nexus news | March 2019
NEWS, VIEWS AND INFORMATION
FOR APLS MEMBERS
The Big Survey: a Big Analysis
Best of PAC: neonates & five great education papers
From the CDC: course content updates
Introducing Noel Roberts
APLS Papua New Guinea in depth
Under canvas for rural courses
From the CEO
Welcome fellow members of our APLS Community to the first edition of APLS Nexus for 2019!
The APLS Board will be taking on a slightly different look this year. At the end of 2018 we said farewell to long-serving members Malcolm Higgins, Alan O’Connor and Jennifer Martens and we welcomed newly elected Board members, Marissa Alexander and Andrew Blanch to the team. In keeping with our aim to broaden our Community, we have also extended an invitation to the President of APLS New Zealand to join our Board in an ex officio (but non-voting) capacity to further strengthen our partnership.
I would like to thank everyone who responded to our Big APLS Survey. At last count we had over 800 responses from members of our APLS community – instructors and past candidates. We have performed some initial analyses (see later) and the results will really help to shape our priorities for developing new educational offerings over the next few years.
As mentioned at our AGM in October, we are keen to keep our organisation vibrant and will be revitalising our APLS working committees by inviting involvement from new members this year.
We have a number of APLS members contributing to the 2019 Australian Resuscitation Council Spark of Life conference in Sydney 9-11 May (I encourage you to attend) and we have already started planning the program for our 2019 APLS PAC conference for Perth in October this year.
Over the next few months you can also expect the launch of our new “micro-education” offerings – APLS Bite-Size Updates. We are finalising the initial set of 3-5 minute topics that will be available for viewing on your desktop or mobile devices.
I think APLS is entering a very exciting phase in its development and I feel very privileged to be a part of the APLS Community. We have a great organisation, a great culture, and a great membership (you!). We aim to have our APLS Community of Practice making a positive contribution to the health of Australian kids every day. To achieve this, we continue to strive to improve our educational products, our educational techniques, and support (and grow) our membership.
And finally, I would like to formally recognise the contribution that Tom Grattan-Smith has made to our organisation in his role as our APLS Clinical Officer. This position has been one of the best investments that APLS has ever made and Tom has been instrumental in realising many of the great improvements APLS has sought to establish over the last few years. If human cloning was legal, I’d be making several copies of T G-S!
Here’s to a great 2019!
The results are in for our Big APLS Survey. Between December and February, APLS asked every one of our 22,000 members for your opinion on our work.
And... here are the results.
You can download the full analysis as a PDF here or scroll down for all the details.
We wanted to find out more about you, what brought you to APLS, how we influence your practice – and what new courses and resources you would like to see from us. As we work towards building our community of practice, these survey answers will help us:
- better engage with our community
- better facilitate ongoing learning
- and better influence improvements in paediatric acute care across Australia.
The results will influence every decision we make, and as you will read in our President's and CEO's columns, work has already started on some of the more popular suggestions. So thank you again to everyone who responded.
New to PAC on Demand this month: does a neonate in your waiting room give you palpitations?
Naomi Spotswood, a Neonatologist from Royal Hobart Hospital, demystifies some secrets of neonatology and gives tips on the baby turning blue, green, or various shades of yellow...
Elsewhere, sim teaching and feedback are always hot topics amongst our members. Here, founder of the Simulcast podcast Ben Symon presents his five favourite medical education papers on effective facilitation of scenario teaching, skills teaching and providing feedback.
Refinements to the information to instructors about the new teaching around airways continues, and the CDC will have some final resources available in the next few months.
As part of this the safe emergency airway management workshop slide resources will be improved and we will aim to make a video, giving an example of how the workshop can be run.
It is hoped that this will make the transition to the new material easier, and the teaching of it more consistent.
There is a modified radiology workshop also being trialled and this should be available soon.
In addition, more resources for teaching the correct anatomical landmarks for the chest skills are being developed.
The CDC will also begin the process of reviewing the end of course MCQ test – not only looking at the questions, but when in the course it is used and how it is used.
A working party has been formed to develop two modules covering newborn resuscitation and the management of sick neonates. This will be an optional component of the online learning and will fill an existing gap in the course content.
Finally, we welcome Noel in his role as APLS Medical Officer.
As always, the CDC is keen to have feedback about any aspect of the course material either by email to me, or via the course report submitted by course directors.
Thanks for the time and energy you put into making APLS such an excellent course.
on behalf of the APLS Course Development Committee
We are pleased to announce the appointment of our new APLS Medical Officer – Noel Roberts.
Noel was one of a number of excellent candidates that applied for the new position and we thank all candidates for their application and their time during the application process.
Noel will be known to many of you, but for those who don’t know Noel, he brings considerable teaching experience both inside and outside APLS. He also brings a wide breadth of clinical skills and expertise.
Noel's induction has been in process since January with Tom Grattan-Smith assisting in the smooth transition of this role.
