Uploaded bySteve Mathieu
Digital Media and Clinical Excellence
The document discusses a foam product that has been downloaded 1 million times from 182 countries. While technology can provide educational resources, nothing can replace the experience of bedside teaching by medical professionals directly with patients. The foam product has been a popular educational tool but in-person instruction is still invaluable.
Digital Media and Clinical Excellence
- 18. F O A M 1 million FREEdownloads from 182 countries
- 20. Nothing can ever replacebedside teaching
Editor's Notes
- #2 Thanks very much +/- name I am a Consultant in Intensive Care and Anaesthesia at Portsmouth. Absolute honor to be here talking to you today. Thank you to the organising committee for inviting me I have no financial disclosures I’m going to talk to you about two really important areas that are relevant to every single one of us in this room today
- #3 The first is how you can use digital media to improve your personal educational experience as helping you as a trainer
- #4 The second, is how you can use digital media to enhance the reputation of your department by promoting your services, your story, your value and your team
- #5 Why am I being asked to talk about this...? My departments use of social media through twitter, our own departmental website, separate from the trust site, as well as innovations with the affordable use of other digital media was recognized by the CQC when they inspected our unit in Portsmouth in 2015. We were awarded an ‘outstanding rating’ and also received a number of plaudits for our work I would like to share our experiences and hopefully use it as a platform for further developing educational opportunities and innovation.
- #6 My personal journey into digital media in the NHS began properly in 2010 I had just started my consultant post and we had a meeting with my other 14 new consultant colleagues where we were going to discuss our SPA or departmental roles I remember the day very well. I was surrounded by people that had only recently been training me. I sat amongst the current president at the time of the Intensive Care Society. The Regional advisor for ICM training who had only recently signed me off as being competent to complete my CCT in Anaesthesia and ICM. I felt inspired. I was really excited when we starting to discuss what our roles would be within the department. I had been prepped by several people…”Don’t agree to do anything straight away”… I sat back…research...interesting but someone else far more qualified....governance...oohhh....maybe but “don’t agree to do anything”...someone else wanted to carry on doing this....the role of being the deputy Faculty Tutor for ICM training. Something I desperately wanted to do and very much part of my educational and mentorship career goals. YES! (“don’t agree to do anything straight away” but I want to do this.. More roles were discussed…. M & M lead…rota...IT...I’m not sure what happened at that point. Most people looked away and their was silence...be very very wary when this happens. Unfortunately whether it was because I was looking the other direction and forgot that important lesson and my hand went up. By a unanimous decision and more importantly in the absence of anyone else volunteering…I was the new IT lead!
- #7 I had no real idea what it would entail. IT for me was essentially playing computer games as a child. I had started to dabble with twitter and produced an unsuccesssful electronic journal club using wordpress. My interest and ability had eveloped really from this point. There will be many people in the audience who are far more capable than I am Josh – movie Big with Tom Hanks
- #8 So that’s a bit of background and the reason I mention it is to reassure anyone that you can push the boundaries of what was traditionally a rather nebulous and less glamorous role in IT to something really quite innovative, rewarding and fun. It’s opened up many opportunities for me including being invited to talk to you today
- #9 So let’s move on and talk about what ways can we use digital media for your own benefit as a learner and for the benefit of others with you as a trainer
- #10 So what I mean is using our current digitial age to allow educational resources and information to be avaialble your finger tips and then being able to share it widely and discuss it with anyone around the globe
- #11 This includes: 1. Rapid access to useful articles & engaging in simple discussion using twitter, facebook and reddit 2. Using feed aggregators to pull that information and then store it on your phone, ipad, laptop 3. Creating a repositry or personal library of all this information by means of websites and blogs 4. Listening to presentations through podcasts and watching conferences live through videocasts It can be as simple as recording your departmental teaching so that you then create a library of resources for those trainees that cannot attend or for induction purposes. St. Emlyns have done this for new starters to EM This all needs to be high quality, have some form of peer review process and ideally free. Open access and not hidden behind subscriptions and paywalls
- #12 Do we really need this? YES Lets go back to the 1950’s… Learning was easy. If you do a pubmed search under ‘intensive care’ or ‘critical care’ there will be 1 article returned. ‘Basically, all that is required is the current issue of The Journal, an easy chair, pencils, a pad of paper and postal cards, along with a genuine, sustaining interest in all fields of medicine’ Do the same literature search for 2015 and there are 24,000 citations. Let’s say only 1 % are relevant, you would still need to read 50 articles every single week to keep up to date. We need to adapt…
- #13 Shift patterns are changing; learning opportunities are different; individual styles of learning are evolving; web based resources are expanding We need to stop the cycle of teaching sessions which can end up with lonely trainers and unsatisfied trainees We need to share the best learning experiences and make them available for all at any time and any place Digitial Media can be used to help us..
