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Simulation Curriculum Development, Competency-Based Education, and Continuing Professional Development

  • Jonathan Pirie
  • Liana Kappus
  • Stephanie N. Sudikoff
  • Farhan Bhanji
Chapter
Part of the Comprehensive Healthcare Simulation book series (CHS)

Abstract

Simulation-based education offers the potential to support healthcare providers to develop and maintain the essential competencies relevant to clinical practice—in a manner that can help them improve patient care and outcomes. Competency frameworks and models for competency-based education may help support this transformational change in education and assessment. Simulation should be appropriately coupled with other instructional methods to deliver the appropriate curricula for learners. The analysis, design, development, implementation, and evaluation (ADDIE) model offers a process to develop, implement, and evaluate curricular development. Each of the key phases will be described and the key considerations of each phase will be discussed. Future directions including high-stakes examinations and the development of standardized national curricula are also discussed.

Keywords

Curriculum development Continuing professional development (CPD) Competency-based education (CBE) Assessment 

References

  1. 1.
    Kohn LT, Corrigan JM, Donaldson MS (Institute of Medicine). To err is human: building a safer health system. Washington, DC: National Academy Press; 1999.Google Scholar
  2. 2.
    Dow AW, Salas E, Mazmanian PE. Improving quality in systems of care: solving complicated challenges with simulation-based continuing professional development. J Contin Educ Health Prof. 2012;32(4):230–5.CrossRefPubMedGoogle Scholar
  3. 3.
    Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005;27(1):10–28.CrossRefPubMedGoogle Scholar
  4. 4.
    McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation-based medical education research: 2003–2009. Med Educ. 2010;44(1):50–63.CrossRefPubMedGoogle Scholar
  5. 5.
    Cook DA, Hatala R, Brydges R, Zendejas B, Szostek JH, Wang AT, et al. Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA. 2011;306(9):978–88.CrossRefPubMedGoogle Scholar
  6. 6.
    Cheng A, Lang TR, Starr SR, Pusic M, Cook DA. Technology-enhanced simulation and pediatric education: a meta-analysis. Pediatrics. 2014;133(5):e1313–e23.CrossRefPubMedGoogle Scholar
  7. 7.
    Knight LJ, Gabhart JM, Earnest KS, Leong KM, Anglemyer A, Franzon D. Improving code team performance and survival outcomes: implementation of pediatric resuscitation team training. Crit Care Med. 2014;42(2):243–51.CrossRefPubMedGoogle Scholar
  8. 8.
    Grafinger DJ. Basics of instructional systems development. INFO-LINE Issue 8803. Alexandria: American Society for Training and Development; 1988.Google Scholar
  9. 9.
    Kern DE. Curriculum development for medical education: a six-step approach. Baltimore: Johns Hopkins University Press; 1998.Google Scholar
  10. 10.
    Rosen MA, Salas E, Silvestri S, Wu TS, Lazzara EH. A measurement tool for simulation-based training in emergency medicine: the simulation module for assessment of resident targeted event responses (SMARTER) approach. Simulation in healthcare: journal of the Society for. Simul Healthc. 2008;3(3):170–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Kraiger K, Ford JK, Salas E. Application of cognitive, skill-based, and affective theories of learning outcomes to new methods of training evaluation. J Appl Psychol. 1993;78(2):311–28.CrossRefGoogle Scholar
  12. 12.
    Benner P. From novice to expert. Am J Nurs. 1982;82(3):402–7.PubMedGoogle Scholar
  13. 13.
    Benner P. Using the dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice and education. Bull Sci Technol Soc. 2004;24(3):188–99.CrossRefGoogle Scholar
  14. 14.
