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An Integrated Four-Year, ACGME-Based Simulation Curriculum for Anesthesiology Residents |
Elizabeth H. Sinz, M.D., Steve J. Kimatian, M.D., W. Bosseau Murray, M.B., Ch.B., Jody L. Henry, B.S., Sally J. Rudy, R.N. Anesthesiology, H-187, Penn State University College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States |
The ACGME competency requirements and availability of a variety of simulators and simulation faculty enabled us to fully integrate simulation-based teaching in an updated curriculum. This innovative curriculum provides an average of nine simulation experiences per year for all residents for a total of 36 simulation experiences over the four-year residency. We describe the curriculum in the context of the didactic topical areas. Using a Healthcare Matrix[1] allowed us to align learning objectives with both the six ACGME competencies and the six Institute of Medicine Aims for Improvement in health care delivery[2].[table1]All sessions are 2 hours long. Residents are required to attend and relieved from duty. Curriculum covered over 2 years as juniors (CBY, CA-1) and 2 years as seniors (CA-2,3). Didactic topics were converted to simulation experiences where simulation-based instruction would be most effective for conveying the learning objectives. We use a wide variety of simulation modalities such as full patient simulators, flat screen simulation, task trainers, case exercises, standardized patients, and the residents themselves. Modalities are often combined to achieve the greatest impact such as the combination of standardized patients and a full mannequin to explore death and dying. [1] Bingham et al. The Joint Commission Journal on Quality and Patient Safety, Feb 2005,31(2) [2] Weaving the Fabric: Strategies for Improving Our Nation's Healthcare. Oakbrook Terrace, IL: Joint Commission, 2003. http://www.jcaho.org/about+us/public+policy+initiatives/weaving+the+fabric.htm Anesthesiology 2005; 103: A1240 |
| Junior Residents | Senior Residents-Subspecialties |
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| Basics of Anesthesiology | Critical Care Medicine | | 1. Crisis Resource Management | 1. Anaphylaxis, 2. Trauma & Awareness | | Pharmacology | Cardiothoracic & Vascular | | 2. Medication Errors, 3. Shock Scenarios | 3. PA catheters & Double lumen ETTs, | | Perioperative Medicine | 4. Building a Bypass Circuit | | 4. Airway Toys, 5. Physics of Ventilation, | Practice Management | | 6. Rare & Coexisting Diseases | 5. Root Cause Analysis | | Patient Safety | Obstetrical Anesthesia | | 7. Equipment Failure in the OR, | 6. Airway management in OB, 7. OB Resuscitation | | 8. Alternative-site airway management | Professionalism | | Physiology | 8 & 9. Anesthesia Supervision I & II | | 9. Understanding ABG's & Ventilators, | Neurosurgical Anesthesia | | 10. Tension Pneumothorax | 10. Venous Air Embolism | | Anesthetic Management | Geriatric Anesthesia | | 11. Central Venous Access, | 11. Death/Dying | | 12. Hypotension & Bronchospasm, | Pediatric Anesthesia | | 13. Epidural Placement, | 12. Family Interactions, 13. Malignant Hyperthermia, | | 14. Regional Anesthesia | 14. PALS | | Subspecialties | Acute & Chronic Pain Management | | 15. Increased ICP, 16. PACU events, | 15. Regional Block Practice | | 17. OR Cardiac Arrest | Patient Safety | | Practice Management & Research | 16. Fire in the OR, Laser Safety, 17. Difficult airway teaching, | | 18. Inservice exercise | 18. Difficult airway credentialing |
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