A1240
October 25, 2005
9:00:00 AM - 11:00:00 AM
Hall C4
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 ResidentsSenior Residents-Subspecialties
Basics of AnesthesiologyCritical Care Medicine
1. Crisis Resource Management1. Anaphylaxis, 2. Trauma & Awareness
Pharmacology Cardiothoracic & Vascular
2. Medication Errors, 3. Shock Scenarios3. PA catheters & Double lumen ETTs,
Perioperative Medicine4. Building a Bypass Circuit
4. Airway Toys, 5. Physics of Ventilation, Practice Management
6. Rare & Coexisting Diseases5. Root Cause Analysis
Patient SafetyObstetrical Anesthesia
7. Equipment Failure in the OR,6. Airway management in OB, 7. OB Resuscitation
8. Alternative-site airway managementProfessionalism
Physiology8 & 9. Anesthesia Supervision I & II
9. Understanding ABG's & Ventilators,Neurosurgical Anesthesia
10. Tension Pneumothorax10. Venous Air Embolism
Anesthetic ManagementGeriatric Anesthesia
11. Central Venous Access,11. Death/Dying
12. Hypotension & Bronchospasm,Pediatric Anesthesia
13. Epidural Placement,12. Family Interactions, 13. Malignant Hyperthermia,
14. Regional Anesthesia14. PALS
SubspecialtiesAcute & Chronic Pain Management
15. Increased ICP, 16. PACU events,15. Regional Block Practice
17. OR Cardiac ArrestPatient Safety
Practice Management & Research16. Fire in the OR, Laser Safety, 17. Difficult airway teaching,
18. Inservice exercise18. Difficult airway credentialing

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