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Table 4 Ignition checklist for mobile community-based in situ simulation

From: Community-based in situ simulation: bringing simulation to the masses

1. General needs assessment
 □ Connect with outside hospital providers
 □ Informal discussions with stakeholder clinicians at the putative site regarding needs (bottom–up)
 □ Formal discussions with administration at putative site regarding needs (top–down)
 □ Formal discussion with administration at academic medical center regarding felt needs of remote site
 □ Develop needs assessment questions based on above
2. Targeted needs assessment
 □ Determine key topics/issues the remote site wants to focus on
 □ Explore with safety/quality/transport team at academic medical to identify deficiencies in care at site
 □ Prioritize topic areas
 □ Identify target learner groups and educators
3. Goals and objectives
 □ Broad goals: developed optimize patient outcomes
 □ Define objectives BEFORE case development: specific, measurable, achievable, realistic, timed
 □ Use objectives to develop cases
  Construct cases with content experts/inter-professional team (pilot test at your center)
  Refine cases based on feedback from community
 □ Pilot cases before site visit to work out kinks, issues—target flow and physiology
 □ Refinement of cases over time as new or changing needs evolve
4. Educational strategies/logistics
 □ Establish “no-go” criteria to minimize impact on actual patient flow with community site
 □ Emphasize need for trauma bay or resuscitation room as adds to realism and can test system
 □ Plan for best time of day—usually early morning is les busy for EDs
 □ Plan for travel—equipment, papers, back up technology, power strips, medications, etc.
 □ Use of unit specific resources (limitations on what can be opened/used)
 □ Schedule staff members to match
5. Implementation/sustainability
 □ Sign-up sheets for staff members, schedule far in advance, discuss payment vs. volunteer
 □ Designate community site champion to get staff excited
 □ Funding
  Indirect funding: educational/research grants, non-profit foundation support, donations
  Direct funding from academic or community medical centers: demonstrate value of program
 □ Community hospital staff engagement
  Train the trainer programs
  Dedicated program liaison personnel (“pediatric/other specialty champion: RN and/or MD”)
 □ Iterative evolution of academic medical centers role: how much sim, how often
6. Evaluation and feedback
 □ Evaluations: completed at conclusion of session- computer/paper
  □ In-person “hot” debriefing—on day of simulation
   Select format: rapid cycle deliberate practice for psychomotor skills, advocacy/inquiry for complex cases, spot debriefing, after action review model
   Determine time limit after each case
    Ensure flow of the session
    Parking lot—answer other questions through email or after the session
   Adapt debriefings over time: tele-debriefing, use of video
 □ Structured systems level debriefing/feedback—within 1 month
  Academic medical center: on number of transfers, engagement of community/customer
  Community site with specific action items for improvement
  Systems integration approach: engagement of quality, safety teams