So, disclosures. So, I will be navigating my talk in brief about on the same topics that I established panel has already discussed about. So, my talk would be about the types of simulation-based research, how to get the support and funding, the main bodies of it, and how to develop your career in this field if you're interested, and the advances in simulation currently. So, simulation, as we already know, it's basically replication of the real-world phenomena in a safe environment to achieve an ability to practice and research. And when you're really planning a simulation-based research, it's really important while planning and going through the process of it if you're able to reach the conceptual and the emotional realism that you are striving for during your research question. Over the last two decades, the simulation has come a long way. We just started with learning and using simulation for learning and training, for procedures, skill, the team dynamics, and medical code skill. And later on, we started to understand that it's really important to go through the process of a protocolized debriefing, who, what, when, why, and to understand the difficult family situation and to practice that not just in front of the family because that can have poor consequences when you have the poor interactions with the family, but to practice that beforehand and have your trainees practice that beforehand and how to have a proper simulation for breaking the bad news. And almost all hospitals in this current era actually have safety drills at a regular protocol. Interestingly, all these areas of simulation can become a research question if you're interested in it. And the interest comes from being aware about the need in the program that you're working and the unit that you're working. I picked up this study for a reason. This study was actually done in Bihar, India in a very low resource setting, and they wanted to assess the debriefing and evaluation tool using post-simulation video-assisted data. So they actually highlight a couple of points here. One, the study was actually done in a low resource setting so they didn't have all the high fancy stuff and high big simulation labs available to them or even the mentors who could guide how to plan this study. But what they tried, they felt the need that we need to practice the debriefing protocols for our nurse instructors. We need some multi-institutional support. It was not a multi-institutional research, but the group actually reached out internationally to find the experts in this field to help them design the study. Then they used a technology to conduct their study. So I feel like this actually is a great example to understand that if you feel the need, it can be a simulation-based research can be done anywhere and it's feasible. It's a vast topic, simulation and research, so you'll of course have to understand the challenges that are related to simulation as well as research. So the expert in both these fields are kind of important. But if you're just beginning your career, oh, how do I go back? If you're just beginning your career, it's important to have the right kind of mentor that can help you navigate your research. So I think I need to go back on my slides. Do you know how to? Sorry. Oh, previous? Sorry, thank you. Okay, yes. So this is just, in short, all these tools that are going to help you to plan your simulation and then eventually to plan a simulation-based research, they are gonna come with all the challenges associated with it. So Ilana, Mohamed, and Kristen, they have already talked a lot about in detail. I think one of the major thing that I feel in this scenario is important is in the last couple of years, there's a lot of movement of the healthcare professionals. So if you're planning a study that involve training people beforehand and then studying them as a pre- and post-intervention, it becomes very important, how are you gonna have those people be part of pre- and post-intervention studies? And then, of course, data collection and data analysis if you actually have the right kind of resources available for you for that. It always starts with an idea, and I would say idea always comes if you're trying to be aware about the need, again, in your unit and your department. And then you have to generate a hypothesis and see if that research question is even valid, if you can go ahead with it, and what is already done in that field, and how you can modify it if it's already done, and how you can improve it further. There are several study types and designs. You can go from descriptive, theory testing and generation, evaluating intervention, multi-center studies, mixed method studies, and they are no way mutually exclusive. You can have one study type together with another study type just to plan your study in a proper manner. It all depends on what you want to study and what your research question is, and how you can navigate it in the best way. So descriptive study design, I personally feel are great. For studying the rare case scenario, which could be catastrophic, so personally for me, study scenarios like shunt clotting for a Norwood patient, or malignant hyperthermia, these are the scenarios I don't really ever wanna see in my unit, but I do want to train the healthcare staff, the trainees, the nurses, this would be a great scenario for a descriptive study design to plan and replicate those settings again and again without actually impacting the outcomes of your patient, and getting that confidence that, yes, my staff is ready to go ahead, and then studying and putting out a research on that. Theory generation and testing, so I think simulation-based research is, again, great if you have some theory, just like adverse effect of sleep deprivation on physician performance and stress in anesthesiologists, because all of these theories, if it's just coming into your mind, if you're thinking about it, just coming back from my training years, if I'm thinking about it, that I'm working overstretched hours, and it's not making me be at full potential to take care of that patient, just that idea, that theory, can become your research question, and to plan a simulation-based research based on that. Evaluating intervention, it goes with a pre- and post-design. SBR is a great tool for that, because you can actually replicate your pre- and post-phase very identically, and if you're getting your outcome measure that you're interested in, that can give you quite a bit of confidence that it's the intervention that you're putting into that research that is actually bringing out that outcome measure. Multi-center studies would have definitely their benefits of providing a larger sample size, and so it will bring the generalizability of the study. You can share the resources amongst collaborative sites, so it helps in mitigating some of the challenges that can happen in smaller hospitals. It would provide the network promotion and mentorship that may be needed by somebody who's just starting their career. And then, of course, having a bit more standardized process approach of a multi-center study can help in isolating the independent variables and reducing the bias. Just as this slide is heavy, multi-center studies are not easy, so kudos to Ilana. They are not easy to conduct. They have to go through several processes. There are several sub-steps, so there's a long timeline. There's a lot of effort that's behind these multi-center studies. And then mixed method strategies. This is a very evolving, blending approach. When you have an idea, you want to test it out first as it's in the simulation lab, and then you want to bring it out more in a bedside or in the database study manner. It provides a generalizability, and it provides a multi-center approach. Challenges associated with data collection would also be many, but again, it depends on how you can try to mitigate that challenges. We have to always look out for what is available at my institution, who I can reach out to, who would be there to mentor me to help mitigate these challenges. SPR, at times, would require the monetary funding, and quite a bit of it, so looking for your local institutional bodies, looking into your department, reaching out to the people who may already be working in the grant application. It's, I think, a good way to go. And then the national bodies that I mentioned here. It's a very competitive process, so that's where comes the role of mentorship, and looking out who can help me, and then these congress or national conferences when you can have roundtable discussion, be at the panels like this, and then just contact people who are already working and researching, and just, I would say, just do a simple permit and see if there's a research question you're interested in who's already doing research in that field, and just contacting them. I would say this simulation for professional development. I think this has helped me personally in a long way. I was always interested in simulation from my med school years to residency, and I did not have the right mentorship at that time, was always considered just as a med student. Okay, there's a lot to do, but if you have a passion, if you look out for it, I think there is a way. There is a way. Reach out to people, contact people, become part of the communities in SCCM and other regional organization that you could become part of. And the current advances in simulation, as we are seeing, just as the need of the time and what is available in the technology, these advanced life support provider courses, they are getting more and more blended. They are coming out from just being, having a certification, a renewal done from the simulation lab to becoming a part of online simulation, then doing just the hands-on for the things that you really need to. There is digital technology available to conduct simulation training for complex anatomical configuration surgeries, and then involving online synchronization, clinical simulation. This became, of course, big during the pandemic era. There was no safety with face-to-face and person-to-person contact, but here there are people actually involved in getting trained for an actual mock-up scenario online. And then involving the robotic simulation surgeries and the artificial intelligence for learning, training, and researching, really, for surgeries and the complex pathologies. And in the end, I would say collaboration is the key. It's not easy to get funded. It's not easy to even prepare the application for your grant. So collaborating with the national organizations like Inspire, we're actually having their conference right now in this moment of time, and then reaching out people on social media and attending conferences as much as you can, if it allows, your time allows. And I think that would be it for me. Thank you.

simulation-based research

training

team dynamics

medical procedures

conceptual and emotional realism