nexus news | October 2015
NEWS, VIEWS AND INFORMATION
FOR APLS MEMBERS
As we approach another Annual General Meeting, it is a good time to reflect on the past year and consider what lies ahead.
The big story has obviously been the introduction of the pre-course online learning and modifications to the face-to-face course. This was always going to be an ambitious project for a small not-for-profit company run by volunteers and supported by a handful of office staff.
Enough has been written about this and discussed over the past few years and I don’t intend to labour the point. However, I will express one final word of gratitude to the team responsible and the scores of volunteer instructors who contributed to deliver what has been received as an extremely high quality educational product.
There is no doubt from the candidate feedback that the course has been significantly improved. Thank you also to all of you, who have taken the time to familiarise yourselves with the online learning, suggest improvements, and adapt to the changes in the way we deliver the course.
There are major challenges in how to implement change to a group of 1000 volunteer instructors. Over the coming months we will be dealing with this again as we update the technology we use to provide the monitor interface and clinical feedback during scenario testing.
The old electronic hard wired Heartsims have served us well but a lot has changed in the field of medical simulation since the late 1990’s and they are well past their use by date.
We will be moving to ALSi units from iSimulate as our defibrillator monitors which afford much greater physiologic monitoring fidelity and improved capacity to provide feedback to candidates as they progress through a scenario. There will be a demonstration and education session at PAC together with further education over coming months during a staged roll-out into courses.
The APLS course has a very good reputation in Australia and there is always a risk in tampering with something that isn’t broken. However, the Board is of the opinion that the need to change, update and innovate are prerequisites for our ongoing success in the delivery of contemporary resuscitation education.
An impediment to this in the past has been our reliance on clinicians volunteering their time to drive new initiatives. A great step forward this year has been the employment of an APLS Clinical Officer (Tom Grattan-Smith) who can ensure there is knowledge within the office to implement decisions and feedback from the Board, committees and instructors.
Hopefully the changes that have been made and those which are planned are viewed positively by the broader instructor group. Diversity of opinion from members on our committees is vital to get this balance right.
It is also important for this diversity to be incorporated at the Board level. A sensible strategy for how we address the need to change and renew the Board is in my opinion as important as how we go about implementing any other change within APLS.
The sustainable governance of a company of volunteers, perhaps more so than any other organisation, relies on the interest and involvement of a cross section of its membership. We have welcomed 2 new members to the Board over the past 12 months, and would be delighted to hear from other instructors who are interested in getting involved over the next few years.
If you wish to discuss this further, please contact myself, any of the Board members or our CEO, Phillip Davies.
A new era of simulation technology is coming to APLS.
APLS is upgrading the monitoring equipment used in scenario training in order to enhance the simulation experience of candidates. APLS has selected ALSi from iSimulate, an Australian health simulation company, because of its ease of use and range of features.
ALSi will allow instructors to run scenarios with a more realistic evolution of the clinical course with easy modification of that clinical course in response to the expected and unexpected interventions made by the candidates.
So that there will be a smooth transition to ALSi based courses, training for APLS instructors and coordinators is being developed. Over the next few months there will be test runs at selected courses to iron out any glitches.
Roll-out is planned for 2016, and here's the ALSi in action:
We are delighted to also announce that at the coming PAC conference, the founder and medical director of iSimulate, Dr Anthony Lewis will be running a 1.5 hour interactive session on how to use ALSi in APLS courses.
Anthony is an anaesthetist based in Sydney and over the past 15 years he has taught on ALS, ATLS and APLS courses. Four year ago he started to look for a better way to deliver enhanced scenario teaching using mobile technology. Together with Peter Mckie, he created ALSi and four years later it is now a complete mobile simulation solution which runs on 2 iPads.
Key features are:
- Simple ‘on-the-fly’ controls.
- Easy to run built-in scenarios.
- Student screen can be configured to be a vital sign monitor, a monitor with waveforms, an AED or a defibrillator.
- The defibrillator mimics a manual defibrillator with synchronized shock and pacing options.
- Over 60 ECG waveforms including CPR artifact.
- Images such as chest x-rays, CT scans, patient images as well as videos such as ultrasound or echo can easily be incorporated into scenarios.
