Learners
You will be working with your team to manage a simulated patient using the VRR. You will apply your knowledge and rehearse your crisis resource management skills. Have fun!
Everything you need to participate in a VRR sim can be found here.
Sim Basics
Simulation is a way to gain experience working as a team while reviewing the management of sick patients. It will allow you to practice making decisions when you might be experiencing performance anxiety and perhaps feeling outside of your comfort zone. Sim is a low-stakes environment where you can put yourself out there, make mistakes and learn from them. Your facilitators are here to support you and guide you.
Crisis Resource Management (CRM) skills are the non-technical skills required for effective teamwork in a crisis situation. Simulation is one of the best ways to rehearse CRM skills outside of real resuscitation scenarios. Learn more about CRM here.
Sim Anatomy
Prebrief
Review the objectives of your session, the principles of sim, and how the VRR works.
Run Case
Divide into roles and manage your patient as a team, guided by your facilitator who will be providing case updates.
Debrief
Discuss CRM skills and medical content. Reflect on your emotional reaction to the case. Think about what went well and what might have gone better.
Typical Team Roles
Team Lead
Makes management decisions.
Communicates orders and delegates tasks to team.
Maintains situational awareness.
Uses summary statements to keep everyone on the same page.
Airway
Asks questions to assess the airway and breathing (ex: "Is the airway patent?).
Monitor the oxygen saturation closely.
Apply oxygen, do airway maneuvers, use airway adjuncts, and prepare for intubation.
Charter
Takes notes about history, physical exam findings, orders, medications (dose, route, time). Times when it is appropriate (ex: during CPR).
Meds & Monitors
Apply monitors to patient. Watch the monitor closely for changes in vital signs.
Prepare and administer medications.
Note: Depending on the case, this may be better divided into 2 roles.
The VRR
How it works
Everyone will open up your "Virtual Resus Room", a shared Google slides document. You will type, click and drag, copy and paste to "use" equipment and complete resuscitation tasks. The changes you make will be viewable near-instantaneously by your team.
You will divide into the traditional team roles to care for your simulated patients. Your team should strive to use your communication skills (use of names, clear task delegation, closing the loop) to maintain a calm, controlled environment. You will be able to see your fellow participants in your Zoom window.
Your facilitators will provide you information about your patient, answer your questions, and provide prompts as the case progresses.
What you need
Laptop with Internet connection and Camera
Tablets/iPhones work - but using Google Slides on these devices can be cumbersome.
Tip: If you are participating from work/hospital, make sure your institution allows access to Google (some hospitals block it - you may need to tether to your phone's Wifi to access Google if this is the case!).
Link to your teleconference meeting (ex: Zoom)
Link to your shared Google Slide "Room"
Your facilitator will likely provide this to you at the beginning of your session
A little bit of imagination!
We are NOT pretending that clicking and dragging pictures around slides simulates the complexity of real life practice.
We do know, however, that the VRR is an effective tool for mental rehearsal, generating important debrief discussions, and rehearsing communication skills.
The better you can buy into the online setting (with its obvious limitations) - the better the experience will be for you and your fellow learners.
Setting up your screen
Completing Sim Tasks
Chart
Take notes by typing notes in the textbox on the left. Make sure to include drug dose, route, and timing.
Apply Monitors
Click and drag equipment over the patient silhouette. Do the same to "place" IVs, NG, Foleys, etc.
Watch the Vitals
After the monitors have been applied, the facilitators will update the vitals as the case progresses. So pay attention to the monitor!
Give medications
Select and copy your medication from the tray on Slide 2. Paste onto Slide 1. Drag into the Medications Given box to "administer".
Administer Oxygen
Click and drag the oxygen delivery method of your choice over your patient's face. Make sure to type in your flow rate!
Gather Airway Supplies
Select and copy from the airway tray (Slide 3). Paste onto Slide 1.
And more!
Your facilitators will "reveal" physical exam findings, investigations, procedural slides, etc as the case progresses.
How-to Video
Learner Intro - VRRComputer Tips
Mac
Copy: Command - C
Paste: Command - V
If you want to select multiple objects: press and hold Shift, then click over each object individually.
PC
Copy: Control-C
Paste: Control-V