nexus news | July 2015

 

nexus
NEWS, VIEWS AND INFORMATION
FOR APLS MEMBERS
JULY 2015

QUICKLINKS: 
President's report
PAC 2015: speakers announced
e-learning goes live
Lifestyle: into the blue
PEDs scholarship relaunches
From the CEO
Office news

President's report

APLS Australia has become the proud parents of a bouncing baby e-learning product. 

We contemplated parenthood for years but kept putting it off until we realised our contemporary medical education clock was ticking and time was running out. Then last year we took the plunge, got pregnant and set about planning life with our new addition.

The first couple of trimesters were a lot of hard work and at times felt like we were getting nowhere. In the last few months of gestation we tried to mentally prepare ourselves for the changes that would lie ahead. Inevitably the big day came in April and e-learning was born.

Forgive me the trite analogy but what we have achieved and what lies ahead is not so far removed. We should be proud of what has been developed by a group of volunteer instructors and a handful of non clinical office staff.

Whilst we can pat ourselves on the back at how wonderful our “new baby” is – the reality, (rarely acknowledged by new parents) is that it has faults. 

We always knew this when we released the e-learning and modified face to face course. It would not be perfect, and over the first 12 months changes and modifications would be required.

The Course Development Committee have been reviewing the feedback and already started to address some issues. There is other content that is planned to be changed but by necessity cannot be rushed.

We are planning additional filmed content for the burns module to better address burns management. We will re shoot the VF scenario, now working closely with the ARC we have committed to remove any variation in the teaching of defibrillation.

This latter issue has been a cause of much debate over years. Whilst there remain valid reasons for some variations in adult versus paediatric resuscitation, the actual skill of defibrillation should be no different and our teaching will reflect this.

The opportunities to further improve the course go well beyond e-learning. Whether replacing the obsolete Heartsims with a better monitor interface, sourcing alternative airway models or reconsidering our approach to testing.

If you have identified something that can be improved and you are willing to offer your expertise and time to help implement it then please get in touch.

Stuart Lewena
APLS President
 

Speakers announced for PAC 2015

Joining us in Sydney for PAC 2015?

Hot off the press, here's our outstanding speaker line-up for the annual APLS conference. Early bird delegate discounts end one week today, so don't miss out.  

Confirmed speakers and topics include: 

  • Annette Holian | Chest trauma in children
  • Joanne Morris | Adolescent mental health
  • Warwick Butt | ECMO for non-intensivists
  • Dom Cincotta | Allergies and anaphylaxis
  • Panel: Deon Brink, Paul Bloomfield, Tina Kendrick | Transport dilemmas 
  • Paul Middleton | How doctors and paramedics can help each other
  • Ed Oakley | "We know what the evidence is. Why don't we do it?"
  • Panel: Andrew MacDonald, Cathy McAdam | The Indigenous child in ED
  • Karen Zwi | Refugees: medical problems
  • TBC | Sports medicine: sideline care
  • Naren Gunja | Toxicology
  • Franz Babl | Practicalities for research
  • Karen Dunn | Morbidity and mortality in acute care
  • Di Crellin | Establishing a nurse practitioner role

This year’s Paediatric Acute Care Conference takes place in beautiful Coogee Beach between Thurs 22nd – Sat 24th October. Thursday is dedicated to APLS instructors, with Friday and Saturday open to all.

PAC 2015's social program will be as vibrant as ever, with a welcome dinner on Thursday evening and a gala affair on Friday night.

We’d love to see you there. 
 

e-learning goes live

It’s been all change for APLS since April, with the introduction of online learning and a new face to face course structure.

The e-learning package has already picked up one prize, winning a Platinum award at LearnX Impact, dubbed “the Oscars of e-learning”.  

But what do instructors on the frontline think?

“As somebody who was sceptical about changing the course at all, I was very pleasantly surprised by the quality and content of the new e-learning,” says instructor Trevor Burchall.