- Laboratory investigations can be edited and displayed.
- Patient sound library including paediatric voice phrases and lung sounds.
ALSi uses 2 iPads. A facilitator iPad which is held by the instructor and controls the student monitor iPad which can be set up to simulate monitoring through a defibrillator. The student iPad is located in a bespoke yellow bag to mimic a real-life monitor.
The yellow bag also contains ECG leads, SpO2 probe, BP cuffs, ETCO2 tubing and defibrillator pads. All of which can be applied to a manikin or actor to help increase the level of physical fidelity. Also inside the bag is a critical component of ALSi called Apple Airport Express. This is a small wifi router that provides the wireless connection between the iPads allowing them to interact. Rather like a computer speaks to a wireless printer over a wifi network.
APLS is working with iSimulate to modify the existing APLS scenarios for the ALSi format. In addition, if you go to this link on your own iPad – https://www.isimulateonline.com/apls – you will find instructions on how to download ALSi Facilitator for free.
If you access to a second iPad you can install the full version of ALSi (ALSi Full) which allows it to work as a student monitor. The full version will time-expire at the end of November.
The 2016 APLS course calendar is now available, visit www.apls.org.au/calendar to find a course near you.
If you’re a candidate looking to take – or refresh – your APLS certification, you can choose from 65 courses spread across all states of Australia.
For instructors, head to Choose your Courses to put your requests in early.
From 60 courses last year, the five extra courses for 2016 are due to a significant increase in interest in APLS.
The introduction of our award-winning online learning package and many departments now requiring mandatory APLS certification means demand for courses is high.
Over 46,000 unique users visited apls.org.au in the last 12 months, up from 36,000 and 31,000 in previous years.
More than a quarter of our 2016 courses are in rural & regional locations. We’re always open to suggestions for new venues and locations, so let us know if your town isn’t on the list.
In total, over 1500 doctors, nurses and paramedics will train in APLS next year, with a similar number taking our one day PLS course.
Instructors can choose their courses now and instructor spots will be allocated on a first-come, first-served basis with a preference for local instructors. Teaching on two APLS courses a year is expected to maintain your status as an APLS instructor. The ‘1 home, 1 away’ rule will also apply, so mix up your preferences.
12 instructors are needed for each course and we also try to maintain a waiting list, giving us leeway for cancellations and hopefully reducing the amount of SOS emails.
Approvals will be sent via email and you can always check your ‘My Courses & Bookings’ on the APLS website to see your confirmed courses.
Here's the program for our biggest PAC conference yet, with one week left to book.
This year's conference features 200 delegates, 24 great speakers, 14 hot topics, two fun social events, two extra days of workshops and updates for APLS instructors and PREDICT members, at least five ukuleles and one beautiful beachside location.
Registration closes Mon 12 Oct, and we'll see you all in Coogee.
Skill station, APLS Sri Lanka (photography by Tom Walwyn)
Rasika was having a well-earned rest from his demanding paediatric practice.
It was Boxing Day morning and he was walking along the beach with his family and friends. His wife and their 8 month old son were 50 metres ahead with the other women – when he saw the wave coming.
He ran forward but was hit by the wave before he could reach them. Swept tumbling inland, he was able to grab a tree branch and secure a hold. By some twist of fate his wife was nearby and he was able to reach her and bring her to the tree.
But their baby was lost.
Within a few minutes the baby’s body surfaced not far away. Again Rasika entered the water to retrieve the now lifeless body. He immediately gave mouth to mouth and, miraculously, the baby started crying.
60,000 Sri Lankans were not so lucky that day. The 2004 Boxing Day tsunami took a devastating toll across a country already wracked by the countless tragedies of a 20 year long civil war.
It was on a background of stories such as this that in 2005 Simon Young and I separately approached contacts in Sri Lanka with an offer to bring APLS to the country.
We were fortunate enough by chance to meet Dr Srilal de Silva, the Director of PICU at the Lady Ridgeway Children’s Hospital in Colombo. He is a man of quiet humility but of magnetic leadership. He introduced us to Prof Sujeewa Amarasena, the current president of the Sri Lankan College of Paediatrics, a man of small stature belying an endless energy and a tremendous capacity to get things done!
