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Conference paperMulki O, Plumptre I, Granados A, et al., 2016,
Bimanual vaginal examination: Using innovation through cognitive task analysis to standardise practise and enhance teaching
, Publisher: Wiley, Pages: 205-205, ISSN: 1470-0328 -
Journal articleKneebone R, Weldon S-M, Bello F, 2016,
Engaging patients and clinicians through simulation: rebalancing the dynamics of care
, Advances in Simulation, Vol: 1, ISSN: 2059-0628This paper proposes simulation-based enactment of care as an innovative and fruitful means of engaging patients and clinicians to create collaborative solutions to healthcare issues. This use of simulation is a radical departure from traditional transmission models of education and training. Instead, we frame simulation as co-development, through which professionals, patients and publics share their equally (though differently) expert perspectives. The paper argues that a process of participatory design can bring about new insights and that simulation offers understandings that cannot easily be expressed in words. Drawing on more than a decade of our group’s research on simulation and engagement, the paper summarises findings from studies relating to clinician-patient collaboration and proposes a novel approach to address the current need. The paper outlines a mechanism whereby pathways of care are jointly created, shaped, tested and refined by professionals, patients, carers and others who are affected and concerned by clinical care.
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Conference paperRalhan S, Weldon S, Kneebone R, et al., 2016,
Sequential Simulation Workshops: An Innovative Approach to Working Together (engaging front-line staff, patients and publics) to Develop New Integrated Models of Care
, Trainees in the Association for the Study of Medical Education -
Journal articlePowell P, Sorefan Z, Hamilton S, et al., 2016,
Exploring the potential of sequential simulation.
, The Clinical Teacher, Vol: 13, Pages: 112-118, ISSN: 1743-498XCONTEXT: Several recent papers have highlighted the need for better integrated care to improve health care for children and families. Our team spent a year exploring the potential of 'Sequential Simulation' (SqS) as a teaching tool to address this need with young people and multidisciplinary teams. SqS allows the simulation of a series of key events or 'crunch points' that come together to represent the patient journey, and highlights the impact of individuals on this journey. The pilot SqS was based on an adolescent with asthma - a common condition that requires excellent multidisciplinary care with the patient at the centre. INNOVATION: The SqS was designed using transportable sets and audio-visual equipment to create realism. Actors were employed to play the roles of the young person and mother and health professionals played themselves. The SqS was run at different events with varied audiences, including young people, health professionals and teachers. It was used to explore the difficulties that can arise during a patient journey, the importance of communication throughout, and to highlight the significance of each individual in the patient experience. RESULTS: The SqS was met with enthusiasm and felt to be an innovative and effective way of promoting better teamwork and communication. It was well received at a school asthma education event for pupils and community teams, demonstrating its varied potential. The year was the first step in the introduction of this exciting new concept that has the potential to help promote better integrated care for paediatric patients and their families. Our team spent a year exploring the potential of 'Sequential Simulation' as a teaching tool [to provide better integrated care].
