How the smash hit ResusTO conference showed off the Allan Waters Family Simulation Centre

By Mary Dickie

Participants tend to a high-tech manikin during a realistic scenario at our Simulation Centre’s state-of-the-art labs. (Photos by Katie Cooper, Marcelo Silles and Kevin Saychareun)

The inaugural ResusTO conference had a bold mission: to not only rethink accepted approaches to emergency resuscitation, but to redefine the medical conference itself, recasting it as a much more interactive experience through the use of creative simulation.

“Sitting in a lecture hall for three days is not that effective from an educational perspective,” says ResusTO organizer Chris Hicks, an emergency physician and trauma team leader at St. Michael’s. “We wanted to create a conference of depth rather than breadth, and put some education theory behind what we were doing.”

Held Sept. 13-14 at St. Michael’s Li Ka Shing Knowledge Institute, Allan Waters Family Simulation Centre and Emergency Department, ResusTO brought together specialist speakers and more than 80 acute care medicine providers to discuss procedural and psychological skills, inter-professionalism in critical care, teamwork and more. Those skills were then tested in innovative simulations of emergency resuscitation scenarios in the Simulation Centre, ED and Intensive Care Unit, including critical airway management, hysterotomy and Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). And then everything was discussed once again in extensive debriefing sessions — and all the discussions were made freely available online.

The conference, inspired by Australia’s Social Media and Critical Care (SMACC) gathering, was a resounding success, selling out and resulting in astounding social media numbers — 3.7 million impressions, 1,513 tweets, an average of 39 tweets per hour — and demand for a ResusTO 2.0 next year.

A good part of its success was due to the conference organizers being able to use the Simulation Centre’s state-of-the-art labs and high-tech manikins to challenge participants with realistic scenarios, led by its simulation educators and specialists. “The Sim Centre team did an incredible job,” says Dr. Hicks, who’s also director of St. Michael’s emergency residency sim program. “They did hundreds of hours of prep work to get everything ready.”

As Nazanin Khodadoust, manager of the Allan Waters Family Simulation Centre, points out, “It’s the behind the scenes work that really made it successful. The expertise of our simulation team, the hours of preparation, communication with clinicians, trial and error, collaborating and consulting with other subject matter experts and bringing it all together to make it happen — and making sure everything we did met the educational objectives for the sessions.”

The Simulation Centre was established in 1996, but when it moved into its current home in the Li Ka Shing Knowledge Institute in 2011, its focus changed from purely medical to inter-professional, and the number of users grew from about 1,500 a year to over 6,000. “Many different people use our centre, from nursing orientation to dieticians, staff physicians and residents, respiratory therapists, social workers or spiritual care workers who maybe just want to run a scenario where they have to give bad news to a patient’s family,” says simulation educator Christine Leger. “There are different spectrums on how intense the scenarios are, based on what we want the participants to get out of it.”

“It’s a really wide range of uses,” agrees Khodadoust, “from education and research to Quality Improvement, using simulation as a gap analysis tool. There might be a gap in the environment, policy or the system that leads several people to make the same mistake, for instance. So we use simulation to find out how we can identify and fill that gap in order to prevent that error from happening again.”

At ResusTO, each day began with a plenary session; then the participants broke into teams to put the ideas they’d talked about into action. “It wasn’t a didactic, sit-down conference,” says Leger. “There were speakers addressing topics relevant to the group, and then it was like, ‘OK, now let’s go practise it.’ Which is why you do simulation, so people can practise and gain confidence in a safe environment where they’re not going to harm a patient.”

Leger points out that the conference also highlighted the value of using different types of simulation for different purposes, like rapid cycle deliberate practice for skills training and in-situ to improve efficiency, for its varied participants.

“We had residents in training, paramedics who resuscitate people in the field but do handoffs at the hospital, and doctors from rural hospitals who do resuscitations where it’s just them and two other people,” she says. “Plus nurses working in different areas. It was nice to have a mixture of people and backgrounds so they could learn from each other.”

The conference shone a spotlight on the Simulation Centre and received rave reviews from participants, but Khodadoust stresses the enduring value of simulation as training for unforeseen emergency situations. “Those don’t happen often,” she says. “You might go through your residency or years of working as a nurse and never see one. But when it happens, seconds count. And that’s where simulation comes in, because if you’ve done it before, it brings down your stress level dramatically, and you know how to proceed.”

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

St. Michael’s Hospital with Providence Healthcare and St. Joseph’s Health Centre now operate under one corporate entity as of August 1, 2017. United, the three organizations serve patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education.