2019 HSC Section 2 - Practice Management

Emotional Intelligence and Simulation

study on voluntary participation in simulation by surgical residents, Chang and col- leagues 55 found that, even though surgical residents found simulators to be helpful, the frequency with which the residents practiced technical skills on the simulator was low. For example, 0% of postgraduate year (PGY) 4 and PGY5 residents returned to the simulator after an introductory session. These investigators also concluded that to be effective, an educational intervention for busy residents must be mandatory. Several studies have demonstrated the performance gains that can be made when simulation is mandatory and afforded protected time for residents. In one study by Seymour, 56 a structured simulation curriculum was associated with an increase in resident technical skills in laparoscopic surgery. Within the realm of nontechnical skills, protected simulation to learn how to break bad news has been shown to be well liked and well received by resident physicians across multiple specialties including surgery, emergency medicine, and pediatrics. 43,57,58 Furthermore, these studies demonstrated that performance of residents breaking bad news as rated by a faculty reviewed improved after participating in the simulation curriculum. The other critical lesson from the studies on breaking bad news, which is highly rele- vant to designing simulation for developing EI, is that simulation is only 1 piece of the overall intervention. Before simulation, the residents or medical students who partic- ipated in the simulation were required to prepare for the simulation session by completing readings, watching videos, or attending more traditional didactic sessions. This preparatory work was then followed by the simulations that provided an oppor- tunity for the trainees to enact the lessons they learned from their previous work. Feed- back was provided to the trainees so that they would have the opportunity to improve on future sessions, which highlights the importance of spaced or intermittent sessions. By creating a more longitudinal design with repeated observations, the trainees are afforded the opportunity to demonstrate improvement and consequently the effective- ness of prior intervention sessions. Multiple sessions also provide the space for forma- tive as well as summative feedback and assessment. To summarize, the authors believe that effective simulation interventions aimed at EI will demonstrate the following characteristics: Occur during protected educational time without competing academic or clinical responsibility Require preparatory work before the simulation session Provide postsimulation feedback/assessment and allow postsimulation review of behavior and performance to allow for self-reflection with opportunities for delib- erate practice Be longitudinal in nature to allow for tracking of progression The use of simulation for EI development or assessment is rich with opportunities for research and investigation. One fundamental area of research is the development of appropriate EI simulation cases. This process may require a presimulation needs assessment, as well as iterative creation of standardized, simulated cases that present emotionally demanding scenarios to simulation participants. Residents, patients, nurses, program directors, and attending surgeons could all be polled to identify the types of situations that are most commonly faced or most commonly strain EI. Then, standardized case scenarios based on these needs assessments could be drafted, piloted, and revised. Another area of research is evaluating the effectiveness of simulation to discriminate between individuals with different EI profiles. Standardized performance metrics could FUTURE RESEARCH

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