Noel's role as Medical Officer is slightly different to the one Tom did on the basis that we have created an additional role in the clinical structure of the company, with Tom now being in the role as Honorary Clinical Officer in which he will work closely with Jane Stanford our Clinical Educator and Noel as our Medical Officer. Each of them separately but also collectively will be an important part of effecting our new strategic plan but also ensuring continuing quality of our courses and products.
We congratulate and affirm Tom and Noel in their new roles and are sure you will join us in welcoming Noel to the team.
Noel can be contacted via firstname.lastname@example.org.
APLS recently gained funding to expand its courses to its nearby neighbours in the Asia-Pacific region, resulting in the proud launch of APLS in Papau New Guinea. Here’s the warts, wallabies-and-all story of how a new international course came together.
The project of bringing APLS to Papua New Guinea (PNG) had long been championed by local PNG paediatrician and APLS instructor Dr Kone Sobi, with support from Dr Zafar Smith, an emergency physician based in Townsville, Australia.
Dr Sobi and Dr Smith met for the first time in May 2018 to start the preparations. There was overwhelming interest and support from the wider APLS community with over 30 applications from people wanting to help and instruct on the course.
An experienced team of five instructors from anaesthetic, emergency, intensive care, paediatric and general practice backgrounds – who had all travelled to Papua New Guinea in the past – ventured to Port Moresby to facilitate the course for 12 PNG candidates.
With so many applications from Australian and New Zealand-based instructors, the difficulty was deciding who to be on the faculty. The decision was made to prioritise people with previous PNG experience. One instructor had been to PNG seven times, another had worked with the military for six months in PNG and some instructors could speak the local Tok Pisin language. This was certainly a strength to have faculty that were familiar with the local culture and environment.
This is the first time that such a course has been carried out in Port Moresby, with local staff from multiple disciplines coming together to learn and share their experiences.
We made the decision to use the same course material as in Australia – with discussion-based plenary sessions, emphasis on pre-course preparation and online learning – rather than the specific international set of slides used on previous overseas courses. This meant there was more consistency in the material being taught to PNG candidates, and the standard would be on a par with any other course taught in Australia or New Zealand. Despite the high cost and unreliability of internet access in Port Moresby, 9 of the 12 candidates managed to complete all of the online learning prior to the course. Each candidate also received a hard copy manual eight weeks prior to the course and ongoing support from their mentor as the course approached.
All PNG candidates attended the course for free, and all instructors paid their own airfare and volunteered their time. This was also a unique partnership between APLS and YWAM Medical Ships who supplied for free the venue for the course.
Dr Smith had stayed aboard the YWAM ship in January 2018 on a previous visit to PNG, and was able to make arrangements with senior YWAM staff to have the course and faculty based on the ship itself.
Instructors slept on board the YWAM PNG medical ship which was docked in the Port Moresby harbour, with local PNG candidates coming on board each day – via boat, which added some excitement to the morning - to attend the course activities. Port Moresby’s high crime rate contributes to it being often ranked one of the least liveable cities in the world. The cost of safe accommodation in Port Moresby has been one of the biggest barriers to running APLS in PNG, and the ship offered a very safe and affordable home for the course.
Simulation equipment including mannequins and scenario materials were donated to the PNG paediatric team to use for ongoing training and future APLS courses in Papua New Guinea, with a long list of sponsors and hospital departments to thank.
Some sim equipment came from closer to home – Dr Sobi was able to purchase two wallaby carcasses from a nearby village for use in the chest drain skill station and several umbilical cord tissue samples for umbilical vein cannulation. These animal and tissue models provided a realism that greatly surpassed that of plastic models and aided candidates in learning the tactile skills for these surgical procedures.
This will be the first of many APLS courses to be run in PNG over the coming years. The vision is that within five years, APLS courses in PNG will be self-sufficient with all local instructors. The next step is to select six candidates from this course to attend a PNG GIC in July, and for these six new instructors to facilitate another APLS provider course in mid 2019.
Thank you to the following organisations for their financial sponsorship and support for the course:
Advanced Paediatric Life Support, Australia
• International committee chairperson Sue Phin
• Geraldine, Ray, Sharlene and David Watton
• Mr David Mcloughlin, representative of UNICEF PNG
• Dr Ghanashyam Sethy
YWAM PNG Medical ships
• Ship Captains: Jeana Wiemeyer and Matt Scott
• Clinic medical team leaders: Melissa Kauk and Ana
University of PNG, School of Medicine and Health Sciences
• Professor Nakapi Tefuarani, Dean of the School of Medicine & Health Sciences
• Claire Matainaho, Program Manager, Health Education & Clinical Services Program
Paediatric Society of PNG
• President of the Paediatric Society, Dr James Amini
Thank you to the following organisations for the donation and hire of extra simulation equipment:
• Australian College for Emergency Medicine (ACEM) - Karen Eastwood, ACEM Foundation and IEMC Coordinator - for the donation of 24 APLS manuals
• Townsville Clinical Skills Simulation Centre - Melita Trout and Diane Hutchinson - for the donation of an infant mannikin and simulation equipment
• James Cook University - Dr Roy Rasalam, Director of Clinical Studies; Brooke Parker and Karryn Lytton, from the Nursing School; Andrew Moore from Medtech - for the valuable loan of two ALSi simulation ipad kits
• Townsville Emergency Department - Travis Cole (Nurse educator) for sim equipment donation
• Caboolture Emergency Department - Connie Gray (Nurse educator) for sim equipment donation
• Mount Isa Emergency Department - Bellinda Scammell (Nurse educator) for sim equipment
And finally, some candidate feedback:
“This course helped to reinforce the importance of a systematic approach and also not to get distracted with other problems in the patient until ABCD [airway, breathing, circulation, disability] has been sorted. I will help the people I work with to also follow this structured approach all the time.”
