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ACS-AEI Standing Committee Reports to the Consortium

American College of Surgeons-Accredited Education Institutes (ACS-AEI) Standing Committees are given the opportunity to report their activities and accomplishments to the Consortium during the Friday lunch break at the Annual ACS Surgical Simulation Conference. Here are the biannual committee reports from this year’s meeting.

Administration and Management Committee

The Administration and Management (A&M) Committee has been developing several projects since the committee met in person last September. This year, the A&M Committee offered an annual concurrent track entitled “Managing the Business of a Simulation Center: A Roundtable Discussion” at the March meeting. These program sessions are geared toward individuals who have management and leadership roles in AEIs and who also work collaboratively with highly trained professionals from a variety of disciplines. This year’s facilitated roundtable discussions focused on soliciting practical knowledge on three popular topics in simulation center administration: marketing and social media, budgeting, and pricing/revenue models. The AEI information collected from the 2017 track will be used for best practices and future tracks and Hot Topics Series sessions.

The 2017 Hot Topics Series began with a well-attended session on February 9, “How to Identify and Manage a Conflict of Interest in an AEI,” conducted by Alisa Nagler, JD, MA, EdD, Assistant Director for Accreditation, Validation, and Credentialing, American College of Surgeons Division of Education. Dr. Nagler’s presentation incorporated the Institute of Medicine’s definition of a conflict of interest (“a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest”). Consortium members took a presurvey to determine the parameters of the discussion for an AEI. Interested members will find the webinar in the Hot Topics Series archives located in the ACS-AEI Member Portal.

The A&M Committee’s group purchasing concept has gotten some traction since the last in-person meeting. This project is in the works to harness the collective power of the Consortium to be able to purchase items at a discounted rate. At the March meeting, the A&M Committee had some concrete group purchasing examples to further discuss how the Consortium may be able to approach this concept.

The next A&M Committee newsletter issue is scheduled for release in June.

For more information on committee activities, please contact Farrah F. Leland, JD (batchel@uw.edu), and Jennifer Calzada, MA, MPH (jcalzada@tulane.edu), A&M Committee Co-Chairs, or Jeffrey B. Howells, MS, MBA (JHowel1@lsuhsc.edu), A&M Committee Vice-Chair.

Best Practices Committee

The Best Practices Committee offered its popular workshop entitled “ACS-AEI Best Practices: Several Ideas YOU Should STEAL from Your Peers” at the Annual ACS Surgical Simulation Conference. Northwestern Simulation presented faculty development, the University of Chicago discussed how they select new technologies and techniques, and the Mayo Clinic demonstrated some of their low-fidelity/low-cost models for simulation. Participants engaged in group discussions and small roundtables to learn how to incorporate each of these best practices at their own institutes.

The Best Practice Committee is currently working on building a library of best practice resources, identified by the Accreditation Review Committee (ARC), which will be housed in the ACS-AEI Member Portal. Starting in June 2017, any new best practice identified by the ARC will be featured in the Portal (with the permission of the AEI), along with resources and a description of how the best practice helps meet the stated criteria. The Best Practices Committee also maintains a collection of best practice videos on the ACS YouTube page.

If you are interested in joining the committee or have ideas about how to disseminate or promote ACS-AEI best practices, please contact David R. Farley, MD, FACS (farley.david@mayo.edu), and Gladys L. Fernandez, MD (Gladys.FernandezMD@baystatehealth.org), Best Practices Committee Co-Chairs.

Curriculum Committee

The Curriculum Committee has had several projects in the works for the Consortium since its last report. The well-received 2017 workshop entitled “How to Design an Educationally Effective Curriculum for Your Simulation Course” was a joint effort by the Faculty Development and Curriculum Committees and provided attendees with an overview of the process of curriculum development for simulation-based courses and how this process differed from the traditional approaches for curriculum development.

Co-Chair Jane M. Eggerstedt, MD, FACS, is leading the ACS-AEI/APDS project group to develop a series of OSCE-like simulation modules to teach residents communication skills using the milestone competencies as its framework. The group is currently configuring how the curriculum toolkit will be structured.

Curriculum Committee members are currently exploring re-directing the textbook project into a user-friendly and interactive tool that helps users navigate the curriculum development process (for example, a Turbotax for curriculum development). The Curriculum, Best Practices, and Faculty Development Committees will be collaborating on the content for this project.

For more information on the committee’s activities, please contact Jane M. Eggerstedt, MD, FACS (jegger@lsuhsc.edu), and Robert M. Rush, Jr., Col, MD, FACS (robert.m.rush4.mil@mail.mil), Curriculum Committee Co-Chairs, or Aimee K. Gardner, PhD (aimee.gardner@bcm.edu) Curriculum Committee Vice-Chair.

Faculty Development Committee

The Faculty Development Committee welcomed aboard three new committee members at the 2017 March meeting: Jeremy M. Lipman, MD, FACS, FASCRS; Douglas S. Smink, MD, MPH, FACS; and Daniel J. Vargo, MD, FACS.