    Carraccio CL, Benson BJ, Nixon LJ, Derstine PL. From the educational bench to the clinical bedside: translating the Dreyfus developmental model to the learning of clinical skills. Acad Med. 2008;83(8):761–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Daley BJ. Novice to expert: an exploration of how professionals learn. Adult Educ Q. 1999;49(4):133–47.CrossRefGoogle Scholar
  16. 16.
    Bandura A. Social learning theory. New York: General Learning Press; 1977.Google Scholar
  17. 17.
    Bogue R. Use S.M.A.R.T goals to launch management by objectives plan; 2014 [cited 2014 September 20]; http://www.techrepublic.com/article/use-smart-goals-to-launch-management-by-objectives-plan/.
  18. 18.
    Anderson LW, Krathwohl DR, Bloom BS. A taxonomy for learning, teaching. and assessing: a revision of Bloom’s taxonomy of educational objectives. Harlow: Longman; 2001.Google Scholar
  19. 19.
    Schumacher DJ, Englander R, Carraccio C. Developing the master learner: applying learning theory to the learner, the teacher, and the learning environment. Acad Med. 2013;88(11):1635–45.CrossRefPubMedGoogle Scholar
  20. 20.
    Knowles MS. Self-directed learning: a guide for learners and teachers. New York: Cambridge, the Adult Education Co.; 1975.Google Scholar
  21. 21.
    Kolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliffs: Prentice-Hall; 1984.Google Scholar
  22. 22.
    Choi J-I, Hannafin M. Situated cognition and learning environments: roles, structures, and implications for design. ETR&D. 1995;43(2):53–69.CrossRefGoogle Scholar
  23. 23.
    Schon DA. Educating the reflective practitioner: toward a new design for teaching and learning in the professions. New Jersey: Wiley; 1987.Google Scholar
  24. 24.
    Sharp LK, Bashook PG, Lipsky MS, Horowitz SD, Miller SH. Specialty board certification and clinical outcomes: the missing link. Acad Med. 2002;77(6):534–42.CrossRefPubMedGoogle Scholar
  25. 25.
    Ten Cate O, Snell L, Carraccio C. Medical competence: the interplay between individual ability and the health care environment. Med Teach. 2010;32(8):669–75.CrossRefPubMedGoogle Scholar
  26. 26.
    Carraccio CL, Englander R. From Flexner to competencies: reflections on a decade and the journey ahead. Acad Med. 2013;88(8):1067–73.CrossRefPubMedGoogle Scholar
  27. 27.
    Cheng A, Hunt EA, Donoghue A, Nelson-McMillan K, Nishisaki A, Leflore J, et al. Examining pediatric resuscitation education using simulation and scripted debriefing: a multicenter randomized trial. JAMA Pediatr. 2013;167(6):528–36.CrossRefPubMedGoogle Scholar
  28. 28.
    Brett-Fleegler M, Rudolph J, Eppich W, Monuteaux M, Fleegler E, Cheng A, et al. Debriefing assessment for simulation in healthcare: development and psychometric properties. Simul Healthc. 2012;7(5):288–94.CrossRefPubMedGoogle Scholar
  29. 29.
    Khanduja PK, Bould MD, Naik VN, Hladkowicz E, Boet S. The role of simulation in continuing medical education for acute care physicians: a systematic review. Crit Care Med. 2015;43(1):186–93.CrossRefPubMedGoogle Scholar
  30. 30.
    Ten Cate O. Medical Education Competency-based. The Wiley Blackwell encyclopedia of health, illness, behavior, and society. New Jersey: Wiley; 2014.Google Scholar
  31. 31.
    Kohn LT, Corrigan JM, Donaldson MS (Institute of Medicine). To err is human: building a safer health system. Washington, DC: National Academy Press; 2000.Google Scholar
  32. 32.
    Baker GR, Norton PG, Flintoft V, Blais R, Brown A, Cox J, et al. The Canadian adverse events study: the incidence of adverse events among hospital patients in Canada. CMAJ. 2004;170(11):1678–86.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Shaw R, Drever F, Hughes H, Osborn S, Williams S. Adverse events and near miss reporting in the NHS. Qual Saf Health Care. 2005;14(4):279–83.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Asch DA, Nicholson S, Srinivas S, Herrin J, Epstein AJ. Evaluating obstetrical residency programs using patient outcomes. JAMA. 2009;302(12):1277–83.CrossRefPubMedGoogle Scholar
