Simulation at the College of Medicine 2011

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: B 444/445 B 444/443

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

Users • • • Nursing 3 rd 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 1 st 2 nd 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 2 nd 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 3 G 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