“It’s a great resource and very engaging way to learn the course content,” agrees Chris O’Brien. “I had to stop and appreciate the calibre of instructors in there and the experience they bring to APLS. There were some great pearls of wisdom that brought the content to life and made it more relevant to my clinical practice.”

For those who are yet to log on, APLS online learning is an 8-10 hour package of pre-course learning, introducing the key concepts of the APLS course. Experts host interactive skills modules with video overviews and a range of virtual exercises, and filmed clinical scenarios tie the subjects together into the APLS structured approach.

“Some of the activities are frustrating for type A personalities, and there have been technical glitches and errors but overall, it’s excellent,” says director Susie Piper. “It’s also useful as a director to receive feedback on how long the candidates have spent on e-learning: you can pick the really anxious ones who’ve spent hours and hours on it or the ones that have been slack, which is useful to help mentors support candidates appropriately.”

Like any tech launch of this size, some early adopters uncovered bugs – ranging from modules looping, progress being lost and screen types displaying incorrectly. Reported problems peaked a month after launch with 20+ issues a week.

We’re now down to around 3 per week, and all are unique to individual users’ setups – inevitable when everything from 15 year old web browsers on a rural internet connection to ultra-techy urbanites switching between their phone, iPad and laptop are being used.

If you had problems, please accept our apologies for any time wasted. If you see them in the future, let us know straightaway so we can diagnose and fix it.

But it’s not just pre-course preparation that has changed. A new timetable, updated course materials and tweaks to the face-to-face course structure aim to make the most of candidates arriving better prepared than ever before.

Number 1: faculty from the first APLS course with e-learning

The lecture format has been replaced by plenaries – interactive discussion-based sessions to revise core knowledge already covered in the e-learning. Skill stations and workshops remain as before, though pain management and blood gases workshops have been removed. And scenarios are longer: each candidate works through six extra illness scenarios, with feedback time increased to allow reflection and discussion about the cases. 

Day 1 commences at 10am to allow faculty and candidates to travel from home that day. Day 2 is still long, but the teaching sessions are interactive and even though candidates appear tired they have not given feedback indicating this is a problem. Day 3 finishes at 4pm. 

Testing has stayed the same, with skills testing on Day 1 and MCQ and scenario testing on Day 3.

Candidate feedback from the first 10 face to face courses is very positive, with scenarios providing the most beneficial learning.

There are more candidates receiving <80% on their MCQ than with the previous course. The Course Development Committee is aware of this and is looking at revising some of the MCQs – so they are more reflective of the key knowledge needed for clinical care.

Lucky last: faculty on the final APLS course before e-learning

As one of the key features of the APLS learning program is the faculty, candidates are also being asked to feedback on the attitudes, skills and behaviours of instructors. Feedback to date is consistent with average ratings of > 6/7 across all domains. Whilst our current feedback tools have their limitations they do provide an avenue for candidates to voice their opinions. The narrow range of scores indicates that despite the diversity of faculty and candidate groups the APLS F2F program reliably addresses the learning needs of candidates. 

“The plenaries went well, and everyone was much happier with day 2 afternoon sessions,” says Susie Piper. “It doesn’t feel quite as busy or tiring, and it’s easier to run with a smaller faculty in case of cancellations. My main tip for instructors is don’t underestimate the time you need to spend on e-learning prior to the course, as it’s not fair on our candidates if we’re not familiar with the content.”

“The plenaries are very tight time-wise so good planning and even practice is worthwhile, ” adds director Cathryn Parsch, “and the director needs to keep themselves largely free to trouble-shoot and support rather than run sessions. But running many scenarios is fun for faculty, and overall, the changes have improved everyone’s experience.”

Instructors who are yet to teach on an e-learning course can review the updated course materials on the APLS website, and Course Development Committee members are available to discuss the new format.

Enquiries on e-learning and course updates can be made via the office, and we look forward to seeing you on a new course soon. 
 

