Simulation Technology and Immersive Learning, coupled with the resources of Northwestern
University’s Feinberg School of Medicine, has allowed Northwestern to make unique
and crucial contributions to the field of simulation-based training and research,
most prominently in the areas of:
- Advanced training programs in surgical skills
- Mastery of procedural skills for emergency physicians, internists, and neurologists
- Risk-informed simulations to reduce adverse events
- Interprofessional education
- Procedural sedation protocols for non-anesthesiologists
Northwestern’s success in this area is based upon years of effort, building expertise
and infrastructure in support of dedicated investigators. For a full listing of
our research, please click
PIVOT: Patients' Insights Views & Observations of Teams
Patients’ Insights Views & Observations of Teams (PIVOT), a new research project that includes several members of Simulation Technology and Immersive Learning (STIL) staff, seeks to capture what patients observe about medical teams during their time in the emergency department.
The purpose of his study is to determine which teamwork-related behaviors patients may observe and describe that would be helpful to know from a healthcare provider perspective. This information will provide the basis for instrument development to measure patient perception of teamwork qualities observed when receiving care in the ED. Future work on this project will include testing of that instrument. Ultimately, research into patient-perceived teamwork-related behaviors and potential ties to clinically relevant markers of quality may be information healthcare team members feel is helpful to know to improve patient outcomes.
For more information on PIVOT, click here.
Corridor of Innovation: Simulation for Improved Healthcare Outcomes, Chicago to
Funded by the Jump Trading Simulation and Education Center Award through the OSF Foundation
For this project, a pioneer in its field, Northwestern University Feinberg School
of Medicine and its partner hospitals will work in partnership with co-investigators
from the University of Illinois College of Medicine at Peoria and the OSF Saint
Francis Medical Center, known as the UICOMP-OSF system. Together, they will work
to create programs that will educate learners and simultaneously develop the knowledge,
skills, and attitudes of instructors engaging in simulation-based education.
Each of the separate studies addresses at least one crucial issue within a medical
specialty and also fosters further understanding of how simulation-based training
can improve clinical outcomes, reduce risk to patients, and streamline medical training.
The project has the potential to build a foundation for more systemic, structured
training of medical students, residents and other medical personnel through the
use of simulation to provide true-to-life experience and individualized feedback.
Additionally, a partnership between an urban academic medical center and a high-
quality regional tertiary care system will serve as a model for the use of simulation
to improve patient care throughout Illinois and the nation. Overall, this collaboration
provides new avenues to discovery, addressing how healthcare simulation may be best
used to increase healthcare quality and safety, while lowering its expense.
Critical Areas for Improvement in Care Delivery of Emergency Department Severe Sepsis
PI: Emilie Powell, MD, MBA
The long-term goal of this research is to optimize severe sepsis emergent care delivery
across institutions throughout the United States and improve associated mortality.
This project will identify critical areas for improvement in the quality, safety,
efficiency, and effectiveness of severe sepsis care delivery. Special attention
will be given to improving patient safety by identifying the root causes of failures
in emergency department (ED) severe sepsis resuscitation. The project will use innovative
risk assessment techniques, adopted from other high-risk industries, across three
institutions. The next step will be to use this experience to develop a tool kit
for system-wide teamwork education and operational improvements in severe sepsis
Reducing Errors and Complications by Training Medical Residents in Central Venous
Catheter (CVC) Insertion to Mastery Standards
PI: Jeffrey Barsuk, MD, MSCI
The overall objective of this research is to teach medical procedures using simulation
technology and the mastery-learning model with the aim of improving trainee skill
performance and reducing medical errors at other institutions. More specifically,
our proposal will train medical residents in central venous catheter insertion to
mastery standards at these institutions with the hope of showing improvement in
patient care and reduction in iatrogenic complications (including catheter-associated
Quality Improvement Techniques in a Team-Based Response to the Obstetric Emergency
of Shoulder Dystocia
PI: William Grobman, MD, MBA; Jane Holl, MD
The researchers have previously utilized quality improvement techniques to develop
a team-based response to the obstetric emergency of shoulder dystocia (Grobman et
al, Simulation in Health Care, 2010). They determined that after this protocol was
implemented, the frequency of complete, consistent documentation of key elements
regarding shoulder dystocia increased significantly, achieving a rate of over 90
percent. Moreover, brachial plexus palsies that were diagnosed at the time of shoulder
dystocia, and those that remained present at the time of the newborn’s discharge
from the hospital declined significantly (Grobman et al, American Journal of Obstetrics
and Gynecology, 2010). The research team believes these outcomes can be replicated
in other health care institutions, specifically within the OICOMP-OSF collaborative.
Advanced Skills Training for Rural Surgeons
PI: Amy Halverson, MD
The American College of Surgeons (ACS) is developing a multidisciplinary course
to meet the unique needs of rural surgeons, and is working with STIL for the administration
of a pilot course which will include web-based educational and self- assessment
modules. The simulation lab will be used for hands-on, mentored practice and simulation
to teach leadership and communication skills. The goal is for the first four modules
(described below) to be utilized at ACS training centers nationwide, with additional
modules being developed next year.
