image.png 12 KB View full-size Download

Hello Sim Enthusiasts! 
December is the time to bundle up in your favorite bathrobe, turn on the smooth jazz channel and read up sim articles…oh wait, maybe that’s just me…=P
We’ve received a record number of amazing applicants across the country for the new EMRA Simulation Vice-Chair position and we are thrilled to see so many eager, talented physicians interested in promoting the field of simulation. We will be reviewing the final selection with the EMRA Board and will announce the Vice-Chair on Basecamp.

Simulation Pic.png 141 KB View full-size Download
I hope you find these newsletters useful, and as always, if you have any questions, comments, or would like to become more involved in the division, do not hesitate to reach out.  Over the past several months we have been able to plug close to a dozen members in to Sim-related projects/initiatives.  
Email us if you are interested - simulation@emra.org.
-Xiao Chi (Tony) Zhang, MD, MS
Chair, EMRA Simulation Division
MDCalc Fellow
Medical Education Fellow, Thomas Jefferson University, Philadelphia, PA

Summary of content

Upcoming Events
Journal Article of the Month
Simulation Resources
Old Business


#1: EMRA Simulation Vicechair Selection Process – Official Decision to be Announced Soon!
As stated in the introduction, we were thrilled to have so many applicants for the Vice Chair position. Official decision TBA in 2018! 
#2 SIMS National conference, Jan 20 2018
UT Health McGovern Medical School is hosting the first SIMS National Conference on Jan 20, 2018. This is a national organization dedicated to increased student exposure to simulation, so students from all parts of the country are welcome. This is a full day event, with opportunities for medical students to present posters, network with leaders in the field of simulation, high-fidelity scenarios, and exciting skills labs. Registration is $30 per student, which covers entrance to the event, registration for the competition, all skills labs, lunch, and a free T-shirt. Register here: https://goo.gl/forms/YwlAD0aUYs5P77Xm2!
image.png 502 KB View full-size Download
#3: EMRA Simulation Research Grant
As a sneak peek, I’ve been in contact with Dr. Lau on his simulation project: A Just-in-Time, In Situ Pediatric Procedural Sedation Simulation Program for Emergency Medicine Residents and he is finding very interesting results. As previously mentioned, we are hoping to expand this scholarship to provide additional monetary support for amazing simulation projects. So the more applications, the more we can request EMRA to fund this scholarship! Please continue to send us submissions during the next award cycle! 

#4: Introduction to Simulation
We will be positing a link to the Simulation website on creating a simulation program geared towards medical students, as developed by the creators behind SIMS – Student Initiative in Medical Simulation. Link: http://www.joinsims.com/simulation-resources. This website contain SIMS initiative and resources done in a very professional manner. Please take a look either on our website or in this newsletter.
#5: SimWARS @SAEM 2018
We had record response and interest from those interested in contributing to case writing for ACEP17.  We were able to accommodate all interested parties, getting them place in groups tasked with writing cases for the upcoming SimWARS event! Let’s keep up the momentum for SAEM 2018! Keep your ears and your creative juices flowing! Anticipate concrete deadlines in Feb 2018. 
#6: Society for Simulation in Healthcare (SSIH) Opportunity
Message from SSIH representative - “The Formal Training Affinity Group in affiliation with the Society for Simulation in Healthcare has developed a ‘Fellows Forum’ and would like to invite simulation fellows and trainees to join. This is open to any and all simulation fellows/trainees in all professions, disciplines and degrees. You DO NOT need to be a paying SSH member! You need to create a (free) online SSH account and follow the instructions below to join.  You can then set your account to send you updates when other fellows or moderators post. To clear up confusion, you do not need to be a paying SSH member to sign up for an online account. Any interested simulation fellows/trainees who are not formal SSH members can still sign up for an account and join the forum.
The intention of this group is to provide a peer-moderated safe place for current fellows and trainees to get information and share experiences.
Instructions for creating a FREE SSH Account and joining the forum
Go to www.ssih.org 
Click “Sign In” at the top right corner of the page
Log in to your account, or create a new account
Once you’ve signed in or created a new account, click on the “Welcome, First Name” area at top right corner of the page
From there, scroll down and click on the “SimConnect”button
Once in SimConnect, find the “Simulation Fellows Peer Group” community under the “My Communities” tab
Click on the “Request to join" button and fill out the information in the email
An email will be sent to the SSH staff, who will approve you to join the community
#7: ‘CHAOS’ is coming to CORD 2018!!??
This project is gaining amazing momentum from both the EMRA board and EMRA Committee Leaders. Everyone who’s heard ANYthing about this mysterious event wants to do EVERYthing just to get in on the action. Details are still shrouded in secrecy (well, except for Nick and I), but we have something amazing planned for CORD 2018, a competition that has never been done before in the history of EMRA. Definitely keep your ears peeled for this exciting event! More details to come later.
#7: New Resources!!!  (see below)
#8: Please review the “Old Business” section (below) for prior updates that are still relevant!  

