Training and education

CAMES applies research-based insight to improve courses and other learning activities, just the high throughput of course participants is feeding research and development projects with practical insights and ideas. CAMES' ambition is to have an impact not only in the Capital Region of Denmark, but internationally, when it comes to running simulation-based training and education for the health care systems.

Philosophy

You practice before performing procedures on patients - This is not only a bon mot. CAMES strives daily to reach this goal.

CAMES strongly believes in a developmental perspective on learning. Therefore, training activities always start with the needs of learners (see reference 1) and their pre-requisite level at the start of the course. The learning outcomes of CAMES' courses typically concern technical clinical skills, communication skills and relational competencies, team-working competencies, and development of a more complex understanding of problem solving and patient safety (see references 2-4). If appropriate for the intentions of the learning outcomes, training activities are concluded with performance-based assessment and feedback (see references 5-11), though CAMES obviously recognizes the value of reflection-on-learning.

Theoretical preparation is explicitly expected of course participants, either as reading materials or as an e-learning module. CAMES' teaching and learning activities always include practical training like role playing, simulated patients, virtual reality, full-scale simulations with debriefing, or training on pig models and cadavers. If possible, distributed learning and self-regulated practice periods are preferred when courses are planned. The key philosophy behind this is flexibility in training, mastery learning recognizing trainees' different paces, and a focus on transfer to clinical practice.

CAMES publishes intensively about the organization's learning philosophies and teaching-learning activities. See examples from 2018 alone below, as referred above:

1. Nayahangan et al. How to identify and prioritize procedures suitable for simulation-based training: Experiences from general needs assessments using a modified Delphi method and a needs assessment formula. Medical Teacher 2018;40(7):676-683.
2. Bjerrum et al. Surgical simulation: Current practices and future perspectives for technical skills training. Medical Teacher 2018;40(7):668-675.
3. Larsen et al. Training residents to lead emergency teams: A qualitative review of barriers, challenges and learning goals. Heliyon 2018;4(12):e01037.
4. Henriksen et al. Stress when performing the first lumbar puncture may compromise patient safety. Neurology 2018;90(21):981-987.
5. Dagnaes-Hansen et al. Direct Observation vs. Video-Based Assessment in Flexible Cystoscopy. Journal of Surgical Education 2018;75(3):671-677.
6. Hasselager et al. Assessment of laypersons' paediatric basic life support and foreign body airway obstruction management skills: a validity study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2018;26(1):73.
7. Havemann et al. Examining validity evidence for a simulation-based assessment tool for basic robotic surgical skills. Journal of Robotic Surgery 2018; 14:1-8.
8. Jensen et al. A novel assessment tool for evaluating competence in video-assisted thoracoscopic surgery lobectomy. Surgical Endoscopy 2018 Oct;32(10):4173-4182.
9. Todsen et al. Competency-based assessment in surgeon-performed head and neck ultrasonography: A validity study. The Laryngoscope 2018;128(6):1346-1352.
10. Tolsgaard MG. A multiple-perspective approach for the assessment and learning of ultrasound skills. Perspectives on Medical Education 2018;7(3):211-213.

Robotics and robot-assisted surgery

CAMES is designing industry independent education aimed at a national scale, and as a single-point-of-entry to training and introduction of new versions of robots and related technology. Robotics is seen as an emerging possibility of conducting minimum invasive surgery (RAMI) with superior ergonomic advantages.

An educational model comprising simulation, team training, 3D introduction to challenging procedures, apprentice training and supporting research will run from 2020 and onwards. Team training involves medical specialists such as nurse anesthetists and doctors, just as the training includes focus on emergency procedures.

An intention is to establish a validated skill certification in the form of an "operating license" to apply RAMI at regional level for a start.

Size of activity

The overall number of course participants is relatively stable, though individual courses can differ somewhat from year to year.

In 2018 (which resembles 2017 and 2016) CAMES ran the following: 

Type of courses 

• Basic undergraduate courses for primarily medical students covering ABCDE on different levels, basic skills training, communication and patient safety. All courses are small group training (groups of 8) with manikins, simulated patients, role play and other types of simulated and active learning.
• Courses concerning pre-hospital and in-hospital emergencies using full-scale simulation and debriefing in small groups.
• A concept with more than 80 patients trained as Patient Teachers in communication. They teach students from all health care schools, mono-professionally as well as interprofessional courses. The Patient Teachers also give individual feedback to students and specialists.
• Advanced technical skills training for junior doctors who are introduced to the skills by a specialist (one-on-one) followed by self-training, where the trainee is assisted by dedicated simulator assistants. The self-training period ends with an assessment by the specialist.
• Courses for junior doctors introducing to workplace-based learning and doctor-patient communication based on reflective teaching that include a high degree of simulation, role playing, and experimental learning in the workplace. The courses last from 2 to 6 days.
• Courses training specialists in non-technical skills like teamwork, situation awareness, decision making, leadership, administration, and cooperation.
• Courses for facilitators and skills trainers (train-the-trainer courses) covering all of the above for local, national and international participants.