- #14 Twitter is an incredible way of signposting resources, interacting and networking with similar like minded health care professionals If you don’t have a twitter account I do encourage you to at least try it.. Twitter is really just the start and the way most health care professionals begin to use digital media to enhance their learning
- #15 Websites offering open access resources and discussion forums allow you to and rapidly improving knowledge translation and engage with experts and research investigators. It allows you to keep up to date with the medical literature. Here are some really useful ones. Not an exhaustive list but worthy of mention…
- #16 Open access resources whether they are websites, podcasts and video-casts mean that you can tap into these resources at time that suits you. Gym, driving to work et If you are delivering a presentation why just to your department when many more can benefit from it this is the concept of asynchronous learning where students may end up learning the same material at different times and locations. It allows trainees to educate themselves in a way that suit their needs at times that suit them If you cannot attend a training session then you should be able to access this resource - this is the concept of asynchronous learning where students may end up learning the same material at different times and locations. It allows trainees to educate themselves in a way that suit their needs at times that suit them)
- #17 Even if we don’t use it, the next generation of doctors are and we need to be able to understand it role within education
- #18 This is the analytics for smacc conference last year Nearly 100,000 tweets and 182 million impressions. Impressions - no of times hashtags appear in someones twitter time line. Massive reach. LITFL = 20 million page views in one year! comparable to NEJM! Researchers are recognising this and engaging clinicians on twitter and blogs sites by contributing to the discussion forum or being interviewed on podcasts is now becoming much more common practice
- #19 smacc podcasts - all of them from smacc conference. Go onto iTunes and listen to these 20 minute podcasts for FREE
- #20 We must not forget the established methods for learning that have served us well for generations. The wise owl…our mentors..bed side teaching Nothing can and should ever replace this. Learning from an experienced mentor who is able to assimilate knowledge, appraise it and combine it with their wealth of experience is fundamental to the learning process. Social media & specifically FOAM can be used as adjuncts to support this educational experience. Making learning, easily accessible and fun. They are more computer literate and have been connected to internet from very early stages. They are used to using modern technology to rapidly access information. Once students graduate, they are subjected to many challenges with training which I have eluded to already. As trainers we therefore need to be aware of these resources and help guide them to the right ones and help develop their ability to critically appraise and utilise the information
- #21 We must not forget the established methods for learning that have served us well for generations. Bed side teaching - nothing can and should ever replace this. Learning from an experienced mentor who is able to assimilate knowledge, appraise it and combine it with their wealth of experience is fundamental to the learning process. Social media & specifically FOAM can be used as adjuncts to support this educational experience. Making learning, easily accessible and fun.
- #22 Next, I want to describe how you might use digital media to enhance the reputation of your department
- #23 We are very lucky to have an IT team dedicated to daily troubleshooting, training and innovations. Now whilst I appreciate you may think well ‘we can’t afford that luxury’ …perhaps you are right, afterall, I work in a trust that has an annual deficit of around 30 million pounds! However, we do not rely on trust IT, they cover general trouble shooting and provide 24/7 support on site if needed to sort out any unplanned downtimes of our CIS The innovations we have been able to develop within our department are very much because of this interface between clinician and digital technology expert. I think we are still early in our journey and if you consider other non NHS industries, we are years behind.