“Really glad I attended this course. Consolidated a lot and learnt a lot and the face to face was just freaking suberb. Thank you so much.”
“This course has actually helped me to identify and follow the structured approach and the algorithm pathway to manage the child despite not necessarily knowing the diagnosis from the start.”
“The plenary sessions were just superb. Inclusive and realistic. The scenarios were outstanding. Well devised. The feedback and debrief was outstanding.”
“Enjoyed hearing of the faculty’s experiences with their critically ill patients and what happened. Some funny but good learning. Faculty were good actors. Felt safe and easy to approach the faculty. Learnt a lot in these 3 days. Thank you.”
Dr Zafar Smith
on behalf of APLS International
As a regional paediatrician I have a soft spot for APLS courses in rural locations. Interesting towns, interesting candidates and faculty. Enthusiasm seems the operative word, though I realised that I flew over lots of the country and only got a glimpse of the locality.
This year my wife and I decided to try something different. I got a gig on the inaugural Longreach course. We explored the possibilities and decided to take a weeks' holiday beforehand and camp (yes tent and sleeping bag) in National Parks on the way up from Orange to Longreach, Gundabooka, Currawinya and Welford, as well as free camping in Yowah and Stonehenge.
Arrived with a few days to explore Longreach, Barcaldine (tree of Knowledge and Australian Workers Museum) and a visit to the pub at Ilfracombe (archetype State of Origin Rugby League rivalry).
This was followed by great course with amazing participation. My first experience with a coach.
Following the success of the Longreach experience and with acceptance of the Mackay course, Julie and I decided to take another weeks leave and travel up slowly with a longer stay this time at Carnarvon Gorge.
First stop Kaputar National Park, near Narrabri with near zero temperatures and rain, still spectacular. I can’t recommend Carnarvon Gorge enough. Spectacular gorges, wonderful plant life and amazing native animals. Blackdown Tablelands National Park was a brief stop but shared some spectacular scenery and fantastic short (but steep) walks. Onto Mackay for a collegiate and supportive course.
It amazes me how cleansing dirt under the fingernails is.
Welcome to 2019, all APLS members.
2019 is a significant year for APLS as we roll out and effect our new strategic plan devised by the APLS Board in 2018. This is in addition but complementary to our running the APLS business as usual with our APLS, PLS, GIC and ESD courses as well as supporting international courses in various locations in South East Asia.
We have been ably assisted in our strategic focus by the great contribution of our members who have participated actively in the APLS Big Survey. Your responses in that survey has helped shape our thinking in developing, refining and effecting that strategic plan.
In short, the Big Survey results confirm that the Company should be considering adding additional products to its course offerings including a Refresher APLS Course (probably two days in duration) and an 'APLS+' Advanced Paediatric Course.
The development of new courses takes some considerable time given that we want theses courses to be of equivalent quality in terms of teaching and education for our candidates but also, we will need to have faculty appropriately trained to instruct on these additional courses. Moreover, running extra courses will necessarily mean we will have to increase our active director and instructor base.
This increase in the instructor base obviously has to be planned in a systematic orderly and effective way to ensure both business continuity and also the longer-term sustainability of the new courses.
The results of the survey also supports strongly APLS producing a regular email of “bite sized” (3-5 min video) education segments on paediatric acute care topics and research. We are seeking to start the production of theses videos in the next few months. Once again when this commences, we will appreciate your feedback on the “bite sized” segments program and will be interested in your feedback on what potential contemporary and “hot button” issues should be the subjects of this program.
The Big APLS Survey confirmed that for the existing business of APLS, APLS must continue to deliver educational excellence in all its courses and continue to invest in technologies and equipment to help ensure continuing high standards on courses. We obviously intend to do that. It also confirmed that APLS has generally influenced your practice in a positive and meaningful way, in that most, regularly use the APLS structured approach and APLS algorithms.
APLS is looking forward to the challenges of 2019 and effecting our strategic plan for and in conjunction with our members.
Register now: resus.org.au/2019-spark-of-life-conference-registration/