Adam Cheng

Alberta Children's Hospital, University of Calgary · Departments of Paediatrics and Emergency Medicine

Simulation-based research has grown substantially over the past two decades; however, relatively few published simulation studies are multicenter in nature. Multicenter research confers many distinct advantages over single-center studies, including larger sample sizes for more generalizable findings, sharing resources amongst collaborative sites, a...

Background: Simulation-based research (SBR) is rapidly expanding but the quality of reporting needs improvement. For a reader to critically assess a study, the elements of the study need to be clearly reported. Our objective was to develop reporting guidelines for SBR by creating extensions to the Consolidated Standards of Reporting Trials (CONSOR...

One vital aspect of emergency medicine management is communication after episodes of care to improve future performance through group reflection on the shared experience. This reflective activity in teams is known as debriefing, and despite supportive evidence highlighting its benefits, many practitioners experience barriers to implementing debrief...

The Promoting Excellence and Reflective Learning in Simulation (PEARLS) blended approach to debriefing encourages educators to purposefully merge various debriefing strategies to tailor discussion to learner needs and learning context. While debriefing is a key component to simulation-based education, few resources exist to promote implementation o...

Despite proven benefits for team and individual performance, a number of perceived barriers limit clinical post-event debriefings, which impacts healthcare team functioning and patient care. An overemphasis on debriefing after rare events such as cardiac arrest and major trauma resuscitations necessarily means that debriefings will also occur infre...

Introduction With increased incorporation of simulation-based methodologies into quality improvement activities, standards for reporting on simulation-specific elements in healthcare improvement research are needed. Methods We followed established consensus process methodology to iteratively create simulation-based extensions for SQUIRE 2.0 report...

Objectives An aerosol box aims to reduce the risk of healthcare provider (HCP) exposure to infections during aerosol generating medical procedures (AGMPs), but little is known about its impact on workload of team members. We conducted a secondary analysis of data from a prospective, multicenter, randomized controlled trial evaluating the impact of...

Objectives To evaluate the effectiveness of augmented reality (AR) and virtual reality (VR), compared with other instructional methods, for basic and advanced life support training. Methods This systematic review was part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR) and reported base...

Objectives To evaluate the effectiveness of scripted debriefing relative to no use of script during debriefing in resuscitation training. Methods This scoping review was undertaken as part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR) and based on the Preferred Reporting Items for Sys...

To determine if data collected through digital charting are more complete and more accurate compared to traditional paper-based charting during simulated pediatric cardiac arrest. We performed a single-center simulation-based randomized controlled trial. Participants were randomized to a novel handheld digital charting device (intervention group) o...

The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Sc...

Aim: To compare the effectiveness of Peyton's four-step approach for teaching resuscitation skills with alternative approaches. Methods: For this systematic review, we followed the PICOST format (population, intervention, comparison, outcome, study design, timeframe) using Peyton's four-step approach as the standard. We included all studies anal...

Most recommendations on cardiopulmonary resuscitation were developed from the perspective of high-resource settings with the aim of applying them in these settings. These so-called international guidelines are often not applicable in low-resource settings. Organisations including the International Liaison Committee on Resuscitation (ILCOR) have not...

Background: The aim of this scoping review was to identify factors that would enable or hinder the opportunity for laypersons to undertake resuscitation education. Methods: We searched PubMed, Ovid EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL) to identify studies published from January 1, 1966 to December 31, 2...

Purpose: To describe the leadership performance of team leaders and CPR Coaches, and to determine if there is a correlation between leadership scores and CPR performance during management of simulated pediatric cardiac arrest events. Methods: This is a secondary analysis of data from a prior randomized controlled trial. We observed the performan...

Aim: To determine if data-informed debriefing, compared to a traditional debriefing, improves the process of care provided by healthcare teams during a simulated pediatric cardiac arrest. Methods: We conducted a prospective, randomized trial. Participants were randomized to a traditional debriefing or a data-informed debriefing supported by a de...