  35. 35.
    Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, et al. Competency-based medical education: theory to practice. Med Teach. 2010;32(8):638–45.CrossRefPubMedGoogle Scholar
  36. 36.
    Cruess SR. Professionalism and medicine’s social contract with society. Clin Orthop Relat Res. 2006;449:170–6.PubMedGoogle Scholar
  37. 37.
  38. 38.
    Medical Scan Mistakes. What’s behind the problems? 2012; http://www.cbc.ca/news/canada/medical-scan-mistakes-what-s-behind-the-problems-1.1161747.
  39. 39.
    Frank JR, Danoff D. The CanMEDS initiative: implementing an outcomes-based framework of physician competencies. Med Teach. 2007;29(7):642–7.CrossRefPubMedGoogle Scholar
  40. 40.
    Batalden P, Leach D, Swing S, Dreyfus H, Dreyfus S. General competencies and accreditation in graduate medical education. Health Aff (Millwood). 2002;21(5):103–11.CrossRefGoogle Scholar
  41. 41.
    Simpson JG, Furnace J, Crosby J, Cumming AD, Evans PA, Friedman Ben David M, et al. The Scottish doctor–learning outcomes for the medical undergraduate in Scotland: a foundation for competent and reflective practitioners. Med Teach. 2002;24(2):136–43.CrossRefPubMedGoogle Scholar
  42. 42.
    Cohen ER, Feinglass J, Barsuk JH, Barnard C, O’Donnell A, McGaghie WC, et al. Cost savings from reduced catheter-related bloodstream infection after simulation-based education for residents in a medical intensive care unit. Simul Healthc. 2010;5(2):98–102.CrossRefPubMedGoogle Scholar
  43. 43.
    Barsuk JH, Cohen ER, Feinglass J, Kozmic SE, McGaghie WC, Ganger D, et al. Cost savings of performing paracentesis procedures at the bedside after simulation-based education. Simul Healthc. 2014;9(5):312–8.CrossRefPubMedGoogle Scholar
  44. 44.
    Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM. Fundamentals of laparoscopic surgery simulator training to proficiency improves laparoscopic performance in the operating room-a randomized controlled trial. Am J Surg. 2010;199(1):115–20.CrossRefPubMedGoogle Scholar
  45. 45.
    Barsuk JH, Cohen ER, Feinglass J, McGaghie WC, Wayne DB. Unexpected collateral effects of simulation-based medical education. Acad Med. 2011;86(12):1513–7.CrossRefPubMedGoogle Scholar
  46. 46.
    Bastian H, Glasziou P, Chalmers I. Seventy-five trials and eleven systematic reviews a day: how will we ever keep up? PLoS Med. 2010;7(9):e1000326.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Cervero RM, Gaines JK. Effectiveness of continuing medical education: updated synthesis of systematic reviews. Chicago: Accreditation Council for Continuing Medical Education; 2014.Google Scholar
  48. 48.
    Boet S, Bould MD, Bruppacher HR, Desjardins F, Chandra DB, Naik VN. Looking in the mirror: self-debriefing versus instructor debriefing for simulated crises. Crit Care Med. 2011;39(6):1377–81.CrossRefPubMedGoogle Scholar
  49. 49.
    Carraccio C, et al. Competency-based medical education: a charter for clinician-educators. Personal Correspondence; 2014.Google Scholar
  50. 50.
    Schuwirth LW, Van der Vleuten CP. Programmatic assessment: from assessment of learning to assessment for learning. Med Teach. 2011;33(6):478–85.CrossRefPubMedGoogle Scholar
  51. 51.
    Norcini JJ, Boulet JR, Opalek A, Dauphinee WD. The relationship between licensing examination performance and the outcomes of care by international medical school graduates. Acad Med. 2014;89(8):1157–62.CrossRefPubMedGoogle Scholar
  52. 52.
    Miller GE. The assessment of clinical skills/competence/performance. Acad Med. 1990;65(9 Suppl):S63–7.CrossRefPubMedGoogle Scholar
  53. 53.
    Hamstra SJ, Brydges R, Hatala R, Zendejas B, Cook DA. Reconsidering fidelity in simulation-based training. Acad Med. 2014;89(3):387–92.CrossRefPubMedGoogle Scholar
  54. 54.
    Hodges B. Assessment in the post-psychometric era: learning to love the subjective and collective. Med Teach. 2013;35(7):564–8.CrossRefPubMedGoogle Scholar
