Simulation in healthcare : journal of the Society for Simulation in Healthcare
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The Effective Management of Anesthetic Crises (EMAC) course is a joint initiative between the Australian and New Zealand College of Anesthetists (ANZCA) and simulation centers. This standardized 2.5-day course has become an integral component of training for Fellowship of ANZCA and as such is an innovative development on the global anesthesia scene. ⋯ The course is perceived by participants as changing their practice and improving their management of anesthetic crises. Exposure to the concepts of effective crisis management is now widespread in the anesthetic community in the region and should contribute to improved patient safety.
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Despite its relatively short track record, simulation has been successfully introduced into the surgical arena in an effort to augment training. Initially a fringe endeavor at isolated centers, simulation has now become a mainstream component of surgical education. The surgical community is now aware that the old adage, "see one, do one, and teach one" is no longer acceptable from the ethical standpoint of practicing procedures on patients. ⋯ Importantly, simulation standards are being established and there is an unprecedented national acceptance and endorsement of simulation as an invaluable educational tool; in fact, simulation is being mandated for surgical residency programs. Team training will likely expand the impact of surgical simulation considerably and help assure multidimensional competency verification. For both surgery residents and surgeons in practice, simulation holds great promise as a safe, effective, and efficient means of acquiring new skills.
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Biography Historical Article
Michael S. Gordon, MD, PhD and the University of Miami Center for Research in Medical Education.
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We report on our experience with an approach to debriefing that emphasizes disclosing instructors' judgments and eliciting trainees' assumptions about the situation and their reasons for acting as they did. To highlight the importance of instructors disclosing their judgment skillfully, we call the approach "debriefing with good judgment." The approach draws on theory and empirical findings from a 35-year research program in the behavioral sciences on how to improve professional effectiveness through "reflective practice." This approach specifies a rigorous self-reflection process that helps trainees recognize and resolve pressing clinical and behavioral dilemmas raised by the simulation and the judgment of the instructor. The "debriefing with good judgment" approach is comprised of three elements. ⋯ Advocacy is a type of speech that includes an objective observation about and subjective judgment of the trainees' actions. Inquiry is a genuinely curious question that attempts to illuminate the trainee's frame in relation to the action described in the instructor's advocacy. We find that the approach helps instructors manage the apparent tension between sharing critical, evaluative judgments while maintaining a trusting relationship with trainees.