Exploring the role of distributed simulation to advance the delivery of surgical education and teamwork training

Abstract

Burns can represent devastating injuries surgically, psychologically and socially. A multidisciplinary team approach to patient management is requisite to successful patient management. Burns education is currently under-represented in national undergraduate surgical curricula with a resultant graduating workforce with sub-optimal burns management knowledge. There is therefore a drive to improve burns education nationally. In order to develop burns teams to perform with skill and efficiency, it is important to develop and advance their technical and non-technical skills. Simulation has proven to be a powerful modality to augment surgical training. Recreating authentic clinical challenges is crucial in optimising simulation-based team training. The majority of such team-based simulation takes place in dedicated simulation facilities or centres which are static and can be costly. This thesis presents eight peer-reviewed publications that chronologically represent a thematic series of publications in simulation and surgical education with an ultimate focus on burns education. The theoretical framework explores simulation strategies in light of educational theory, culminating in the development of "The Burns Suite" (TBS); a novel modality to advance the delivery of interprofessional burns education. TBS represents a low-cost, high-fidelity, portable, immersive simulation environment. It facilitates the delivery of an interprofessional realistic burn resuscitation scenario based on "advanced trauma and life support" (ALTS) and "emergency management of severe burns" (EMSB) principles. Scenarios were refined utilising expert opinion through cognitive task analyses. Participants considered TBS experience authentic due to its high psychological and social fidelity. This thesis contributes to burns surgical education by providing a better understanding of educational theory underpinning successful simulation and facilitating its interprofessional delivery via TBS. This approach can facilitate the design of future simulation scenarios that provide unique educational experiences where team members can learn with and from other specialties and professions in a safe, controlled environment. Addressing economic and practical limitations of current immersive surgical simulation is important. The low-cost approach of TBS has major implications for surgical education as a whole, particularly given increasing financial austerity. This thesis proposes that alternative, complex, and challenging scenarios and/or procedures can be recreated within TBS, providing a diverse educational immersive simulation experience that can be extrapolated into other surgical specialities and interprofessional arenas

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