Simulation at the College of Medicine 2011

Topics

• Evidence that simulation works?• What are we doing now?• How is sim used in other medical schools?• Sim utilization now?

Simulation, what is it?

• Is NOT a curriculum• Animates existing curriculum• Certain topics covered better in sim

experience than in a lecture

(Best Evidence Medical Education Collaborative) review of the literature from 1969-2003

• deliberate practice with feedback• exposure to uncommon events • reproducibility • the opportunity for assessment of learners • the absence of risk to patient • no studies to show that simulation training

improves patient outcomes

• medical insurers offer malpractice insurance discounts for faculty who participate in simulator training

• The simulation group performed at twice the level of the ward group in half the training time. (Wooliscroft, 1987) (Harvey)

• Accelerated and sustained learning compared with the routine teaching method (Gordon)

Location: B444/445 B444/443

What are we doing now in undergrad medicine simulation?

• Second year Cardiac/Resp scenarios• Jursi on call scenarios SOB/Sepsis• Jursi task training LP, Airway, (Blackboard)

Pilot for September (5 students)

• Compare ACLS weekend to 5 week modules• Scenarios demo “gold” from systems

• Pilot self directed learning Annotated video teamwork/communication

Scheduling Students and Teachers if we add something new

• Simulation Faculty• 100 students• Existing curriculum structure• Synchronization

A 1-Week Simulated Internship Course Helps Prepare Medical Students

for Transition to Residency

Mayo Clinic, Laack 2010 Simulation in Healthcare

University of Miami first year patient safety (one week)

• Jigsaw puzzle• House of Horrors• Colleague high on drugs• Patient safety videos• Patient with allergy to penicillin• Call from Risk Management• Call from Lawyer

Users

• Users Clinical Sciences 85/17groups of 5• Oct-Dec (cardiac) Jan-Mar (Resp)• JURSI 60/15 groups of 4• Sept-Apr MI/Sepsi/PE• NURSING 3rd year Med/ Surg• Oct/Nov Feb/Mar cardiac

Users

• Nursing 3rd year Med / Surg• Sept/Oct Oct/Nov Jan/Feb Feb/Mar Resp• Nursing second degree• Nov/Dec Feb/Mar• Nurse Practitioner• Mar

Users

• Anesthesia Residents• Friday afternoon 30/3 sessions per year• Peds ER• Monday morning all year• ER• Every second Monday all year• Internal Med• All residents 1st 2nd year 1 session per year

Future users

• Obstetrics• Nursing new curriculum• mid Sept-Oct, Feb-Mar full time use now

Standardized Patients

• Clinical Sciences A 8 SP in April 10 sessions• Clinical Sciences C 10 SP in Nov for 8 sessions• Nurse Practitioner SP & Drama students• Nursing 2nd degree SP for osce• Clinical Sciences ABC JURSI Hx/Px/osce• Int Med SP academic osce• Pharmacy Physio SP for PBL osce• Licencing exams Med,Pharm, Physio SP

High Fidelity Manikins

• Laerdal Sim man• Laerdal 3G• Laerdal sim baby• Harvey

Task trainers

• Central Line Blue Phantom• Trauma Man• Auscultation breath sounds• Intubation heads• Lumbar puncture• Thoracocentesis

Task trainers

• Breast, Rectal• Arterial stick• IV arm• Annie• Breast, testicular, pelvic• NG insertion• Urinary cath• Ear/Eye exam