Acute Presentation Workshop Using Simulation to Teach “High Stakes” Clinical Situations in a Safe Environment Miriam Hoffman, MD; Molly Cohen-Osher, MD;

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Presentation transcript:

Acute Presentation Workshop Using Simulation to Teach “High Stakes” Clinical Situations in a Safe Environment Miriam Hoffman, MD; Molly Cohen-Osher, MD; Lauren Scott, PhD Deborah Dreyfus, MD, MSc; John Wiecha, MD, MPH Department of Family Medicine Boston University School of Medicine

Learning Objectives  Describe the FM Clerkship Acute Presentation Workshop  Understand the importance of high fidelity simulation in medical education  Understand the importance of Family Medicine in role modeling care of acutely ill patients  Discuss approaches to implementation of simulation exercises at your home institutions

Simulation in Medical Education  The continuum of simulation in medical education  Paper cases  Standardized patients  Task simulators  Computer based simulation  High fidelity simulator  Virtual world  Learning environment  High stakes  Safe

Overview of APW  High Fidelity Simulator  Can talk!  Very realistic physical findings  Vital signs  Instructions to the students

Anxiety and Learning/Memory/Performance Yerkes-Dodson Law Yerkes, R. M., and Dodson, J. D. (1908). The relation of strength of stimulus to rapidity of habit-formation. Journal of Comparative Neurology and Psychology, 18,

Video #1

Discussion  Generate a list on the board:  Differential diagnosis  Testing  Treatment

Video #2

Case Debrief  How would you facilitate the feedback conversation?  What are some of the main feedback points?  What questions would you ask the students to get them thinking/reflecting on the experience?

Students’ Perspectives on the Experience  Medical student perspective  Student evaluations

Post-session This session was a useful educational experience Strongly Neutral Strongly Disagree Agree The experience felt realistic Strongly Neutral Strongly Disagree Agree I found the session stressful Strongly Neutral Strongly Disagree Agree

Realistic The experience felt realistic Strongly Neutral Strongly Disagree Agree

Realistic The experience felt realistic Strongly Neutral Strongly Disagree Agree Great exercise to elicit … symptoms & recognize an emergency- good reminder to check vitals & make sure patient is stable first 70 %

Stressful I found the session stressful Strongly Neutral Strongly Disagree Agree

Stressful  Excellent!! Caught us off guard, forced us to act on our own without instruction  Great shock value, did not expect the patient to crash in front of us  Great simulation, wake-up call that we need to review standards for resuscitation I found the session stressful Strongly Neutral Strongly Disagree Agree 53 %

Useful This session was a useful educational experience Strongly Neutral Strongly Disagree Agree

Useful This session was a useful educational experience Strongly Neutral Strongly Disagree Agree The best part was the suspense- not knowing what was going to happen is good practice Has helped me to define an acute situation & what instant steps I need to take Take-home points: important to think about ddx & not focus on one clinical finding/dx 95 %

Other Comments  We should be in here at least every week  More of these sessions!

Another kind of simulation

Discussion  Similar experiences using High Fidelity Simulators in Family Medicine Education  How can you implement something like this at your own institution?  Thoughts/Comments