Upcoming Events[with tentative timeline] 

  • January 13-17, 2018 in Los Angeles, CA    
SIMS Conference 2018
  • April 22-25, 2018 in San Antonio, TX
  • Chaos in ED – stay tuned
SAEM18 Sim Wars
  • Call for teams – TBD, ?Feb 2018
  • Team announcement – TBD
  • Case finalized – TBD
  • May 15-18, 2018, Indianapolis, Indiana

Journal Article(s) of the Month


“Exposure to Simulated Mortality Affects Resident Performance During Assessment Scenarios”

Goldberg, Andrew MD; Samuelson, Stefan MD; Khelemsky, Yury MD; Katz, Daniel MD; Weinberg, Alan MS; Levine, Adam MD; Demaria, Samuel MD
Background The utility of simulated mortality remains controversial in the literature. We therefore sought primarily to determine whether there was a difference in performance for residents exposed to varying levels of simulated mortality during training scenarios. As a secondary objective, we also sought to determine whether their self-reported anxiety levels, attitudes toward, and engagement in the simulated encounters differed based on group assignment.

Methods Fifty junior anesthesiology residents were randomized to one of the three simulation cohorts. The residents were broken into groups that either always experienced simulated patient survival (never death), always experienced simulated mortality (always death), or had a variable result based on performance (variable death). All residents experienced 12 identical training simulations with only the predetermined outcome as the variable. Residents were brought back 6 weeks after initial training for four assessment scenarios and subsequently rated on nontechnical skills and anxiety levels.

Results Residents in the always and never death groups showed no difference in nontechnical skills using the Anesthetists' Nontechnical Skills Score before and after the simulations. Residents in the variable death group, however, had improved nontechnical skill scores when brought back for the assessment (45.2 vs 41.5 and 42.9 respectively, P = 0.01). Although all three groups had higher State-Trait Anxiety Index scores from baseline after training, only the always death group had higher anxiety scores during the assessment (43 vs 37 vs 37 P = 0.008).

Conclusions We found that participants who experienced simulated mortality that was variably delivered, and more directly related to performance, performed better on later assessment scenarios.

Simulation Resources

New resources:
The leaders of SIMS (Student Initiative in Medical Simulation) recently launched this great website, full of valuable simulation resources including their newly published interactive casebook (iBook) and an updated version of their SIMS Primer (iBook):
  • “The SIMS Casebook is the second in the SIMS Series and includes more than 60 interactive cases for medical professionals to get the most out of their simulation training. The book is organized into chapters that focus on the most common and most dangerous chief complaints that clinicians encounter. Each chapter includes two or more interactive cases to help students learn how to systematically develop a thorough differential diagnosis for the patient’s chief complaint. The cases are peer-reviewed by physicians with extensive experience in medical simulation and each case is supported by references to primary literature.”
SIMS Primer (version 1.2)
  • “This innovative SIMS Primer is the first free resource to include cases with interactive, visual features that will allow healthcare professionals to immerse themselves in a high-fidelity training environment. Student leaders in medical simulation authored the SIMS Primer to accompany the efforts of a newly-created simulation outreach program called the Student Initiative in Medical Simulation (SIMS). The SIMS Primer is a one-stop resource outlining everything you need to know to start your own simulation program. You will learn how to create a club, organize meetings, and facilitate simulated medical cases. We include a sample of introductory lesson plans accompanied by the interactive medical cases to help you jumpstart your first simulation meetings.”
“The Harvard Medical School Gilbert Program Simulation Casebook”
An online casebook (.PDF)
“Introduction to Simulation: An Educational Guide for Medical Students”
An online casebook (.PDF) written by EMRA Board Member, Dr. Shehni Nadeem

Resources posted in prior newsletters:

Old Business

EMRA Joins CORD Academic Assembly 2018
As mentioned last month, EMRA will be hosting its spring meeting at the CORD Academic Assembly.
[Official announcement on the EMRA website - https://www.emra.org/spring-meeting/
EMRA Simulation Webpage  
The EMRA webpage is revamped and we’ve heard really great feedback from end-users. We are actively trying to keep all site information up-to-date, as well as provide links to simulation resources and past newsletters.  Feel free to make suggestions regarding content you would like added to the page. 
EMRA Pediatric Sim Case submissions
We are continuing to compile a NEW compendium of pediatric simulation in collaboration with the great minds behind the Introduction to Simulation, an Educational Guide for Medical Students. If you are interested in being listed as a contributing author to a potential EMRA publication (which makes for an attractive add-on to any CV), please email simulation@emra.org for detailed information and how you can get involved!
EMRA Simulation Projects:
Many division projects are underway!  Stay tuned for updates.

That pretty much covers it for this month!  Let me know if you have any questions or want to get involved. 
- Tony Zhang, MD, MS
just keep simmin’ just keep simming

Simulation Division Board members
Tony Zhang, Chair, xzhang09.emra@gmail.com 
Alex Tran, Public Relations, alextran.emra@gmail.com  
Chana Rich, SimWars Liaison, chana.l.rich@gmail.com 
Nick Salerno, Division Liaison to EMRA BOARD, EMRA Director of Technology, nickrsalerno.emra@gmail.com