In 2017, the Faculty Development Committee worked jointly with the Curriculum Committee for this year’s Committee workshop, “How to Design an Educationally Effective Curriculum for Your Simulation Course,” which was conducted by Nehal Khamis, MD, PhD, MHPE, and Cate Nicholas, MS, PA, EdD. Ninety-five percent of the attendees felt the format fit the overall objectives of the workshop, giving it a rating of 4.2. Participants indicated the content was valuable and that they would definitely implement ideas and suggestions discussed in the session. Participants also offered more suggestions for future Committee workshops.

The Faculty Development Committee evaluated its new Article of the Month series by conducting a survey on the first two cycles of articles for feedback and a possible committee paper. Ninety-one percent of the respondents indicated that they would recommend the new product to other people.

For more information on the committee’s activities, please contact Jeffrey B. Cooper, PhD (jcooper@partners.org), and John T. Paige, MD, FACS (jpaige@lsuhsc.edu), Faculty Development Committee Co-Chairs.

Fellowship Review Committee

At the Annual ACS Surgical Simulation Conference, the Fellowship Review Committee offered a workshop specialized for Fellows. The workshop consisted of presentations by Fellows currently enrolled in ACS-accredited Fellowships in Simulation. This was a unique opportunity for the Fellows to exchange ideas and discuss projects while fulfilling the program requirement for presentation of work at the annual meeting.

In addition to presenting at the workshop, we are pleased to announce that five abstracts from Fellows were accepted for poster presentation, and one Fellow’s abstract was accepted for podium presentation. Keep up the good work!

This winter, the Fellowship Committee issued a survey to former Fellows who have since graduated from their respective programs to assess the impact that the accredited Fellowships had on their careers. The feedback was overwhelmingly positive and revealed that the accredited Fellowships have been instrumental in developing better teachers in simulation-based education.

We are pleased to announce that as of February 2017, the Fellowship Application and Review process is now entirely online. The Fellowship Accreditation Program reaccredited its first Fellowship Programs in December 2016.

There are currently 10 accredited Fellowship Programs. Accreditation decisions are made yearly in December. You can view the list of accredited Fellowship Programs online.

For more information on the committee’s activities, please contact Mitchell H. Goldman, MD, FACS (MGoldman@mc.utmck.edu), Fellowship Review Committee Chair, or Robert M. Sweet MD, FACS (rsweet@uw.edu), Fellowship Review Committee Vice-Chair.

International Committee

The International Committee met during the International Meeting and Breakfast on Saturday morning of the 2017 annual conference. This annual committee meeting is open to all international ACS-AEI members and any U.S. member wishing to cooperate with international institutions.

One of the projects the International Committee has been tasked to develop is the Virtual Patients Library. David M. Fleiszer, MDCM, FACS, FRCSC, is the task force leader, and a survey was conducted with the ACS-AEIs to test the level of interest. The breakfast discussion gave the International Committee some leads on how to pursue support for the project.

Another project in the works for the International Committee is the Sistering Overseas project led by Lisa Satterthwaite, RPN, ORT. This task force is reviewing how the Consortium could approach the concept and developing the structure to undertake the vision.

For more information on the committee’s activities, please contact Evangelos Georgiou, MD, PhD (melatron@otenet.gr), International Committee Chair.

Patient Education Committee

The Patient Education Committee opened their March meeting to members from the Curriculum, Research, Administrative and Management, and Technologies and Simulation Committees for feedback on designing and implementing the first centralized AEI simulation course focused on best practice for discharge of the complex surgical patient. The need for this course is magnified by the fact that 65 percent of all surgical procedures are now outpatient and that home care agencies are advertising in home training for families managing complex postoperative patients. Nearly 80 percent of all AEIs that completed the recent survey identified that it would be helpful/very helpful for the ACS to implement all aspects of certified surgical patient recovery courses from registration to evaluation with the AEIs, then offer the skills components for hybrid courses or be certified to offer curriculum for live courses. Opening courses to the community, including skilled nursing facilities, was an option for 82 percent of the AEIs. It was determined that courses focused on wounds, stomas, trachs, feeding tubes, central lines, and anti-coagulation management were the highest priority. Other course options would include team training on opioid management and non-opioid alternatives; surgical patient recovery and education programs with strategies to educate the patients and care providers to enhance recovery, reduce complications, decrease readmissions, and improve participation; and how to support the transition to home, including enhanced recovery pathways and standardized pre-, intra-, and postoperative education that will drive quality.

Requests for centers to become certified to offer the first courses will be sought by the Committee. The goal is to complete training in Portland, OR, at the September ACS-AEI meeting. Any questions or interest in working with the committee to offer training to the community should be directed to Nancy Strand at nstrand@facs.org.

For more information on the committee’s activities, please contact John M. Daly, MD, FACS (jmddoc@gmail.com), Patient Education Committee Chair.

