Good morning, thank you, welcome to Overcoming Barriers and since we've already done my introduction, let me move on to my disclosures. So I have no disclosures and I really want to reiterate that my mentioning of any organizations or products during my presentation is totally arbitrary. I have absolutely no business relations with any of these companies, but I will reference those simply as examples and because of their expertise and availability of resources in the field. So my key points that I will address in Overcoming Barriers are how to get support, ways to create a simulation environment, what tools to use, how to contain cost, and also ways to incorporate DEI. So some efficient ways to seek support in instituting simulation activities is by engaging your professional resources. And these organizations are the leaders in this field and they can provide you with custom details through their websites and giving you access to articles, approved standards, and networking to facilitate your needs and especially with high fidelity simulation. Another productive way to overcome barriers is to reach out to your other hospitals and universities, preferably within your vicinity, and see what they're doing. Go for a visit. And there is no need in struggling or reinventing the wheel. We can learn from each other. And most everybody in the community is very supportive and willing to share their experiences. So there are many ways to create a simulation environment and depending on what the needs are. So is it to introduce or to improve a certain skill? Do you want to incorporate an entire team to run an in situ simulation scenario or is it going to be virtual? Because there are many ways to make this work. And here are some examples. So not everyone has the availability to use a state of the art simulation lab because of cost and time constraints or scheduling conflicts or simply because of location. So bring the skill to the unit. One of the examples here, if you can see in the upper middle, is the rapid infuser. Gina still worked full time as a clinical educator in our adult ICU and we had a lot of septic and trauma patients, fluid resuscitation was of essence. And everybody was using the pressure bags. Nobody was using the rapid infuser. It just sat in the corner. I'm like, we need to use the infuser. Well, it was a gap. Nobody really knew how to use it efficiently. So bring the skill to the unit. So I just started coming around and pulling a couple of staff aside at a time and do like a ten minute demonstration on the unit. And then with a ten minute teach back. And it was very effective. And then all of a sudden it's like, I'm grabbing the infuser. Everybody now that they knew how to use it went for it and it actually improved our outcomes. So again, it's highly effective. Bring the skill to the unit and nobody has to leave the unit or come in extra. Now, also you can run simulations in an empty room instead of the lab, which often times is nowhere near the unit of where you're at. So keep in mind also that all bedside monitors in your rooms have a demo mode. So if you have an empty room, pull some folks in, throw on the demo mode, and you can again run a simulation. And you can also set up training within close proximity to the unit. So as you see some of the examples that I'm showing on the bottom here, this is actually where I converted a storage room that was located right across from our ICU. I converted it into a training room and I used surplus equipment that we had from the unit, from the hospital, and it didn't cost a dime. So become innovative and you can do this. So tools, again, there are many tools available that already incorporate simulation scenarios, which are validated and reliable, as Mohamed talked about earlier. Many publishers have merged their textbooks with simulation programs containing a plethora of scenarios to include pre-briefing and debriefing procedures. Again, I'm not endorsing anyone in particular, but I have used these tools and I can attest to their functionality and their effectiveness. Now, these simulation healthcare companies also offer complete scenario packages that can be downloaded onto the mannequin software or be run virtually. An augmented and virtual reality does not necessarily need to be designed in a specific area to take place. And we could see that that became key during COVID. Now, even scheduling conflicts and not everybody being able to join live or meet at a specific time or place. Incorporating VR has become essential. So you can put together and apply scenarios and training with the use of a cell phone app, YouTube videos, even without having to spend a great deal of money or determining a space, which leads me to my next key point of ways to curb cost. So one way is grant writing, and especially if you're affiliated with an academic center. So there are a multitude of grants available where simulation can be applied. So look for other sponsors and donors. And many companies have grants and scholarships available and are willing to donate equipment that you can use for training and to enhance your sim lab. And it's worth submitting your application. Sometimes it could be a tedious process, but you never know the generosity unless you apply. So whether you are in an academic setting or an acute care setting, collaborate with your other departments to curb cost. So instead of hiring standardized patients, which can be very expensive, get with the College of Arts or the theater group and run scenarios. Coordinate interprofessional simulation activities with pharmacy and RT students or the Department of Social Work. And the same goes for interdepartmental collaboration in the hospital, between the ED and the ICU, for instance. Let's combine our resources and not train in silos. And it's not only cost efficient, but it also improves communication, workflow, knowledge, skills, and attitude. And speaking of attitude, sometimes that can happen. I don't know if I have any nurses out here, but between ED and ICU nursing, so let's improve all of that. So, and which then brings me to overcoming barriers and incorporating DEI, which is also an integral part of our practice. Because learning, understanding, and applying the principles of professionally addressing gender identity, patient sexuality, and transgender care is of essence. Many of us are not experts when it comes to caring for patients of the LGBTQ plus community. And to provide excellent service to all of our patients, as we are called to do, we must educate ourselves first. Hence, there are some of the leading organizations that offer free resources and seminars to assist us. For instance, we have GLAD, which is the Formerly Gay and Lesbian Alliance Against Defamation. GLMA, which is the world's largest and oldest membership association of LGBTQ healthcare professionals and allies. We have GLSEN, which is the leading national education organization focused on ensuring safe and affirming schools for all students, and the ZapZone Project, which offers free online LGBTQ education sessions and resources for educators and learners. And then lastly, the Trevor Project, which is an American non-profit organization focusing on suicide prevention efforts among LGBTQ youth. These are all free and very reliable resources. Now, we can customize simulation activities based on our needs to enhance and improve our care by role play and practice and communication skills. In practice assessment and treatment modalities, running scenarios, incorporating intersectionality, which is easy to do with a high fidelity mannequin as well. Don't forget that DEI applies to adult health and pediatrics. So for example, you could run a scenario based on if your patient is a middle aged African American transgender female with type 1 diabetes having an acute MI. Or an adolescent Latino patient with gender dysphoria and suicidal ideation. Think about that. Are we really adequately prepared to care for these patients? So implementing case-based simulation scenarios with high fidelity mannequins or standardized patients is a great tool to overcome these barriers. And solicit the help of content experts and develop community partnerships. And remember, most of our employing organizations and affiliations, to include SCCM, have published DEI positionality statements. And we have an obligation to comply. So lastly, as I emphasized also, our plenary speakers, Robert Roswell, that he also said that we need to be redesigning health care by embedding DEI into critical care and to improve patient outcomes. So I thank you, and you're my references.

simulation activities

healthcare

barriers

professional resources

diversity