Lifestyle: into the blue

Two years ago I had a full-time job as Emergency Physician in a district hospital, a VMO position in a tertiary paediatric Emergency Department, and multiple “little” international and national projects on the side.

Today I find myself onboard a 39 feet sailing monohull named Realm, together with my husband and our only crew member, our 4 year old daughter, sailing along the east coast of Australia, while still working as an Emergency Physician.

Never in my dreams... had I combined working, sailing and raising my child.

I have always loved my work, practising Emergency Medicine and being able to improve EM internationally is a longstanding dream; sailing around the world has always been a dream, and it turns out dreams get fulfilled in little steps and two dreams can actually be combined.

Being an Emergency Physician in Australia in the current climate allows me to regularly work in places I have always wanted to work, without a long-term contract. Living aboard Realm creates the freedom to accept irregular work and allows us to sail large parts of the year.

I have enormously enjoyed working in places like Alice Springs, Darwin and Port Macquarie where Emergency Medicine is excellent; the people are brilliant and paediatric presentations fantastic. I even spent a month in the Doha, Qatar, while the boat was safely tied up in the marina during cyclone season.

Modern technology allows me to do many of my projects while onboard. For example, I develop and deliver, together with great Emergency Physician educators from Australia and Europe, a CME program for Dutch Emergency Physicians, who are currently trained in a 3 year training program.

Our program (MNSHA) is mostly web based and we run a mentor program over Skype/Google hangout. This goes across oceans and time differences with ease. I frequently have a mentor session while my mentee is sitting in an office without windows (Emergency Departments are the same all over the world), while I’m sitting on the deck, anchored off an uninhabited island, having just watched the sun go down, surrounded by splashes in the ocean, created by large fish who are being chased by something larger. And we discuss controversies and grey areas in Emergency Medicine...

ACEM is also well developed in the world of web based meetings and I’m very happy to see APLS taking on an e-learning component as well. As long as there is internet access the world is small place.

The ocean is a great world of exploring for our daughter; she can instantly tell you where the wind is coming from, whether it is high or low tide and whether it is shark time. She fully understand the rhythm of the moon and can read the stars. She loves sailing up to what she calls “the lovely islands”, where we go snorkeling and see all the creatures she recognises from the film Nemo. Last year we saw his house, his teacher, most of his class, but never managed to see Nemo himself. So when we recently were in Sydney, we went to aquarium where we saw he was “still in the fish tank”.

We meet some beautiful creatures along the way; turtles, dolphins, whales, pelicans, butterflies, jelly fish, the list is endless.

Distance education is a good solution while we are sailing, but whenever I am at work for a few weeks, she often goes to kindy, for the necessary social interactions. Living on a boat is completely normal for her, and we still encounter all the normal things parents of 4 year old girls encounter.

Our boat is decorated by many of her art works, she loves playing hide and seek (behind the liferaft), climbs in the mast and swings of the halyard. Maybe the only difference is that if Barbie's shoe is missing (again), chances are it ended up in the engine room; with sometimes dramatic consequences.

The other week we were sailing overnight, in order to do a bar crossing for a river entrance at high tide and at first light. Our daughter sleeps in our bed for these occasions and my husband and I run a watch system of 2 hours on, 2 hours off.

She woke up at 2.30am, half an hour into my watch and decided she wanted to join me. We had a beautiful time together in the middle of the night. Looking out for the lights of other ships, spotting the light of the lighthouse, listening to the sails and looking at the stars. There was fluorescence in the ocean, which she had never seen before. She called it “sparkles” and we decided they are made by the sparkle fairy, who lives in the ocean together with the coral fairy. The sparkles were meant to make Realm feel happy and special. And it sure did.

At the end of our shift, we put the kettle on for my husband and then crawled into a warm bed for some well deserved rest.

Being able to do this for a few years is priceless. I am able to combine my work and projects with real quality time with my family. We experience the elements and live with the rhythm of the ocean, while maintaining touch with reality through work.

