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Simulation at the College of Medicine: Evidence, Utilization, and Future Directions

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  1. Simulation at the College of Medicine 2011

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

  3. Simulation, what is it? • Is NOT a curriculum • Animates existing curriculum • Certain topics covered better in sim experience than in a lecture

  4. (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

  5. 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)

  6. Location: B444/445 B444/443

  7. 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)

  8. 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

  9. Scheduling Students and Teachers if we add something new • Simulation Faculty • 100 students • Existing curriculum structure • Synchronization

  10. A 1-Week Simulated Internship Course Helps Prepare Medical Studentsfor Transition to Residency Mayo Clinic, Laack 2010 Simulation in Healthcare

  11. 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

  12. 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

  13. 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

  14. 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

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

  16. 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

  17. High Fidelity Manikins • Laerdal Sim man • Laerdal 3G • Laerdal sim baby • Harvey

  18. Task trainers • Central Line Blue Phantom • Trauma Man • Auscultation breath sounds • Intubation heads • Lumbar puncture • Thoracocentesis

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

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