Transcript Simulated Case Scenario Project

Simulated Case Scenario
Project
Banner Good Samaritan Medical Center
B. Stiegler, D.O.
8.3.2010
Program
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Restriction of resident work hours has
prompted a need for creativity in developing
efficient supplemental forums for medical
education.
Format involves residents interacting with
simulated patients, obtaining a history and
performing a physical examination, then using
this information to write hospital admission
orders.
Purpose
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“To ensure new senior residents can competently and
safely manage basic and common inpatient
diagnoses”
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“To utilize simulation technology to objectively
evaluate developmental milestones expected after
twelve months of internal medicine training”
Objectives
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Primary
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Create direct observation opportunities
Evaluate Educational Innovations Project (EIP)
well defined resident milestones
Secondary
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Encourage interaction/communication b/t internal
medicine, subspecialty attendings re:
management expectations for common floor
emergencies
The Core Competencies
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Accreditation Council for Graduate Medical
Education (ACGME)
Guidelines for training programs based on agreements
of those elements that define a competent physician
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Interpersonal and Communication Skills
Medical Knowledge
Patient Care
Practice Based Learning and Improvement
Systems-Based Practice
Professionalism
The Milestones
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Within the Core Competencies, the Educational
Innovations Project (EIP) committee has
further outlined “developmental milestones”
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Specific skills or skill sets that a resident should be
able to perform adequately by a certain month in
their training.
Milestones are used to guide the development of
case scenarios for the simulation center.
Simulation Training
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Used for assessing clinical performance by
attempting to imitate a real clinical problem
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Incorporate wide variety of options
Allow examinees to reason through a clinical problem
with minimal cueing
Permit examinees to make life threatening errors w/o
hurting patients
Provide instant feedback to allow for correction
Rate examinees performance on clinical problems that are
difficult to evaluate in real life circumstances
Simulation Training
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Formats include
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Paper/pencil patient management problems
Role playing situations
Anatomic models/mannequins
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Good Samaritan Simulated Case Scenario Project
combines all three simulation forms
Good Sam Simulation Center
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Staff
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Karen Josie, RN, SIMS Center Manager
Christine Roberts, MSN, RN Simulation Specialist
Yesenia Preciado, Admin Assistant, Simulation Education
and Training Center
Bridget Stiegler, D.O., AMS Liaison
New Senior residents (2nd year)
Monthly “Case scenario”
Include residents on elective rotations
Tuesday AM, no clinics
1.5 hours – return to elective after your case
Good Sam Simulation Center
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Prior to test day
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Literature relevant to case
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Quiz
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“2002 Guidelines for the Use of Antimicrobial Agents
in Neutropenic Patients with Cancer”
Encourage preparedness, guide study
Gather in the SIMS Center lobby at assigned
time
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0800, 0830, 0900, 0930
Good Sam Simulation Center
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30 minutes to perform H&P.
30 minutes to complete admission orders.
30 minutes for one-on-one feedback session with
your attending.
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Discuss the article, your quiz, your H&P style, your
admission orders, and questions about case.
Attending then fills out comprehensive evaluation
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Professionalism, Pre-test score, Preparedness, Assessment
of Milestones.
“Runners”–The Voice of the Mannequin
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Program director
Inpatient teaching attendings
Outpatient teaching attendings
Chiefs
Fellows
Specialists
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Neutropenic Fever: Dr. Echevarria, Dr. McKellar
How is This Useful? For the Resident…
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Useful resources to gain knowledge
A platform to translate your knowledge into
action
Positive reinforcement for well performed
skills
Feedback for skills that need work
Opportunities to practice doctoring in a nonthreatening atmosphere
How is This Useful? For Our Program…
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Allows us to comprehensively address multiple
ACGME core competencies
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Assess developmental milestones expected from a
resident entering 2nd year of training
Allows us to utilize unique technology to provide a
more comprehensive training environment
Provides a method for highlighting individual
strengths/weaknesses and thus adapting 3rd year
experiences to the specific needs of each resident
Future Direction
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Procedure Courses
Third year milestones program
Intern cross-cover emergencies
SIMS Center Committee
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Development of new simulated cases
Development of procedure practice programs
Technology, medical education interest