Femke Geijsel
APLS Instructor

 

PEDS scholarship: developing APLS internationally

Do you know someone from the Asia-Pacific region who wants to introduce APLS to their country?

Maybe PEDS is for them. PEDS – the Paediatric Emergency Development Scholarship – aims to support the development of paediatric emergency systems in countries where these are in their infancy and where funds for such activities or for overseas education are limited.

It involves three aspects:

1.      Hospital attachment program – two week hospital attachment prior to APLS course.

2.      Mentor program – local mentor APLS Instructor to support recipient during hospital attachment and on APLS course.

3.      APLS Course – attending an APLS Provider &/or Instructor course.

Funding of $5,000 is available to cover airfares, accommodation and living expenses.

You can download an information pack and application form here:

PEDS application 2015 (word)

PEDS application 2015 (pdf)

Closing date for applications is October 1, 2015, and please share with any interested parties. 

 
Dr Pises Ngeth was the inaugural recipient of the scholarship in 2004. He is a paediatrician from the Angkor Hospital for Children in Siem Reap, Cambodia.
 
He came out to Australia on the scholarship, did a two week attachment in the Emergency Department at The Children’s Hospital at Westmead, attended a Provider course then helped the team plan a pilot course in Cambodia the following year.
 
He became the first APLS course director in Cambodia and he, along with now 60 local instructors and 5 directors, independently runs 4 APLS Provider courses per year. They have to date trained over 300 Cambodian doctors and nurses. 
 

The last six months have certainly been busy at APLS.

Incorporating the e-learning program into our APLS courses, the reinvigoration of the PLS and International Committees, the appointment of our new Clinical Officer and organising the PAC Conference generally and, in particular the scientific technical program for PAC 2015 have made for a vibrant few months. 

We would like to thank all our members because even despite these significant changes to our business, we continue to run APLS and PLS courses in every state and territory in Australia.

This is in no small part due to the contribution of our membership base. Our members have made a significant contribution during this period, either taking on an extra load as faculty for a number of courses or spending many hours “road testing” the e-learning as part of our Course Development Committee. To this end, the Course Development Committee has made the transition to e-learning courses much easier.

However, each of the APLS committees plays a very significant role in the important clinical governance standards and framework of APLS. Each committee has a wide variety of members from differing backgrounds and with differing skill bases, the committees also provide a forum where APLS members can provide feedback on various aspects of our courses and business.

These APLS committees include the Instructor Development Committee, the Course Development Committee, the PLS Committee and the International Committee. Each has a crucial role to play to ensure clinical and technical excellence across those areas of the business.

Our new Clinical Officer at APLS Tom Grattan-Smith will work closely with these committees to enhance even further their output and effectiveness.

Finally, just a reminder that registration for the PAC Conference 2015 at Coogee Beach Sydney on 22-24 October has been open now for a few months. Numbers are filling up so book as soon as possible to guarantee yourself a place at PAC 2015.

Phillip Davies
APLS CEO

 

APLS would like to welcome four new arrivals: Clinical Officer Tom Grattan-Smith, Administrators Sharlene Kinnaird & Josie Goodrich, and Charlie Richardson who joins the equipment team.

We sadly say goodbye to APLS Administrator Hannah Owen, who is leaving us for Sydney beach life and we wish her the very best of luck. Congratulations also go to our Accountant Leena Davedeen who married her partner James in a gorgeous ceremony in May, attended by a very well turned-out APLS team. 

Many of you will know Tom as an active APLS instructor and Staff Specialist in Paediatrics, Neonate & Retrieval Medicine at NETS. Tom’s role will be to offer clinical guidance and support on projects like course & e-learning materials, course structure and the 6th edition manual. 

Charlie will also be a familiar face from his days as a course co-ordinator and is helping out with the task of keeping APLS equipment maintained and safely travelling from course to course.

Sharlene joins us from Harrison Grierson and Josie from RMIT. Both join the admin team to keep APLS courses running smoothly and we're delighted to have them on board. 

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