June 3, 2020By Lance Baily

Reopening After COVID-19: Downloadable ‘Flexible Medical Simulation Operations Plan’ from M Simulation Program

The COVID-19 global pandemic has shut down thousands of clinical education programs around the world, including countless healthcare simulation facilities. Lou Clark, PhD, MFA Executive Director of the M Simulation Program at the University of Minnesota recently shared with us their team’s “Flexible Operations Plan in the COVID-19 Response” which is an extremely useful document for medical simulation managers looking to consider ways of ‘re-opening’ this summer. From covering core definitions of potential learning activities with online, hybrid, and on-site simulated learning activities to highlighting risks, safety protocols, and utilization guidelines — this downloadable document linked below is an absolute must read for those operating healthcare simulation programs during the COVID-19 crisis!

Dr. Clark shared “I am writing to share our M Simulation Flexible Operations plan, which was approved by our leadership recently as our departmental addendum to the University of Minnesota (UMN) Sunrise Plan. This plan was created with input from our entire M Simulation team and was purposefully written to prioritize the safety of all of our stakeholders including and especially our simulation staff. Classes at UMN are online this summer and, as our plan states, all SP/human simulation events/work will remain online as well at least until the end of August and potentially indefinitely until there is a COVID-19 vaccine available.

This is for the safety of our SPs and staff. The default for this plan states that all simulation events are held online through at least the end of summer unless they meet the criteria our team has set with leadership for on-site simulation events. For example, we have a few events to support incoming residents mid-June, and to prepare 4th year medical students with PPE training at the end of June to return to clinical training sites in July. This plan works for us at UMN. I think it is important to acknowledge that each program and institution must do what works best for their home institution. There is no one-size fits all approach to creating a plan such as this one.That being said if borrowing/using language from our plan helps you – we want you to use it. Please feel free to reach out to me with questions. Best wishes to you as we keep moving forward together!”

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Example Excerpts from the Flexible Medical Simulation Operations Plan in the COVID-19 Response

Employee and stakeholder safety: Since our work necessitates simulating physical procedures in clinical environments and our stakeholders include faculty, residents, and learners who work in clinical simulation environments, our plan outlines resources and procedures to ensure the safest possible working conditions for our full and part-time team members including our more than 300 standardized patients (SPs) classified as independent contractors who do not routinely work in clinical settings. This is imperative as most M Simulation team members and many of our undergraduate learners do not work in clinical settings and risk exposure to COVID-19 from any stakeholders working clinically.

Iteratively assessing and communicating risk: This plan purposefully identifies iterative assessment and communication of risk as expansion of services in summer 2020 may not constitute a one-time reopening of our on-site facilities and associated services. It is more likely that our team will need to streamline or scale back facility use and associated services if there is a COVID-19 resurgence. Transparent communication coupled with integrity and professionalism are core tenets of ethical simulation practice.

Hybrid Simulation – Online and On-Site Simulation: When M Simulation team members are implementing hybrid simulation activities, those working online are in the Low Exposure Risk category of the Occupational Risk pyramid, and the Engineering Controls section of the Hierarchy of Controls inverse pyramid. Those working on- site are in the Medium Exposure Risk category of the Occupational Risk Pyramid, and the Administrative Controls and PPE sections of the Hierarchy of Controls inverse pyramid. Given the current COVID-19 hazard the team members working online still experience the lowest risk possible with the highest amount of control for M Simulation team members and stakeholders.

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Criteria for On-site Simulation: Any simulation project that may be successfully implemented virtually/online will be done so virtually/online in order to keep employees and stakeholders in the low exposure risk category as defined by OSHA COVID-19 workplace guidelines. As the HSEC building is a shared facility this will also help reduce risk for other employees working throughout the building. Moving any simulation activity on- site means that employees and stakeholders will then move to the medium exposure risk category as defined by OSHA COVID-19 workplace guidelines.

This means that those stakeholders working clinically who fall into the high or very high exposure risk category as defined by OSHA COVID-19 workplace guidelines may be interacting with M Simulation team members and other stakeholders who would otherwise remain in the low exposure risk category when working online/virtually. Therefore, M Simulation will prioritize essential training for incoming interns and students returning to the clinical environment to be done on-site as necessary. All other projects will be discussed on a case by case basis with the default being virtual/online simulation.

An Important Message from Dr. Clark & Additional Ways to Connect with Her Support

Interviewed by phone, Dr. Clark shared with HealthySimulation.com writers that this document was produced with an emphasis on establishing important guidelines for communication saying “My doctorate in communication studies has taught me that administrators will want to act as moderators to conversations happening between faculty, learners, staff, and institutional leadership. Many times in healthcare simulation we are asked to accommodate others — but what we need to communicate now is the LEAST dangerous pathway to clinical training. We cannot put requests above the safety of our simulation staff, our learners, or our educators . As such, now is not a time to accommodate, but collaborate instead.

Dr. Lou Clark has worked with numerous clients over the years to provide communication skills training for faculty, staff, and simulated patients / standardized patients (SPs), assist new medical schools in developing their simulation operations plans, and taught teach research skills including serving as a mentor to a variety of stakeholders including clinical faculty. She routinely presents training sessions, workshops, and featured presentations on related topics including qualitative research methods and compassionate/empathic communication in healthcare. She currently serve on the Board of Directors for the Association of Standardized Patient Educators as the Chair of the Grants & Research Committee, and can be hired as a consultant to support simulation programs with her expertise via contacting her on her LinkedIn Profile. She also started a very popular group on Facebook “Simulation Online 2020” which you can join now!

Download the M Simulation Program COVID-19
“Flexible Operations Plan” on the M Simulation Website Here!

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