This pilot course will include modules on Leadership and Communication in the Operating
Room, Advanced Polypectomy Techniques, Emergency Gynecology, Emergency Urology and
Management of Minor Facial Lesions and Lacerations. The content was chosen after
interviewing numerous rural surgeons and conducting a needs assessment survey. Follow-up
assessment of the participants will continue over six months with verification of
proficiency testing in October 2011 at the ACS Annual Clinical Congress.
Development of a Simulation-Based Pediatric Critical Care Stabilization and Transfer
PI: Mark Adler, MD; Melissa Brannen, MD
The key goal of this project is the improvement and regularization of the initial
care and stabilization of children prior to transfer to a tertiary care facility.
The basic plan includes developing a pilot curriculum, based on a content map created
with input from educational design and simulation experts, content experts from
the Children’s Hospital of Illinois ICU, and staff at the target referral hospitals.
The curriculum will be pilot tested and revised based on feedback from both the
target audience and experts. The revised system will then be implemented at a representative
sample of referral hospitals.
Sedation Administered by Non-Anesthesiologists: A Simulation-Based Training Approach
Christine Park, MD
Focused training in the safe delivery of sedative drugs, patient monitoring and
rescue from unanticipated events is necessary in order to ensure safe outcomes for
patients receiving sedation from a non-anesthesiologist. Given than many sedations
are being administered in a variety of non-operating room settings, remote from
readily available help, and in a patient population with increasing co-morbid conditions,
the need to provide effective training and assessment of competence is great in
these potentially high-risk settings.
Although there are many studies on sedation practices in out-of-operating-room settings,
high quality data analyzing practice parameters between practitioners and specialties
are lacking. However, some investigators have observed latent failures and vulnerabilities
among sedation providers which supports the potential of using human simulation
to train and improve rescue system performance. In this project, the investigators
will study the use of mannequin-based simulation as an adjunct to non-simulation
methods of training in the administration of sedation by non- anesthesiologists.
The goal is to identify the elements of training necessary to ensure competent practice
as well as competent rescue performance during the administration of sedation.
Simulation for Maintenance of Specialty Certification
PI: Christine Park, MD
In order to maintain certification in anesthesiology, a practicing anesthesiologist
must meet the requirements for Maintenance of Certification in Anesthesiology (MOCA)
in a recurring 10-year cycle. Currently, MOCA requirements are: a demonstration
of continued clinical practice, passing a written test, participating in traditional
continuing medical education, completing a quality improvement project, and participating
in a simulation-training course.
The investigators propose a study of the use of mannequin-based simulation to conduct
high-stakes assessment of practicing clinicians for maintenance of specialty certification.
The outcomes of the proposed research will be applicable to evaluating competencies
of physicians in a range of acute care specialties (e.g., emergency medicine, critical
care, hospital medicine, or surgery). This collaboration will investigate a number
of necessary elements to conduct simulation-based clinical competency assessment.
Deliberate versus Repetitive Practice of Operative Skill
PI: Carla Pugh, MD, PhD
The use of surgical skills laboratories is on the rise; however, there are still
many unanswered questions regarding the best use of simulation for training and
assessing the broad range of surgical skills necessary in becoming a competent surgeon
and maintaining competency as a trained clinician. The purpose of this project is
to compare two training methods: Repetition-Based Practice vs. Deliberate Practice.
Repetition- Based Practice allows the learner to practice a skill numerous times
until they reach a certain criterion level of performance. Deliberate Practice starts
with a simulation-based assessment of the learner, then subsequent training and
assessment is individualized and based on prior errors. Project outcomes include
validated training curricula and a better understanding of the factors that play
a role in mastery of operative skill.
Improving the Safety of Pediatric Inter-facility Transfers
PI: Donna Woods, PhD, MEd
The goal of this project is to use simulation methods to implement the Clinical
Information Network to optimize the effectiveness of clinical communication, assessment,
and decision-making in the course of pediatric inter-facility transfers and to improve
patient safety and reduce harm. The transfer of pediatric patients from one hospital
to another hospital has been repeatedly shown to be a high risk transition. Accurate
patient assessment and communication of pertinent clinical information are key challenges
to the safe transfer of pediatric patients. The Clinical Information Network was
designed, through ARHQ funded research, to standardize the pertinent clinical elements,
processes, and tools to improve communication, assessment, decision-making, and
documentation during pediatric emergency transfers. The web-based and electronic
medical record (EMR) vendor independent Clinical Information Network tool was informed
by the risk assessments, industrial engineering observations, and expert input.
Implementation of health information technology solutions, however, without testing,
attention to workflow, and other considerations has the potential to introduce new
risks and has been shown to increase morbidity and mortality.