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Conference paperWeldon S, Korkiakangas T, 2016,
Video-Supported Simulation for Interactions in the Operating Theatre (ViSIOTTM)
, The Society in Europe for Simulation Applied to Medicine -
Conference paperKorkiakangas T, Weldon S, 2016,
ViSIOT: Evidence-based training for improving interactions in the operating room
, AORN Surgical Conference & Expo -
Conference paperWeldon S, Korkiakangas T, 2016,
Music in the Operating Room
, AORN Surgical Conference & Expo -
Conference paperKorkiakangas T, Weldon S, 2016,
Mobilizing a team for the Surgical Safety Checklist: Interactional analysis
, AORN Surgical Conference & Expo -
Journal articleSadideen H, Weldon S-M, Saadeddin M, et al., 2015,
A Video Analysis of Intra- and Interprofessional Leadership Behaviors Within "The Burns Suite": Identifying Key Leadership Models
, Journal of Surgical Education, Vol: 73, Pages: 31-39, ISSN: 1931-7204ObjectiveLeadership is particularly important in complex highly interprofessional health care contexts involving a number of staff, some from the same specialty (intraprofessional), and others from different specialties (interprofessional). The authors recently published the concept of “The Burns Suite” (TBS) as a novel simulation tool to deliver interprofessional and teamwork training. It is unclear which leadership behaviors are the most important in an interprofessional burns resuscitation scenario, and whether they can be modeled on to current leadership theory. The purpose of this study was to perform a comprehensive video analysis of leadership behaviors within TBS.MethodsA total of 3 burns resuscitation simulations within TBS were recorded. The video analysis was grounded-theory inspired. Using predefined criteria, actions/interactions deemed as leadership behaviors were identified. Using an inductive iterative process, 8 main leadership behaviors were identified. Cohen’s κ coefficient was used to measure inter-rater agreement and calculated as κ = 0.7 (substantial agreement). Each video was watched 4 times, focusing on 1 of the 4 team members per viewing (senior surgeon, senior nurse, trainee surgeon, and trainee nurse). The frequency and types of leadership behavior of each of the 4 team members were recorded. Statistical significance to assess any differences was assessed using analysis of variance, whereby a p < 0.05 was taken to be significant. Leadership behaviors were triangulated with verbal cues and actions from the videos.ResultsAll 3 scenarios were successfully completed. The mean scenario length was 22 minutes. A total of 362 leadership behaviors were recorded from the 12 participants. The most evident leadership behaviors of all team members were adhering to guidelines (which effectively equates to following Advanced Trauma and Life Support/Emergency Management of Severe Burns resuscitation guidelines and hence &l
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Journal articleBezemer J, Korkiakangas T, Weldon S, et al., 2015,
Unsettled teamwork: Communication and learning in the operating theatres of an urban hospital
, Journal of Advanced Nursing, Vol: 72, Pages: 361-372, ISSN: 0309-2402AimTo explore the unsettling effects of increased mobility of nurses, surgeons and other healthcare professionals on communication and learning in the operating theatre.BackgroundIncreasingly, healthcare professionals step in and out of newly formed transient teams and work with colleagues they have not met before, unsettling previously relatively stable team work based on shared, local knowledge accumulated over significant periods of close collaboration.DesignAn ethnographic case study was conducted of the operating theatre department of a major teaching hospital in London.MethodVideo recordings were made of 20 operations, involving different teams. The recordings were systematically reviewed and coded. Instances where difficulties arose in the communication between scrub nurse and surgeons were identified and subjected to detailed, interactional analysis.FindingsInstrument requests frequently prompted clarification from the scrub nurse (e.g. ‘Sorry, what did you want?’). Such requests were either followed by a relatively elaborate clarification, designed to maximize learning opportunities, or a by a relatively minimal clarification, designed to achieve the immediate task at hand.ConclusionsSignificant variation exists in the degree of support given to scrub nurses requesting clarification. Some surgeons experience such requests as disruptions, while others treat them as opportunities to build shared knowledge.
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Journal articleCope AC, Bezemer J, Kneebone R, et al., 2015,
'You see?' Teaching and learning how to interpret visual cues during surgery
, MEDICAL EDUCATION, Vol: 49, Pages: 1103-1116, ISSN: 0308-0110- Author Web Link
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- Citations: 38
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BookKorkiakangas T, Weldon S, Bezemer J, et al., 2015,
“Coming Up!”: Why verbal acknowledgement matters in the operating theatre
, Publisher: Equinox -
Journal articleKneebone RL, Pelletier C, 2015,
Learning safely from error? Reconsidering the ethics of simulation-based medical education through ethnography
, Ethnography and Education, Vol: 11, Pages: 267-282, ISSN: 1745-7831‘Human factors’ is an influential rationale in the UK national health service to understand mistakes, risk and safety. Although there have been studies examining its implications in workplaces, there has been little investigation of how it is taught, as a form of professional morality. This article draws on an observational study of human factors teaching in four hospital simulation centres in London, UK. Its main argument is that the teaching of human factors is realised through an identification and positive evaluation of ‘non-technical skills’ and the espousal of ‘non-judgemental’ pedagogy, both of which mean that mistakes cannot be made. Professional solidarity is then maintained on the absence of mistakes. We raise questions about the ethics of this teaching. The study is situated within a history of ethnographic accounts of medical mistakes, to explore the relationship between claims to professional knowledge and claims about failure.
