastic surgery education and training. The objectives entail determining the importance of simulation in plastic surgery training and identifying simulation modalities most suited to attain specific outcomes.Methods. Data were collected by means of a Delphi survey to obtain consensus from an expert panel comprising 9 plastic surgeons, supplemented by semi-structured interviews conducted with 8 national and international role players in simulation and postgraduate education.Results. Learning outcomes, levels of training, possible simulation modalities, cognitive levels and descriptive verbs and phrases were described, as these pertain to learning. Participants agreed that simulation in medical education can be used to enhance postgraduate plastic surgery training, with special reference to specific outcomes and cognitive levels. Participants made recommendations for the planning and support of the implementation, aimed at ensuring the quality of training.Conclusion. The objectives set were achieved and the results of the study serve as encouragement and guidance in the striving for the enhancement of postgraduate plastic surgery education and training, and in other medical disciplines

Simulation as an educational strategy to deliver interprofessional education

Background. Various educational methods are available to deliver interprofessional education (IPE) to prepare healthcare students for collaborative practice. One such method is simulation-based health education.Objectives. To identify current IPE methods used in undergraduate programmes in the Faculty of Health Sciences at the University of the Free State, Bloemfontein, South Africa, and to determine the opinions of module leaders on using simulation as a particular IPE teaching strategy.Methods. A quantitative, cross-sectional descriptive study design was employed. Structured interviews were conducted with 47 module leaders of the undergraduate programmes in the Faculty of Health Sciences. These programmes cover 66 modules in the Schools for Allied Health Professions (nutrition and dietetics, occupational therapy, physiotherapy and optometry), nursing and medicine.Results. At the time of the study, IPE activities were used in 29 (43.9%) of the modules, of which 17 (58.6%) were coincidental.  Respondents’ opinions on the potential use of simulation to address formalised IPE activities included the challenge of ‘scheduling’ (73.9%) and ‘logistical and high cost issues’ (19.6%). The most prominent advantage that was foreseen (41.3%) was better clarification of roles among the different professions.Conclusions. The module leaders had a positive attitude towards simulation and its potential use for IPE, with their major concern being logistical challenges. To improve role clarification, a scenario should be developed to engage students from all the relevant professions. The proposed type of simulation was to use standardised patients in a role-play scenario. The outcomes of these activities should be aligned with the principles of IPE

Analysing the thinking and learning styles of the Senior Management Service

With the creation of the Senior Management Service (SMS) in 2001 a specific attempt was made at professionalising the senior management cadre of the Public Service. An inherent requirement for professionalisation is continuous executive development. The article argues that for executive development to meet the requirements of both the organisation and the senior manager, learning and thinking style preferences should be considered in the design and implementation of continuous professional development interventions. The article uses a mixed method research approach to determine the thinking and learning style preferences of senior managers who participated in the Executive Development Programme (EDP) as part of their professional development. The article provides a theoretical perspective of thinking and learning style preferences based on the work done by Kolb (1973) and Neethling (2000). The findings reveal a specific preference towards left brain thinking and learning which is structured, analytical and processdriven with limited preference towards innovative or imaginative considerations. The article argues that the thinking and learning preferences of senior managers is indicative of an environment in which structure and process (or compliance) are emphasised, yet senior managers are expected to be visionary in dealing with service delivery complexities. Thinking and learning preferences should be considered in the manner in which professional development is driven as well as designed. Ultimately professional development should enable the senior manager to perform better at a practical, competency level, but also at a higher level of self-awareness necessary for leading public service delivery in such a complex environment

Preparation of nursing students for operating room exposure: A South African perspective

Background. Limited time for training and preparation of student nurses in a busy operating room (OR) could be attributed to a shortage of qualified OR nurses in South Africa.Objective. To determine the participants’ perceptions of the content and modes of delivery of an improved preparation programme for nursing students to enhance learning in the OR.Methods. A qualitative research approach, which included nominal group discussions with students and OR staff, was used for data collection.Results. The need for an improved preparation programme was confirmed. The programme should address documentation, equipment, maintaining sterility, orientation, swab and instrument control, and OR preparation. Suggested modes of delivery include practical demonstrations in small groups, flip-the-classroom approach and simulation.Conclusion. Adequate preparation has a direct impact on students’ learning in and their impression of the OR, which could result in more students selecting OR nursing as a career path

Perspectives of advanced life support paramedics on clinical simulation for summative assessment in South Africa: Is it time for change?

Background. The Professional Board for Emergency Care (PBEC), the statutory body regulating the quality of emergency care education programmes in South Africa, has mandated these programmes to use integrated clinical simulation as an instrument for authentic assessment. In support of the validity of this instrument, actions by students during simulation are assumed to replicate what they would do in similar circumstances in practice.Objectives. To present and discuss perspectives of advanced life support (ALS) paramedics on the use of integrated clinical simulation as a summative assessment instrument, offer a critique of assumptions regarding the use of this assessment instrument, and recommend improvements for its use.Methods. A qualitative, single, embedded case study design was used to address assessment criteria and case types for integrated clinical simulation as a summative assessment instrument. Qualitative data were collected by means of focus group interviews. Perspectives of ALS paramedics emerged from the results of this study.Results. Participants agreed that integrated clinical simulation was an appropriate assessment instrument if assessment principles were adhered to. Accurate replication of the contextual elements of emergency care practice was perceived as central for eliciting authentic responses associated with ALS paramedic practice. The conditions, context and range of life-threatening conditions across medical disciplines challenged the idea that a single, once-off assessment event could be a valid reflection of competence.Conclusion. To elicit authentic responses, the design of integrated clinical simulation events for summative assessment should include relevant clinical, environmental and social-professional elements of ALS paramedic practice. More than one assessment should be done, and should address the range and complexity of medical and trauma emergencies, thereby assessing the true competence of ALS paramedic students. Assessors should acquire the requisite skills to assess simulation effectively

Simulation in plastic surgery: Features and uses that lead to effective learning

Background. Increased competition for surgical exposure and practice, smaller teaching platforms and shorter training times have an impact on the quality of training and competence of plastic surgery registrars. Demands for accountability and minimising patient risks are the driving forces for incorporating simulation in healthcare education. We addressed the problem of whether the features and uses of simulation would enhance postgraduate plastic surgery education and training and ensure more effective learning.Objective. To identify and describe: (i) how simulation impacts on student learning; therefore, how the effectiveness of learning may be enhanced in postgraduate and/or plastic surgery education and training; and (ii) which features and uses of simulation have the potential to enhance learning in plastic surgery.Methods. A descriptive design was used for the study. Data were collected by means of semi-structured interviews with 8 national and international role players in simulation.Results. The results indicated a positive outcome of simulation, as it provides, e.g. a non-threatening environment for learning and improves clinical competency, ensuring an increase in patient safety. The features and uses of simulation render it an excellent method to enhance learning effectiveness at different cognitive levels and to fulfil a specific role in integrated and holistic training, while providing opportunities to practise specific skills. The lack of clinical opportunities can be addressed, and more clinical exposure and practice will result in fewer medical errors.Conclusion. Simulation-based education in postgraduate plastic surgery education and training proved to be an effective teaching- learning method, which provides solutions to current deficiencies, hindrances and gaps in health professions education. The research question was answered and the use of simulation is recommended to enhance plastic surgery education and training and promote safe patient care