Can a medical education event be “life-changing”? A former sceptic reflects on the ACME course
Starting off sceptical
Two years ago, a colleague showed up for work, all shiny and energised after attending something called an ACME course.
According to ACME's blurb, ‘the Advanced and Complex Medical Emergencies (ACME) course for emergency clinicians offers the opportunity to practice clinical “on the floor’” management of complex emergency medicine (EM) scenarios in a high-fidelity simulation environment’.
“Having a baby or seeing the Foo Fighters live could be life-changing, but a medical education event? I was sceptical.”
"Life-changing," my colleague described it, a faraway look in his eyes, before launching into a list of new ideas for the department. It was endearing, but a tad annoying, like listening to a kid at the playground tell you about their Lego collection when you don't even feel like interacting with your own offspring.
"Hyperbole much, mate?" I thought, wanting to finish handover and get the hell out of there. Having a baby or seeing the Foo Fighters live could be life-changing, but a medical education event? I was sceptical.
But let's suspend judgment for a minute. If, and only if, a "life-changing" educational opportunity were to occur, standard baseline expectations would include a plane flight and a blockbuster location: New York. Barcelona. Hawaii. You wouldn't expect it to occur amidst car dealerships and discount warehouse pharmacies, in the south-eastern suburbs of Melbourne.
Yet this is where you will find Moorabbin Hospital, a fetching example of 1970s Brutalism architecture, embellished with a cheery royal-blue facade. Deep within its bowels – access requiring a level of navigation and security that is perhaps more befitting a nuclear research facility – you will find Monash Simulation.
I found myself there in late 2021, about to begin the three-day Advanced and Complex Medical Emergencies (ACME) course.
Why do the ACME course?
In a crowded calendar of excellent courses and conferences, why should you allocate some of your precious leave to the Monash ACME course? If you're not a Melbournite, why should you skip Barcelona for Bentleigh East?
In short, it's expert-level simulation, done really well. The course is intended for those practicing emergency medicine at a high level: FACEMs, senior trainees, and rural GP specialists or CMOs with extensive emergency experience.
Everything was meticulously planned: it ran like a German train timetable. The facilitators each came with serious simulation and education credentials. During the course I was consistently challenged, feeling just the right amount of discomfort necessary for growth.
There is no way around it – the final day was intense. I don't recall the details of the scenarios, but I do recall the sensations. Sweaty palms hindering smooth glove donning, heart pounding a little, a cacophony of voices swirling around me, yet I was completely present and focused.
“Sweaty palms hindering smooth glove donning, heart pounding a little, a cacophony of voices swirling around me, yet I was completely present and focused.”
The ‘sim’ elements faded into the background. As far as my amygdala was concerned, this was live, and the stakes were high. And it felt really good. To be with my peers – who were by this stage my besties, as the kids would say – practicing our craft. To be working at a high level, then dissecting the complexity of the situations and relating them back to our real-life work experiences.
This brings us to the debriefs. They were, dare I say it, powerful to the point of therapeutic, and equally beneficial as both a participant and an observer. They never felt rushed, with plenty of time to unpack and process the more intense aspects of the scenarios.
There was also time for play! The intensity of the scenarios was broken up with practical skills sessions, and there was an excellent selection of toys – I mean equipment – to practice with. We were given the opportunity to use some of these skills within the scenarios, which was a nifty way to consolidate.
Consolidation of skills
Confession time: prior to the course, I had lost my airway confidence. Being pregnant during the earlier stages of the pandemic, I made a personal risk assessment to leave airway management to my colleagues. This was followed by a period of parental leave, and, once your confidence wavers, it becomes harder to put yourself forward. I thus found myself in the unfortunate situation of not having intubated a person for nearly two years.
Fortuitously, in the week after the course, I faced a challenging intubation situation on shift. Having had the opportunity to practice in a safe environment at the ACME course gave me the mindset to proceed, and it was the start of regaining my airway confidence and proficiency.
“I had forgotten about chaos theory, and the potential of a relatively small event to trigger a larger chain of action and reaction.”
Action and reaction
So, back to the question: Can a medical education event be life-changing?
You see, when I metaphorically rolled my eyes at my colleague, I had forgotten about chaos theory, and the potential of a relatively small event to trigger a larger chain of action and reaction.
The ACME course saw me return to work as my colleague before me had - bursting with enthusiasm and full of bright new ideas for our department. It also opened my eyes to what quality simulation education could achieve and it led me to seek out further opportunities. Action.
During one of these opportunities, a debriefing course, the penny dropped. All the great debriefs I'd experienced over the years? They weren't just open-ended questions about feelings and a bit of a yarn; a high level of skill and mindful curiosity was required to do this well. It was like I'd been watching figure-skating the whole time and mistaken mastery for simplicity.
In a moment of clarity, I decided to undertake my upcoming sabbatical in simulation. Another action.
It turned out I have a knack for debriefing, and it just came to me effortlessly! Kidding, folks. What actually happened is, I landed smack-bang in the middle of the conscious incompetence zone of skill acquisition: knowing just enough to know how far I am from where I want to be. This feels uncomfortable, and I don't like it, yet the only way through is leaning in.
Having the time and headspace to focus on simulation also gave me the energy to return to a sim research project I had begun in 2019 that was sucker-punched by COVID and a new baby. I submitted the project to a conference as a work-in-progress. Action. It was accepted, which gave me a deadline. More actions.
Finding a community
Through this I discovered the marvellous interdisciplinary simulation research community, where every new connection seemed to open opportunities for learning and collaboration. This community is welcoming, passionate and a joy to be part of.
I write these words alongside my new friends and colleagues at an intensive writing retreat, held as part of a simulation conference. Which just so happens to be in Waikiki, Hawaii – slightly nicer than the south-eastern suburbs of Melbourne.
The air is warm, my hair is still damp from my morning swim, and I can smell the faint scent of frangipani. I look out over the impossibly blue Pacific Ocean and reflect on what I have learned today. I feel content, calm and curious. I'm excited about what I'll learn over the next few days, and what further opportunities for action might come along. A break from the intensity of the work-family juggle has been a panacea.
It turns out a medical education event can be life-changing. Who knew?
You can find more information about the ACME Course and upcoming events here.
Further reading in YourED: Why ACME is an important opportunity to reflexively think about clinical practice