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Journal articleBrunckhorst O, Shahid S, Aydin A, et al., 2015,
Simulation-based ureteroscopy skills training curriculum with integration of technical and non-technical skills: a randomised controlled trial
, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 29, Pages: 2728-2735, ISSN: 0930-2794- Author Web Link
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- Citations: 40
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Journal articleKneebone RL, Weldon SM, Ralham S, et al., 2015,
Sequential Simulation (SqS): an innovative approach to educating GP receptionists about integrated care via a patient journey – a mixed methods approach
, BMC Family Practice, Vol: 16, ISSN: 1471-2296BackgroundAn evaluation of an effective and engaging intervention for educating general practice (GP) receptionists about integrated care and the importance of their role within the whole system was conducted.MethodsWorkshops took place in North West London, one of England’s 14 ‘Integrated Care Pioneers.’ Three training days featuring Sequential Simulations (SqS) were held. Forty GP receptionists attended on each day, as well as 5–6 patients and 8–9 healthcare professionals. The SqS developed was from a collection of patient stories, the key scene of which featured a GP receptionist. The scenes were designed to show the consequences for the patient of professionals working in silos. This provided the focus for facilitated table discussions. The discussants suggested ways in which an unfortunate series of events could have been dealt with differently. These suggestions were then incorporated in a re-designed SqS. Evaluation was conducted through questionnaires, field notes and analysis of video material. Descriptive statistics and thematic analysis were applied.ResultsNinety three participants responded to the questionnaire out of 131 attendees. All (93/93) respondents reported that the event was a powerful learning experience and that they had gained confidence in improving patient care. 98 % (91/93) reported that their knowledge of integrated care had improved. The simulation was rated highly as a learning experience [60 % (57/93) - excellent, 39 % (37/93) good]. Further evidence of educational benefit was expressed through comments such as: ‘The simulations really got me thinking about the patient as a human with many problems and situations.’ConclusionSqS is an innovative and practical way of presenting current care pathways and health care scenarios in order to create a shared focus, engage the emotions of the participants and bring the principles of integrated care to life. Facilitated table discussions are an opportuni
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Journal articleKneebone RL, 2015,
When I say … reciprocal illumination
, Medical Education, Vol: 49, Pages: 861-862, ISSN: 1365-2923This paper proposes the idea of education as engagement rather than transmission, by which I mean an open-minded exchange of perspectives resulting in ‘reciprocal illumination’ for everyone who takes part. Terminology is important here. Mention the term ‘public engagement’ and people think of experts pontificating about their pet subject – at science fairs, perhaps, or outreach activities. The assumption is that experts know lots and transmit their knowledge without being changed much, and that members of the public don't know much at all and stand to gain far more. However, perhaps a different framing might open new opportunities.
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Journal articleKneebone RL, Pelletier C, 2015,
Fantasies of medical reality: An observational study of simulationbased medical education
, Psychoanalysis, Culture and Society, Vol: 21, Pages: 184-203, ISSN: 1543-3390Medicine is increasingly taught in immersive simulated environments, to supplement the apprenticeship model of work-based learning. Clinical research on this educational practice focuses on its realism, defined as a property of simulation technology. We treat realism as a function of subjective but collectively organised perception and imbued with fantasy, which we define by drawing on Lacanian studies of virtual reality and workplace organisation. Data from an observational study of four simulation centres in London teaching hospitals is drawn on to present an account of what was taught and learned about medicine, including medical failure, when medical practice was simulated.
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Journal articleBrewin J, Tang J, Dasgupta P, et al., 2015,
Full immersion simulation: validation of a distributed simulation environment for technical and non-technical skills training in Urology
, BJU INTERNATIONAL, Vol: 116, Pages: 156-162, ISSN: 1464-4096- Author Web Link
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- Citations: 45
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Journal articleWeldon S, Korkiakangas T, Bezemer J, et al.,
Music and communication in the operating theatre
, Journal of Advanced Nursing, ISSN: 1365-2648 -
Conference paperPaice L, Weldon S, Ralhan S, et al., 2015,
Sequential simulation (SqS) of a patient journey: an intervention to engage GP receptionists in integrated care
, 15th International Conference on Integrated Care, Publisher: Ubiquity Press, ISSN: 1568-4156
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