Research and Development Committee

The Research and Development (R&D) Committee reported that the 2016 podcast recordings were successful and well received by the Consortium. In addition, several podcasts also provided teaching tools and other resource materials that are available for download on the ACS-AEI Member Portal. The R&D Committee will take the lead on feedback for future topics for the podcasts. One suggestion was that due to the success of the podcasts, perhaps they can be made available to the membership of the College. Staff will look into this possibility.

Updates were given on Consortium multi-institutional research proposals.

Project one, the ROI Project, is being led by co-investigators Amber Trickey, PhD, and Col. Tim Brand, MD, FACS. The project will explore what the return on investment (ROI) is in surgical simulation. The goal is to create a tool and a scoring mechanism that use simulation to assess learners involved in surgical training.

Project two, the National Performance Benchmarks Project, is being led by co-investigators R. Eric Heidel, PhD, and Boris A. Zevin, MD, PhD, FRCSC. This group has been tasked with creating a repository of simulation-based performance metrics used by AEIs. One suggestion from the March meeting was that perhaps a best practice would be using the best scale and providing the reasons for or against it. The R&D Committee was in agreement that the next steps should be to develop a White Paper detailing the optimal measurements of assessment to develop national benchmarks. Ten AEIs should be involved, and all of them will do the same task and also use the same assessment. It was also suggested that the ACGME Milestones Project should be consulted to look at what trainees have been trained in. The R&D Committee will be able to get this information from the AEIs, because they are all involved in the Milestone Project.

The R&D Committee is going to be actively involved with the Advanced Module Manikin (AMM) Project, a multi-institutional study sponsored by the University of Washington and the University of Minnesota and funded by a grant from the Department of Defense (DoD). The group provided an overview of the project at the Annual Surgical Simulation Conference, along with how the AEIs will be involved in the verification of the research.

For more information on the committee’s activities, please contact Erica L. Mitchell, MD, FACS (mitcheer@ohsu.edu), and Dimitrios Stefanidis, MD, PhD, FACS, FASMBS (dimstefa@iu.edu), R&D Committee Co-Chairs, or Mark Aeder, MD, FACS (Mark.Aeder@UHhospitals.org), R&D Committee Vice-Chair.

Technologies and Simulation Committee

The ACS AEI Technologies and Simulation (Technologies) Committee proudly sponsored the interactive workshop, “Better SIMs through Innovation: Nuts and Bolts of Sim Innovation Lab Start-Up and Successful Sustainability.” The workshop opened with an expert panel presentation where facilitators Deborah Rooney, PhD (director of education and research, CSC University of Michigan); T. “Kesh” Kesavadas, PhD (director, HCESC University of Illinois at Urbana-Champaign); and David Hananel, BS (director, CREST University of Washington), presented examples of early, established, and mature simulator innovation programs, with topics ranging from spaces and lab types to budgets and staffing to technologies and resources. The workshop also included a dynamic Q/A and hands-on sessions supported by Troy Reihsen (director, Artificial Tissue Lab, CREST University of Washington), and Niles Mayrand, BBA, CMP (manager, CSC University of Michigan), where attendees trialed new 3-D printing technologies, interacted with novel simulators, and connected with others interested in simulator innovation.

Developed jointly by the University of Michigan Simulation Center and the Technologies Committee, the SVI tool is founded on scientific evidence from the medical simulation community and designed to facilitate decision-making during the simulator evaluation and purchase process via a standardized mechanism. This tool could add value to AEI membership. The Technologies Committee envisions the SVI tool will be included in an AEI “start-up” package with other content that the AEIs have developed. This package would be particularly valuable for newly accredited AEIs or established AEIs that want to support new staff during onboarding. If AEI committees have content that may complement this package, please contact Dr. Rooney, Technologies and Simulation Committee Co-Chair, at dmrooney@med.umich.edu.

The last 20 years have seen few advancements and no breakthroughs in medical simulation. To further the field, we need to establish the long-term research agenda based on the most pressing training gaps and collaboratively target these gaps with interdisciplinary research teams. This project will review the basic scientific topics AEIs should be researching so that in five years we can be developing significantly enhanced sims that address the training gaps.

Another Virtual Grand Rounds will be coming up on Wednesday, July 26 from 9:00 to 10:30 am CST. Now that a VGR Program Committee under the Technologies Committee is being formed, this group is seeking nominations/volunteers. If you are interested in helping to shape the upcoming VGR program, please contact Olivier Petinaux at opetinaux@facs.org. Note: The VGR program is another program that counts towards your annual ACS-AEI participation under Criteria 4.2.

The Technologies Committee is seeking new members. Please nominate or self-nominate and join this great group. For information, please contact Amy Johnson at ajohnson@facs.org.

For more information on the committee’s activities, please contact Glenn E. Talboy, Jr., MD, FACS (talboyg@gmail.com), and Deborah M. Rooney, PhD (dmrooney@med.umich.edu) , Technologies and Simulation Committee Co-Chairs, or David M. Hananel, BS (dhananel@uw.edu), Technologies and Simulation Committee Vice-Chair.