I have just returned from my 8th visit to this beautiful island of so many contrasts. Together with 18 dedicated volunteer Australian instructors over the years we have run a series of Provider and Instructor courses throughout the island.
I feel one of the most important was in 2013 when Srilal, soon after the end of the war, arranged for a course in Jaffna for the many doctors who had been isolated for years by the fighting. We hope that in some small way this has helped in the difficult healing process.
This year the courses were run in the Hill Country in an army training camp and it did indeed seem strange teaching about the seriously ill and injured child surrounded by razor wire and AK47’s!
However, we have now trained over 70 local instructors. Sri Lankan instructors ran this year’s GIC. Srilal was able to report that there has been 34 local courses training over 800 doctors. This was achieved with a small grant from UNICEF and great dedication by the local instructors.
In a recent poster presented at the Cairns RACP meeting the Sri Lankan investigator was able to show a reduction in preventable deaths from 16 in 2011 to 1 in 2013 in their Emergency Treatment Unit at the Lady Ridgeway Hospital, following staff APLS training.
On the last day of this year’s Instructor Course, Sujeewa made an announcement. The Director General of Health has dedicated funds to set up 9 training centres throughout the country with the ambitious plan of having all health professionals dealing with children APLS and neonatal trained within 5 years.
Each of us who have gone to Sri Lanka have been overwhelmed by the generosity, hospitality and comradeship provided by our Sri Lankan colleagues. We have all been left with many indelible memories and have enjoyed wonderful sights and tremendous food.
I am hopeful that there will be opportunities for others to support the local faculty as they undertake their challenge. Watch the International web page for details.
Following this year’s Sri Lankan course we ran the first Provider course in the Maldives – but more of that in the next newsletter.
We're delighted to announce free, open access to PAC conference content with our new media partner, Don't Forget The Bubbles.
APLS have teamed up with the popular paediatrics blog to stream highlights from PAC and embrace the FOAM movement. Highlights from previous conferences are already available and new videos will be released frequently throughout the year.
All at APLS and Don't Forget The Bubbles are excited to be bringing our message to FOAMed – Free Open Access Meducation – and a potential global audience.
We are very busy at APLS head office preparing for the PAC Conference at Coogee Beach on 22-24 October 2015.
At present we have about 180 delegates attending the conference, together with about 20 presenters/speakers and about 10 APLS staff – with a good mix of APLS and non-APLS members. Registration closes on 12 October 2015, so there is still time for you to register if you have not already.
In my view, we have an excellent technical program with speakers from various fields, states and workplaces. I would like to personally thank the PAC Scientific Committee for their wise counsel and enthusiasm in preparing the program.
As was the case last year, on the Thursday afternoon of the conference we have a specific program for APLS instructors and directors. There will be opportunities to try out an ALSi simulation monitor (replacing the Heartsim defibs on courses from 2016), updates on clinical and educational matters, and a chance to have your say in shaping the direction for APLS over the next 12 months.
As you are aware, our PAC Conference is the premier event on the APLS calendar. Preparations for the 2015 event began almost immediately after the closure of PAC 2014. In preparation for 2016, we have booked conference facilities in Adelaide for the corresponding week in October in 2016. Details will be forthcoming for PAC 2016 at this year’s conference.
The last month has also been busy in the office with the release of the 2016 course calendar. We have been inundated by all the requests from instructors and directors for preferences for courses. We are working our way through all the requests, and we will respond as soon as we can. We are seeking to assess these requests in the context of the general rule of wanting instructors/directors to do one course in their home jurisdiction and one in another state.
I also endorse everything that our Chair said in his column about the APLS online learning integration. Such a transformational change being made in an almost seamless transition from the original course is a credit to everyone involved.
Our e-learning is state of the art. Evidence of this is our recent award at the LearnX Impact Awards. APLS and our e-learning developer Nine Lanterns were awarded the “Best Learning Services eLearning Development Company” at these prestigious Awards. The package is also a shortlisted finalist at the e-Learning Industry Association’s Excellence Awards in the Community category, with winners announced mid-November. So watch this space for more good news.
See you in Coogee.