Importance: The aerosol box has been used during the management of patients with COVID-19 to reduce health care practitioner (HCP) exposure during aerosol-generating medical procedures (AGMPs). Little is known about the effect of aerosol box use on HCP contamination and AGMP procedure time. Objective: To investigate whether use of an aerosol box...

Managing difficult debriefing can be challenging for simulation facilitators. Debriefers may use eye contact as a strategy to build and maintain psychological safety during debriefing. Visual dominance ratio (VDR), a measure of social power, is defined as the percentage of time making eye contact while speaking divided by the percentage of time mak...

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscita...

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscita...

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscita...

This document aims to provide guidance to healthcare workers for the provision of basic and advanced life support to children and neonates with suspected or confirmed COVID-19. It aligns with the 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care while providing strategies for reducing ris...

Background: Clinical knowledge and skills acquired during training programs like Helping Babies Breathe (HBB) and Essential Care for Every Baby (ECEB) decay within weeks or months. We assessed the effect of a peer learning intervention paired with mentorship on retention of HBB and ECEB skills, knowledge, and teamwork in 5 districts of Uganda. Me...

The aim of this scoping review initiated by the Education, Implementation and Teams Task Force of the International Liaison Committee on Resuscitation was to identify faculty development approaches to improve instructional competence in accredited life support courses. We searched PubMed, Ovid Embase, Cumulative Index to Nursing and Allied Health L...

Aim To evaluate the effectiveness on educational and resource outcomes of blended compared to non-blended learning approaches for participants undertaking accredited life support courses. Methods This review was conducted in adherence with PRISMA standards. We searched EMBASE.com (including all journals listed in Medline), CINAHL and Cochrane from...

Purpose The acquisition and interpretation of clinical results during resuscitations is common; however, this can delay critical clinical tasks, resulting in increased morbidity and mortality. This study aims to determine the impact of clinical result acquisition and interpretation by the team leader on critical task completion during simulated ped...

Introduction: Simulation-based research has played an important role in improving care for communicable diseases. Unfortunately, few studies have attempted to quantify the level of contamination in these simulation activities. We aim to assess the feasibility and provide validity evidence for using integrated density values and area of contaminati...

Background: As simulation matures, it is critical to develop pathways for researchers. A recent analysis, however, demonstrates a low conversion rate between abstract and peer-reviewed journal publication in our field. The International Network for Simulation-based Pediatric Innovation, Research, and Education has used the ALERT Presentation proce...

Healthcare organizations strive to deliver safe, high-quality, efficient care. These complex systems frequently harbor gaps, which if unmitigated, could result in harm. Systems-focused simulation (SFS) projects, which include systems-focused debriefing (SFD), if well designed and executed, can proactively and comprehensively identify gaps and test...

The healthcare simulation field has no shortage of debriefing options. Some demand considerable skill which serves as a barrier to more widespread implementation. The plus-delta approach to debriefing offers the advantages of conceptual simplicity and ease of implementation. Importantly, plus-delta promotes learners’ capacity for a self-assessment,...

Introduction: Use of frameworks for simulation debriefing represents best practice, although available frameworks provide only general guidance. Debriefers may experience difficulties implementing broad recommendations, especially in challenging debriefing situations that require more specific strategies. This study describes how debriefers approa...

Debriefing clinical events

The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Tre...

The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Tre...

Aims Coaches improve CPR outcomes in real-world and simulated settings. To explore verbal feedback that targets CPR quality, we used Natural language processing (NLP) methodologies on transcripts from a published pediatric randomized trial (coach vs. no coach in simulated CPR). Study objectives included: determining any differences by trial arm in...

Introduction: Pediatric quality improvement (QI) collaboratives are multisite clinical networks that support cooperative learning. Our goal is to identify the contextual facilitators and barriers to implementing QI resuscitation interventions within a multicenter resuscitation collaborative. Methods: A mixed-methods evaluation of the contextual...