  55. 55.
    Norcini J, Anderson B, Bollela V, Burch V, Costa MJ, Duvivier R, et al. Criteria for good assessment: consensus statement and recommendations from the Ottawa 2010 Conference. Med Teach. 2011;33(3):206–14.CrossRefPubMedGoogle Scholar
  56. 56.
    Holmboe ES, Sherbino J, Long DM, Swing SR, Frank JR. The role of assessment in competency-based medical education. Med Teach. 2010;32(8):676–82.CrossRefPubMedGoogle Scholar
  57. 57.
    Holmboe ES, Ward DS, Reznick RK, Katsufrakis PJ, Leslie KM, Patel VL, et al. Faculty development in assessment: the missing link in competency-based medical education. Acad Med. 2011;86(4):460–7.CrossRefPubMedGoogle Scholar
  58. 58.
    McGaghie WC, Siddall VJ, Mazmanian PE, Myers J. Lessons for continuing medical education from simulation research in undergraduate and graduate medical education: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines. Chest. 2009;135(3 Suppl):62S–8S.CrossRefPubMedGoogle Scholar
  59. 59.
    Feldman M, Lazzara EH, Vanderbilt AA, DiazGranados D. Rater training to support high-stakes simulation-based assessments. J Contin Educ Health Prof. 2012;32(4):279–86.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Gallagher AG, Cates CU. Approval of virtual reality training for carotid stenting: what this means for procedural-based medicine. JAMA. 2004;292(24):3024–6.CrossRefPubMedGoogle Scholar
  61. 61.
    Hatala R, Kassen BO, Nishikawa J, Cole G, Issenberg SB. Incorporating simulation technology in a Canadian internal medicine specialty examination: a descriptive report. Acad Med. 2005;80(6):554–6.CrossRefPubMedGoogle Scholar
  62. 62.
    Levine AI, Schwartz AD, Bryson EO, Demaria S Jr. Role of simulation in U.S. physician licensure and certification. Mt Sinai J Med. 2012;79(1):140–53.CrossRefPubMedGoogle Scholar
  63. 63.
    Gallagher CJ, Tan JM. The current status of simulation in the maintenance of certification in anesthesia. Int Anesthesiol Clin. 2010;48(3):83–99.CrossRefPubMedGoogle Scholar
  64. 64.
    Royal College of Physicians and Surgeons of Canada. The Royal College’s MOC Program: Short Users Manual. [cited 2014 December 12]; http://www.royalcollege.ca/portal/page/portal/rc/members/moc.
  65. 65.
    Ingrassia PL, Ragazzoni L, Tengattini M, Carenzo L, Della Corte F. Nationwide program of education for undergraduates in the field of disaster medicine: development of a core curriculum centered on blended learning and simulation tools. Prehosp Disaster Med. 2014;29(5):508–15.CrossRefPubMedGoogle Scholar
  66. 66.
    Dudas RA, Colbert-Getz JM, Balighian E, Cooke D, Golden WC, Khan S, et al. Evaluation of a simulation-based pediatric clinical skills curriculum for medical students. Simul Healthc. 2014;9(1):21–32.CrossRefPubMedGoogle Scholar
  67. 67.
    Cheng A, Goldman RD, Aish MA, Kissoon N. A simulation-based acute care curriculum for pediatric emergency medicine fellowship training programs. Pediatr Emerg Care. 2010;26(7):475–80.CrossRefPubMedGoogle Scholar
  68. 68.
    Bank I, Cheng A, McLeod C, Bhanji F. Determining content for a simulation-based curriculum in pediatric emergency medicine: results from a National Delphi Process. CJEM. 2015:1–8.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Jonathan Pirie
    • 1
  • Liana Kappus
    • 2
  • Stephanie N. Sudikoff
    • 2
    • 3
  • Farhan Bhanji
    • 4
  1. 1.Department of Medicine, Department of PaediatricsUniversity of Toronto, The Hospital for Sick ChildrenTorontoCanada
  2. 2.SYN:APSE Center for Learning, Transformation and Innovation, Yale New Haven Health SystemNew HavenUSA
  3. 3.Pediatric Critical CareYale School of MedicineNew HavenUSA
  4. 4.Department of Pediatrics, Centre for Medical EducationMcGill University, Royal College of Physicians and Surgeons of CanadaMontrealCanada

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