As a pediatric emergency physician at Montreal Children鈥檚 Hospital (MCH) and an associate professor of pediatrics at the 91社区 Faculty of Medicine and Health Sciences, Dr. Ilana Bank is well-versed in the complex training that informs a hospital鈥檚 response to emergency situations. Doctors, nurses, respiratory therapists, and other healthcare staff carefully study and practice how to be in the right place at the right time. It鈥檚 all part of Dr. Bank鈥檚 ongoing research, 鈥淔lipping the Classroom in Simulation: An Analysis of Mixed-Modality Simulation-Based Training in Continuing (Inter)professional Development in the Time of COVID-19.鈥�
Dr. Bank鈥檚 study centers around simulations, or mock scenarios, of whole hospital emergency procedures and codes to refine patient and provider safety needs. Through continuously reexamining protocols, a hospital can work toward providing care that is efficient, effective, and holistic.
鈥淗ealthcare is not just about textbook knowledge,鈥� says Dr. Bank. 鈥淎nyone can look up anything in a book. The key to these simulations is understanding human dynamics: our ability to effectively communicate with and trust our team members in high-stress situations.鈥�
When COVID-19 first sent Canada into lockdown last March, hospital staff had to redevelop safety protocols for everything from intubation and CPR to trauma responses and transporting patients between units. For two weeks, Dr. Bank and her colleagues studied every unit procedure, troubleshooting for potential challenges that might result from government-issued COVID-19 guidelines for hospitals.
When the time came to put these ideas into practice, the team utilized a flipped classroom approach. 鈥淲e put together a tabletop simulation, which we could broadcast on Zoom, to run through the new protocols as they developed,鈥� Dr. Bank explains. 鈥淲e walked through every step: who鈥檚 wearing full PPE, who鈥檚 on first response or standby, which hallways to take when we have to socially distance, and so on. This stage allows us to iron out the bigger challenges before attempting an in-person scenario, where we can focus on fine-tuning spacing and communication.鈥�
In one problem-solving simulation, Dr. Bank and her colleagues found they couldn鈥檛 fit a crib through a doorway, requiring either a different mode of transport or alternative pathway. In another, they identified the need for communication devices connecting the inside and outside teams for the trauma bay, since the handling team was considered 鈥渄irty鈥� with potential virus exposure while the outside team was considered 鈥渃lean.鈥� 鈥淭hese were issues we didn鈥檛 always have before COVID,鈥� Dr. Bank notes. 鈥淣ow, when these scenarios happen in real time with real patients, we鈥檙e prepared to keep everyone safe while providing the best care we possibly can.鈥�
Although the in-person component was put on hold for several months while the government limited in-person education, Dr. Bank鈥檚 research team looks forward to continuing simulations in the fall. They鈥檙e grateful for the support they鈥檝e received from the Institute of Health Sciences Education Innovation and Research Seed Fund鈥檚 鈥淪pecial Call: IHSE Research Grants on Educational Advancements or Innovations in Response to COVID-19,鈥� which has allowed them to take their research beyond local and pediatric applications.
鈥淭he COVID-19 Seed Fund grant gives us the means to share and disseminate our insights at the national and international levels,鈥� Dr. Bank affirms. 鈥淲e have no way to predict what new crisis we鈥檒l face a decade or century from now. These types of funding sources open the door to apply our findings in new contexts, both in the present and future.鈥