Introduction: Conflict during simulation debriefing can interfere with learning when psychological safety is threatened. Debriefers often feel unprepared to address conflict between learners and the literature does not provide evidence-based guidance within the simulation setting. The purpose of this study was to describe debriefers' approach to m...

Study aim To summarize the current state of knowledge of deliberate practice and mastery learning (DP and/or ML) as teaching methods for resuscitation education. Methods A scoping review of PubMed, Scopus, and Embase was conducted through March 1, 2021. Studies examining the effect of the incorporation of either deliberate practice and/or mastery...

Developed by the leading experts in neonatal simulation, this innovative new resource delivers neonatology health care providers and educators essential guidance on designing, developing, and implementing simulation-based neonatal education programs. Available for purchase at https://shop.aap.org/neonatal-simulation-a-practical-guide-paperback/ (NO...

Developed by the leading experts in neonatal simulation, this innovative new resource delivers neonatology health care providers and educators essential guidance on designing, developing, and implementing simulation-based neonatal education programs. Available for purchase at https://shop.aap.org/neonatal-simulation-a-practical-guide-paperback/ (NO...

Aim Recent studies have shown that the integration of a trained cardiopulmonary resuscitation (CPR) Coach during resuscitation enhances the quality of CPR during simulated paediatric cardiac arrest. The objective of our study was to evaluate the effect of a CPR Coach on adherence to Paediatric Advanced Life Support (PALS) guidelines during simulate...

Objectives: Effective cardiopulmonary resuscitation (CPR) is critical to ensure optimal outcomes from cardiac arrest, yet trained health care providers consistently struggle to provide guideline-compliant CPR. Rescuer fatigue can impact chest compression (CC) quality during a cardiac arrest event, although it is unknown if visual feedback or just-...

Aim To conduct a systematic review evaluating improvement in team and leadership performance and resuscitation outcomes after such a training of healthcare providers during advanced life support (ALS) courses. Methods This systematic review asked the question of whether students taking structured and standardised ALS courses in an educational sett...

Summary statement: Dr Chad Epps' journey in healthcare simulation touched countless lives in his role as a mentor, educator, leader, collaborator, and friend. Here, we highlight Chad's lasting impact upon which we all stand today.

Context: Current debriefing approaches and faculty development strategies for simulation educators differ around the world. We aim to describe the status of current debriefing practice and faculty development for simulation educators in this study. Methods: We distributed a paper-based survey during 2 international conferences to obtain data fro...

Introduction: Many deaths in Sub-Saharan Africa are preventable with provision of skilled healthcare. Unfortunately, skills decay after training. We determined the feasibility of implementing an interprofessional (IP) simulation-based educational curriculum in Uganda and evaluated the possible impact of this curriculum on teamwork, clinical skills...

Abstract Many simulation programs have recently shifted towards providing remote simulations with virtual debriefings. Virtual debriefings involve educators facilitating conversations through web-based videoconferencing platforms. Facilitating debriefings through a computer interface introduces a unique set of challenges. Educators require practica...

Objectives: To determine the impact of a cardiopulmonary resuscitation coach on the frequency and duration of pauses during simulated pediatric cardiac arrest. Design: This is a secondary analysis of video data collected from a prospective multicenter trial. Forty simulated pediatric cardiac arrest scenarios (20 noncoach and 20 coach teams), eac...

For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of R...

For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of R...

The 2020 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care is based on the extensive evidence evaluation performed in conjunction with the International Liaison Committee on Resuscitation. The Adult Basic and Advanced Life Support, Pediatric Basic and Advanced Life Support, Neonatal Life...

Survival after cardiac arrest requires an integrated system of people, training, equipment, and organizations working together to achieve a common goal. Part 7 of the 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care focuses on systems of care, with an emphasis on elements that are releva...

For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of R...

