Faculty of Medicine and the Marine Institute team up to assist rural communities
Imagine a crewmember is working on the deck of a cruise ship in remote Antarctic waters. Seas are rough and the man is thrown overboard. Luckily the man is rescued from the frigid water, but his life is still in danger. He requires treatment onboard by the ship’s doctor who, due to the remoteness of their location, is the only person available to assist. What steps must the captain and ship’s doctor take together to ensure the safety of the patient?
This scenario, along with about 40 others, has been developed during the past two years by Tuckamore Simulation and Scholarship Research Collaborative, a Memorial University initiative to support research activities using simulation, which is a replication of a task or an event for the purpose of education as well as assessment. “The Tuckamore Collaborative functions by the same principles that spruce and balsam trees use to thrive together as a tuckamore in harsh climates,” said Dr. Adam Dubrowski, a professor in the Faculty of Medicine, founder and co-chair of Tuckamore and academic director of Memorial’s Clinical Learning and Simulation Centre (CLSC). “At Tuckamore, we conduct research to build best practices in how use innovative simulation technology to assist doctors and other health professionals in rural areas to keep up with best skills.”
For the cruise ship situation, several units from within the Faculty of Medicine teamed up with researchers at the Marine Institute to produce a man overboard scenario with rescue at sea, noted Dr. Dubrowski.
The man overboard scenario was developed by the team and then filmed for educational purposes using a faculty member at the Marine Institute’s Offshore Safety and Survival Centre in their environmental theatre, which simulates ocean waves, rain, wind, lighting conditions and sounds. It provides an immersive environment for training of maritime personnel but also for conducting research into human and equipment performance for different maritime and offshore emergency scenarios.
“The rescued ‘patient’ is resuscitated aboard the cruise ship in its infirmary,” explained Dr. Dubrowski. “The health care professional (potential trainee) uses the OSSC simulation laboratory to demonstrate the different steps required to move the patient from the water to the infirmary. Then, at the Marine Institute’s Centre for Marine Simulation, the simulation is further developed using a full mission simulator of a ship’s bridge to converse with the captain in order to discuss the patient’s condition and logistics/challenges of patient evacuation in heavy weather.”
“This collaboration has provided us with a great opportunity to develop new educational scenarios for training of health care professionals who may not have a full appreciation for the nature of shipboard operations and the limitations this sometimes places on them,” said Dr. Rob Brown, a research scientist at the Marine Institute’s OSSC who has been studying human and equipment performance in maritime emergencies since 2003.
Not only are these scenarios available to doctors in rural areas of this province, but they are freely available to anyone on a world-wide web-based journal called Cureus, which shares peer-reviewed, Pubmed and Medline indexed papers.
Dr. Dubrowski has partnered with Cureus to create a channel called ASSET (Archives of Simulation Scholarship and Educational Technologies), which is a repository of simulation teaching and learning tools, along with research supporting their best use. If you go to the Cureus website and search ASSET channel, you will find ‘Trauma and Hypothermia in Antarctica: An Emergency Medicine Marine Simulation Scenario.’
“There are two parts to using simulation as a teaching tool: technology and scenarios. The scenarios are like scripts for a screenplay, where the learner is the main actor,” Dr. Dubrowski said.
The aim is to create simulating events when health care providers have to perform high stake, low accordance skills. The Tuckamore scenarios, many of which include videos, are hosted on Cureus, and although they are contextualized to rural and remote environments, such as Newfoundland and Labrador, the group does work with researchers and educators from other parts of Canada, as well as Singapore, Malawi and Haiti to publish their work.
“Therefore our Cureus channel offers the scenarios to other institutions who may already have the simulation technology but not the scenarios,” added Dr. Dubrowski.
“In doing so, we hope to cut down of duplication of efforts and because the papers describing the scenarios are peerreviewed, we hope that the educational and clinical quality of the scenarios will improve”