Newsletter November 2023: Reactions from the SimLab Faculty at Euroanaesthesia 2023

Dr Crina Burlacu, Dr Amaury Govaerts, Dr Rachel Harvey and Dr Du Toit De Wet

The SimLab has been a constant and popular education event during Euroanaesthesia since 2017. The ESAIC Simulation Committee coordinates it in collaboration with international Faculty with content and simulation expertise. The Faculty taking part in the Airway Management in Perioperative Setting Workshop at EA23 has been reflecting on their professional and personal roles.  

You were asked to work together as an international team of Faculty. What were the main challenges at the preparation stage?  

RH: The challenges for me started with needing to know the rest of the team and needing to understand each other’s anaesthesia and simulation backgrounds. We met virtually initially, which made it harder to get to know each other quickly, but at the same time, it made us quite efficient in meetings as we were working towards a clear shared goal.

AG: The main challenge was to get instructors aligned on the objectives of the scenarios and the messages they wanted to convey. That was crucial for team cohesion and allowed us to deal with the upcoming and inevitable organisational and technical issues during the conduction stage. Being clear and confident in our shared mission encouraged dedication and flexibility to get the job done. Finally, the shared mission was a common thread and eased the debriefing phase.

CB: We wanted the learning objectives to go beyond demonstrating knowledge and technical skills and cover attitudes and behaviours specific to the airway crisis. These are more difficult to demonstrate, especially in a conference-based simulation space where delegates must learn from each other. I was also aware that we would teach a diverse group of delegates of different professional and cultural backgrounds and that different jurisdictions may follow different guidelines. I was keen that we devised a relevant, reproducible, and transferable scenario to the universal clinical practice.

ADdeW: Having never worked as one team, the main challenge was the Faculty’s varied experience and potentially different learning goals on one side and the participants on the other. It wasn’t easy to plan, not knowing what space and equipment were available at the conference centre. 

What did you learn while working with co-faculty from other jurisdictions?  

AG: To me, getting out of your comfort zone is always an opportunity for growth. Being confronted with different ways of running scenarios is an eye-opener on your strengths and weaknesses, some of which you discover on the spot. Focusing on the best aspects of the co-instructors is always very inspiring to me. It’s like a live version of the best “simulation exercise manual”.

 ADdeW: Working with Faculty, whom I have never met before, at a distance initially forced me to discuss and reflect on my simulation principles and consider different viewpoints before coming together. Staggered communication over time allowed for a more considered approach. It led to improved performance and teamwork when we finally met. Without this, there would have been a risk of chaotic and disjointed things and a potential for conflict.

RH: I can only speak positively about working with new Faculty from different parts of the world. 

Regarding simulation teaching, we were all quite like-minded in what we wanted our simulation to focus on. Subtle differences in our style of teaching were positive rather than negative. I am used to a more confrontational debriefing style, and watching it done more gently was interesting. It has changed how I now debrief for the better. Having Faculty who worked in different places meant that understanding the team in the ‘hot seat’ was better as the team was also from all over the world.

CB: Working with a team of colleagues with extensive clinical and simulation expertise is an advantage. However, it could also be difficult because we sometimes have deeply embedded individual stances on practising anaesthesia or conducting the debrief. That made me a bit nervous, yet I came to realise pretty quickly that I was working with people of a similar mindset who equally valued the role of simulation for training and patient safety and were united by the same aspiration to conduct a valuable workshop for the delegates whilst sharing expertise and learning from each other.  

What did taking part in the SimLab as a faculty mean to you as an anaesthesiologist and educator?  

CB: It is a very rewarding experience. As an educator, I always learn from co-faculty and the delegates. No real-life patient is identical, and no simulation scenario goes the same way. It is very interesting to see other people’s perspectives. We teach safe practices and principles of crisis management, which could be applied in multiple critical situations. This consolidates my practice both as a clinician as well as an educator.

AG: Being exposed to the participants, all highly trained professionals, is my annual crisis management rehearsal. The learning clearly goes both ways. Many participant performances become embedded in my brain, and many of them serve as an example to follow as an anesthesiologist. From an educational point of view, the SimLab experience brings me the opportunity to participate in enhancing simulation education on an international level, which remains a real challenge compared to local simulation.

RH: Since COVID-19, I have done less and less simulation-based teaching, having done quite a lot before it. I had gotten out of putting education first and became more focused on a heavy clinical workload. The SimLab reminded me how much I love teaching and how valuable it is. It was also great to be back amongst like-minded educators, and it made me realise that I need to address the balance personally, as I take a lot of satisfaction from delivering high-quality simulation-based education.

ADdeW: As an anaesthesiologist, it was amazing to see how the participants could work together in teams and manage the scenario despite language barriers and slight protocol variations. Using established debriefing techniques allowed cultural barriers to disappear and all participants to participate as equals. 

What were the challenges of conducting the simulation at EA23?  

ADdeW: The logistics and practicalities of making sure the resources were available, working with them, and creating the environment in the conference centre were challenging. There was uncertainty about what piece of equipment we would be asked for during a scenario, so one needed to be prepared.

AG: Over the years, the same challenges seem to occur, e.g., the need to adapt to technical and organisational issues and remain flexible, the challenges of conveying educational messages to participants with different educational and cultural backgrounds, and running the scenarios and especially the debriefing on a very tight schedule.

RH: The challenge of conducting the workshop was keeping focus, as it was so nice to finally meet the team in person! I wanted to chat with them and get to know them as they were enthusiastic and friendly! I had to remember to be as efficient and focused as we were online! Another challenge was being in an enormous conference where I kept getting lost! It was huge, with so much to see. It was busy and noisy, starkly contrasting to a quiet simulation lab! But the atmosphere was energetic, making me feel quite enthusiastic. We had equipment to set up and had to get ready to run the simulations in a new place, having yet to work together as a team before, but it was a fun challenge. I enjoyed it.

CB: I was concerned about creating realism in the scenario, which is difficult to achieve in a conference centre. And I wish we had more time for the debrief! 

What did it mean to you on a personal level?  

AG: What I find fascinating about the SimLab experience is how friendship can build up in such a short period and a stressful context. Paradoxically, I’m more prone to be myself in this context than in my usual workplace, probably because there are no organisational constraints.

ADdeW: As Faculty, we created a bond of professional respect and friendship. This will allow for future collaboration. It also allowed for affirmation that what we do in our centre aligns with best practices in the rest of Europe.

CB: We constructed a real friendship beyond the SimLab. Most of us trialled the scenarios in our institutions and shared the feedback with the others. We discovered that we have similar tastes in music and a love for nature and certain sports. We have kept in touch and hope to meet again.

RH: Personally, this simulation meant a lot to me. I was invited into the team when I had just returned to full-time work after illness and when I was working long clinical hours with less emphasis on education. The team were so welcoming and motivated, which rubbed off on me. It was quite infectious! I left the conference having made new friends and realised that my love of education remained intact. There is still room for creativity as an anaesthetist, especially in the simulation sphere, and being allowed to be creative and interact with other people who work the same way is a great way to feel joy in our work.