Context Although distributed cardiopulmonary resuscitation (CPR) practice has been shown to improve learning outcomes, little is known about the cost-effectiveness of this training strategy. This study assesses the cost-effectiveness of workplace-based distributed CPR practice with real-time feedback when compared with conventional annual CPR train...

Aim of the scoping review: Scientific recommendations on resuscitation are typically formulated from the perspective of an ideal resource environment, with little consideration of applicability in lower-income countries. We aimed to determine clinical outcomes from out-of-hospital cardiac arrest (OHCA) in low-resource countries, to identify shortc...

Introduction: Clinical event debriefing functions to identify optimal and suboptimal performance to improve future performance. "Cold" debriefing (CD), or debriefing performed more than 1 day after an event, was reported to improve patient survival in a single institution. We sought to describe the frequency and content of CD across multiple pedia...

Introduction: Despite the importance of debriefing, little is known about the effectiveness of training programs designed to teach debriefing skills. In this study, we evaluated the effectiveness of a faculty development program for new simulation educators at Mbarara University of Science and Technology in Uganda, Africa. Methods: Healthcare pr...

Statement: The International Network for Simulation-based Pediatric Innovation, Research, and Education co-hosted a novel research accelerator meeting with the International Pediatric Simulation Society in May of 2019 in Toronto. The purpose of the meeting was to bring together healthcare simulation scientists with resuscitation stakeholders to br...

PurposeWe sought to assess compliance to resuscitation guidelines during pediatric simulated cardiac arrests in a pediatric intensive care unit (PICU) and to identify performance gaps to target with future training.Methods In a prospective observational study in a PICU, ten cardiac arrest scenarios were developed for resuscitation training and vide...

Objectives: Optimal cardiopulmonary resuscitation can improve pediatric outcomes but rarely is cardiopulmonary resuscitation performed perfectly despite numerous iterations of Basic and Pediatric Advanced Life Support. Cardiac arrests resuscitation events are complex, often chaotic environments with significant mental and physical workload for tea...

A Call to Action: The Future of Simulation-based Research in Emergency Medicine in Canada - Volume 22 Issue 1 - Adam Cheng, Farhan Bhanji

Aim: Recommendations for standardised communication to reduce chest compression (CC) pauses are lacking. We aimed to achieve consensus and evaluate feasibility and efficacy using standardised communication during cardiopulmonary resuscitation (CPR) events. Methods: Modified Delphi consensus process to design standardised communication elements....

Background: Recommendations for “standardized” communication during cardiopulmonary resuscitation (CPR) events to reduce interruptions in chest compressions (CCs) are lacking. We aimed to achieve consensus on standardized communication during in-hospital CPR, evaluate feasibility and potential to decrease CC pauses, mental task load, and frustratio...

Research makes a critical contribution to healthcare simulation. Many simulation educators and practitioners wish to start researching but are not sure where to begin. This book has provided many approaches. In this chapter, we introduce practical strategies for individuals new to healthcare simulation research to help navigate the social dimension...

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science Wit...

Effective dissemination of research ensures that relevant end-users can utilize results to inform education, clinical care, and/or the future trajectory of the field. In this chapter, we describe the various methods that simulation-based researchers can use to share their work, including conferences, publication, courses, massive online open course...

Statement: Despite the critical importance of debriefing in simulation-based education, existing literature offers little guidance on how debriefing skills develop over time. An elaboration of the trajectory through which debriefing expertise evolves would help inform educators looking to enhance their skills. In this article, we present a new con...

Introduction: The simulation fellowship training community has commenced efforts toward the development of core curricular elements for healthcare simulation fellowships but has not deployed the same effort to create evaluation strategies to monitor fellows' progress. The authors present a current view of simulation fellowship assessment strategie...

Transcranial direct-current stimulation (tDCS), an increasingly applied form of non-invasive brain stimulation, can augment the acquisition of motor skills. Motor learning investigations of tDCS are limited to simple skills, where mechanisms are increasingly understood. Investigations of meaningful, complex motor skills possessed by humans, such as...