- #24 One of the first things I developed when I started as IT lead was a departmental website separate to our trust site. Trust site - usually reasonable for patients and relatives. Information for staff usually buried in the trust intranet site which lacks any functionality to get people interested. Content therefore becomes outdated and gathers cyber dust. Our trust site is actually better since I started this venture. There are ways of doing this without in depth coding knowledge. Wordpress is primarily a blogging site but can be used for this purpose. I use rapidweaver for mac which is more drag and drop and again you can build the site without much knowledge….and it’s fun to do The advantage of having your own departmental website is the freedom that it affords you to show what you offer to the public. It also provides a repository of the incredible work generated from you and your colleagues. Examples for us include… Training and induction material All of our guidelines Our safety ‘watch out notices’ Research opportunities Publications Barriers: governance concerns. Legitimate. Sensible senior clinician involvement. No politics. No personal opinion. Redirect complaints to appropriate channels and avoid answering on twitter. Never had complaint and usually very positive when public do engage
- #25 It’s amazing how such a simple thing as putting some passion and life into guidelines really builds a team spirit. Everyone in our department wants to contribute to them and they have become truly multi-disciplinary efforts. We have rebranded them and importantly put them out there for everyone to see. We have a simple trust disclaimer on them
- #26 We also have developed a series of watch out notices so we share learning experiences within our department but importantly with anyone. Open access on our website
- #28 We have a team brief in the morning and evening. Similar to safety huddles where we concentrate on … We do this around the patient safety screen. Safety hub.
- #30 This is a new inititive – critical cares It is important that there is substance behind the promotion
- #31 The other advantage is potential recruitment of future employees. This is your public face and potential employees are naturally going to look at the kind of department you are and what you are going to be able to offer them. With national recruitment down and potential drop in retention its essential that you promote your department. If you don’t, I guarantee others will On top of all of this is the positive feeling and morale boost that is created by this.. Other benefits – RECRUITMENT Even if that’s not persuasive enough, it can help with your recruitment needs..!! Discussion with DS – focus on this We have recruited full compliment of staff 22 doctors Showcase our unit and our training reputating Reputation = recruitment Manchester / St Emlyns
- #32 Other examples of what we have been doing in Portsmouth Clinical Information System Over 10 years E-prescribing + ability to download information from all our montiors as well as blood gases and lab results. Many of you will already have a CIS. For those departments that do not and plan to in the future, just consider the configurability of the system. This is essential. You need to be able to develop the system to keep it fresh, respond to national changes etc We configured our CIS and then negotiated a deal to become a reference site to demo it to other interested departments. We also sold our configuration back to the company that we purchased it from
- #33 This was our notice board at the entrance do our unit in 2012. Good impression? I’m not sure if no one has turned up for the night or if there has been a velcro failure and the named cons is on the floor
- #34 Along came this… Rasberry Pi. It costs about £40 Driven by the little black box containing a Rasberry Pi computer. Rasberry Pi is a tiny and affordable credit card sized single-board computer developed in the UK by the Rasberry Pi foundation to promote teaching of basic computer science in schools and developing countries
- #35 This is what we have used to create with it…
- #36 Interaction is handled through an input device called a Rotary Encoder and a PIR motion sensor triggers the screen saver during innactivity. You can set up different templates so that you could use it for: Clinics Safety screens Waiting times board Patient, relative or staff information Educational board…here is an example..
- #37 Next to our blood gas analyser we have an information screen for our staff. Idea is to assimilate info whether its patient safety, educational content etc. This is The Bottom Lines summary and review of VANISH – use of vasopressin + steroids in septic shock.
- #38 Positive Incident Reporting A number of departments are already using this to Formal system for capturing and investigating excellence Southampton have a FERF form (favourable event reporting form) We are just now beginning to pilot GREATIX on Portsmouth ICU. From Adrian Plunkett - https://worldhealthinnovationsummit.wordpress.com/2015/08/30/guest-blog-dr-adrian-plunkett-learning-from-excellence/ I believe we can apply this approach to quality improvement and safety in healthcare. Let us focus the lens on the really good practice and attempt to understand that, as well as the other end of the spectrum. Let’s not ignore the bad stuff completely but let us accept that error will always happen. We want systems that can tolerate error; this is resilience. I think we can go a long way to building these systems by studying and replicating excellence. I believe we can apply this approach to quality improvement and safety in healthcare. Let us focus the lens on the really good practice and attempt to understand that, as well as the other end of the spectrum. Let’s not ignore the bad stuff completely but let us accept that error will always happen. We want systems that can tolerate error; this is resilience. I think we can go a long way to building these systems by studying and replicating excellence.
- #39 So… SIMULATION
- #40 POCUS
- #41 AIRWAY
- #42 IT lead….now education technology / digital media lead – encompasses promoting all of these things, learning resources, innovation
- #43 Thanks very much In the spirit of open access medical education, all of my slides are available…