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Rating: 4.8/5 (32 votes cast)

Authors Institution
Anita Sarmah1
Agnes Ryzynski2
Susan DeSousa2
Mabel Choi1
Fahad Alam1
Vanessa Percival1
Isabella Devito3
Department of Anaesthesia, Sunnybrook Health Sciences Centre, Toronto, Canada
Sunnybrook Canadian Simulation Centre, Toronto, Canada
3Department of Anesthesia, Mount Sinai Hospital, Toronto Canada
Theme
7II Simulation and Simulated Patients
Upping the ante: Introduction of innovative educational tools to undergraduate medical students 2nd simulation session
Background

 

At University of Toronto, 260 3rd year medical students rotate sequentially through the Simulation centre on day 2 of 10 during core Anesthesia rotation.  The day consists of part task and high fidelity simulation highlighting team and resuscitation skills. Student feedback consistently requested more simulation time to reinforce their learning.

Summary of Work

 

Following an adopted “Flipped Classroom” approach, time was created for a second simulation with end goal to reinforce learning, entitled “Exit Simulation”.

To “up the ante” we introduced Innovative tools rarely used in Undergraduate medicine. Course objectives were mapped to clinical areas where Anaesthetists care for patients: Preoperative, Intraoperative and Postoperative.

Preoperative scenario

Students perform a real time assessment of a standardized patient.  The group is subdivided into two groups. Each group must develop a management plan and risk stratify patient’s co-morbidities. Groups re-join and pitch their management plans to each other. Team must decide on one plan without hybridizing.

Intraoperative scenario

Students are required to manage an intraoperative crisis.  Roles are assigned to reflect a working operating room. Concept of mental practice pre-simulation is introduced.

Physical barriers to communication are created by the use of surgical drapes and addition of cognitive loads (such as cutting “S”’s with laparoscopic equipment).

Postoperative scenario

Involves the assessment and mgt  of pain and crisis in the PACU setting. SAGAT stops are utilized.

 

 

Summary of Results

Learner Feedback

Preoperative: “Very realistic patient and co-morbidities”; “Great to have the opportunity to think through our own patient plan”.

Intraoperative: “Good introduction to intra-operative communication. I will remember some valuable lessons”; “visualization before simulation was helpful exercise”; “I enjoyed thinking through case before it started, I will use this in future”

Postoperative: “Taught me to avoid fixating on a problem”; “Reinforced our learning”

Conclusion

Impact

Exit Simulation day consistently ranks highly. Students have commented that the use of mental imagery is transferable across other specialties during clerkship; and the modified SAGAT highlights the impact of fixation error. We are excited about the launch of our new Undergraduate Anesthesia curriculum after our initial positive feedback and anticipate that this additional simulation day helps “close the loop” on their core rotation

Rotation Evaluation

“The rotation was a good educational experience"

Take-home Messages

Challenges/ Opportunities

Needs many facilitators

•Opportunity opened up with RT professional and educational leader

•“I believe this has been a great collaboration and wonderful learning opportunity for the RT students.  I would be happy to have them continue to participate”

Take home Message

The innovational tools used here have potential application across all specialties

Acknowledgement

Thank you to the Globe and Mail for cataloguing the day at the Canadian Simulation Centre, Sunnybrook Health Sciences Centre.

References

1. Abstract presented at AMEE 2012 Abstract Book 9G1
2. Med Ed 2008;42:607-12
3. Qual Saf Health Care. 2004 October; 13(Suppl 1): i65-i71

Designed & Managed by Innovative Technology®
Background
Summary of Work

Gaming/ Competition

Teams are scored on their performance during each scenario and points tallied.

A certificate is awarded to the winning team and  their photograph is uploaded onto the University of Toronto Portal

 

Summary of Results
Conclusion

Take-home Messages
Acknowledgement
References
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