Adaptability, multidisciplinarity and teamwork: the keys of CISA
CISA, UIC Barcelona’s Integral Center for Advanced Simulation, tells us about its current activities and development plans
Technology evolves at dizzying rates, but our academic teams are not far behind either. The analysis of the academic results in clinical simulation methodology, together with the concern of those of us who make up UIC Barcelona, means that the Integral Center for Advanced Simulation (CISA) must be at the highest level of adaptability to changes in order to respond to the teaching needs.
The excellent results that clinical simulation allows to obtain in the development of technical and non-technical skills of the students made UIC Barcelona, without hesitation, commit to developing this methodology and 8 years ago we went from two small rooms, one for Medicine and the other for Nursing, to a Unit of more than 1000 m2, our current CISA.
Naive us when, despite being clear that promoting simulation was the right path, when we set foot in the Unit, a brand new and spacious space, we thought… How are we going to fill so many meters?
Well, here we are, 8 years later and with an occupation of around 8,000 hours in the 10 school months that we have. With an activity that runs from 8 in the morning to 8 in the afternoon, and with more than 12 degrees taking part in it.
Our degrees have clinical simulation activity in CISA in almost all their courses, their distribution depends on multiple factors, such as the study load of practices in health centers. Even so, Medicine and Nursing have simulation activity from the first year to the last.
One of the aspects that distinguish us are the Objective Structured Clinical Evaluations (OSCE) that we have been carrying out for more than 10 years and that the continuous interest in improving the evaluation by competences means that year after year we define new challenges and adapt to new needs.
At present, a total of 12 first call ECOEs are carried out per academic year. The oldest degrees are Nursing and Medicine (2009), followed by Physiotherapy and Psychology, which were joined in 2018, as well as the Master’s Degree in Health Emergencies and Emergencies, which in 2022-2023 also incorporates this evaluation method.
We carry out ECOEs of very diverse designs, according to need; from a single wheel with 22 stations, to ECOEs with 5 wheels with 7 mirror stations (35 stations in total), going through various modalities such as 2 mirror wheels with 12 stations. These include ICU contexts, operating rooms, emergency rooms, ward rooms, consulting rooms, delivery rooms, home environments such as rooms in a home, bathrooms or dining rooms, pre-hospital contexts such as companies, etc.
Scenarios are recreated with standard patients (actors), as well as with simulators, which are characterized with moulage if necessary. If the technique requires it, we also work with part-trainers for more specific skills.
Our concern for students to feel safe and prepared means that we have spent years facilitating their preparation for these tests through self-study, an activity that allows students to practice any of the techniques carried out during the course outside the curricular plan. It is voluntary and it allows the student to prepare in a consolidated way, since most of the techniques and skills are not easy to practice if it is not in a safe environment.
The OSCE for us is not a simple evaluation of the student, we also evaluate ourselves in each one of them. An OSCE allows us to assess our own training method during the degree, allowing us to direct the student’s learning based on what was observed during the tests and according to the results obtained. In turn, it is also transferred to the preparation, contextualization and characterization of clinical cases, evaluating future adaptations in teaching that improve understanding, interpretation and immersion in the case.
Asking yourself what difficulties and limitations you have allows you to perfect the method, while improving the development of the student’s skills.
The video recording system that we implemented from Tligent allows us to connect more than 40 cameras located wherever we want. It is a system that gives us maximum versatility and flexibility, we can place one or more cameras in the same box, as well as locate them outside the boxes (corridors, waiting rooms, even outdoors). It integrates both cameras and patient monitors, emitting a signal as just another camera. It allows viewing both in real time from other rooms and viewing delayed recordings, plus storing them in a safe repository and in compliance with current data protection regulations.
In addition, this system is integrated with an online platform that allows students to access those videos that the teaching staff consider they should see. Each student sees only their videos privately and they can be shared for the student’s self-assessment or evaluated by the instructor using a rubric-based tagging system. We have implemented this system for two years and it is very enriching for the students since it allows them to analyze the simulation they have carried out, assess their strong and weak points, and compare them with the feedback from the instructor of the labeled version.
We are currently in full development of a new software together with STP Group, which aims to integrate all the management of a simulation center and/or laboratory. It integrates the session calendar, inventory of equipment and consumables, as well as session teaching sheets for an adequate provision and forecast of preparations according to the material required by each technique. All of this is linked to occupancy statistics, investments, consumption,…
Our philosophy is based on the need approach, such as the academic need, transversal of all departments, the need to progress, to improve, to overcome new challenges, and the great team of technicians that support the Unit are the key to it.