IDEA Series: Pre-recorded Video Simulation Series for Residency Conference

During medical simulation, the inherent unpredictability of learners’ performances and decisions can make it challenging to consistently achieve desired learning objectives. The amount learned and the errors made can vary wildly between groups. Paradoxically, a stellar student can minimize the learning for the other providers if he or she takes over and effortlessly completes the case. Likewise, the visceral impact of seeing a case go horribly wrong can have tremendous teaching value.1

In addition to these challenges, the COVID-19 pandemic has introduced additional barriers to medical simulation training; physical distancing measures have resulted in limited or canceled simulation activities for most emergency medicine residency programs.


Social Distancing Simulation: Tips for Leading a Virtual Session With Student Learners

We’ve all had to get a bit creative over the past few weeks. COVID-19 has ushered in an era of not only pushing healthcare workers and hospitals into uncharted territory, but also challenging the structure and delivery of medical education. Simulation education is one of many teaching modalities that is affected by this change given its case-based, in-person structure with a team of learners. These characteristics unfortunately violate the 6-foot rule of social distancing. While traditional simulation is not typically conceptualized as a virtual modality, many of its principals can be successfully adapted for remote learning.


By |2020-05-31T19:16:34-07:00Jun 1, 2020|COVID19, Education Articles, Simulation|

IDEA series: The Bleeding Arm Tourniquet Simulation

Tourniquet simulation

Education in emergency response to trauma is a global health priority [1]. Mortality rates are nearly twice as high in patients with trauma in low-income as compared to high-income countries [2]. With uncontrolled bleeding as the number one cause of death from trauma, tourniquet application has been the focus of training programs, like the “Stop the Bleed” campaign in the United States [3]. Although understanding how to apply a tourniquet is a life-saving intervention, use of a windlass tourniquet may not be intuitive [4].  The windlass tourniquet in its simplest form is the “stick-and-rope.” Winding the stick in the tourniquet creates a mechanical advantage for providing compression. Simulation of the windlass technique can be used to teach management of uncontrolled bleeding. Here we describe a low-cost simulation model that combines low- and high-fidelity techniques to train healthcare personnel on windlass tourniquet application.


IDEA series: REDman simulation for teaching resuscitation skills in low-resource settings

REDman simulationIn many parts of the world, emergency medicine is just beginning to emerge as a specialty. In Pakistan, for example, it was introduced as recently as 2012. Hands-on training in the management of critically-ill medical and trauma patients is imperative for adequate preparation of board-certified emergency physicians, but accurate simulation can be hard to come by in developing nations. There are very few training programs and dedicated centers for healthcare professionals, and even fewer that have simulation [1]. High-tech simulation equipment is often cost-prohibitive; a mobile, low-tech simulation lab could potentially address the need for advanced training in resuscitation for emergency physicians training in under-resourced hospitals.


By |2020-02-14T09:40:38-08:00Feb 21, 2020|IDEA series, Simulation|

IDEA Series: Building a High Fidelity Biosimulation Task Trainer for Resuscitative Hysterotomy

The Problem

idea series teaching residents quality improvementThe peri-mortem cesarean section, rebranded in recent years as the “Resuscitative Hysterotomy”, is a potentially lifesaving procedure for both a pregnant mother and her child. It is both daunting and infrequently performed, necessitating frequent review of indications, techniques, and pitfalls to ensure the best possible outcome for mother and baby. The decision to perform this procedure should be made only in pulseless women with a uterine fundus above the umbilicus, which indicates a gestation of >20 weeks.1,2 Prior studies suggest the procedure should be performed within 5 minutes of maternal cardiac arrest in order to maximize the probability of favorable maternal neurologic outcome and the secondary goal of fetal survival.3 Given the paucity of clinical exposure to this potentially-life saving intervention, resuscitative hysterotomy is an ideal candidate for simulation-mediated deliberate practice.


By |2018-10-28T21:53:00-07:00Aug 28, 2018|IDEA series, Simulation|

A cost-effective, two-layer wound closure task trainer

Buried SuturePerforming a two layer wound closure can be a challenging procedure in the Emergency Department for clinicians with limited wound care experience. Challenges include suture choice, suture placement, and the technique of burying the knot in the deep layer of the wound, and the availability of ready ‘volunteers’ with complex wounds willing to let novices practice on them. Commercially available suture models are expensive, and can be cumbersome to store, and difficult to obtain in a timely manner to provide the learner with opportunities to practice prior to wound repair on a patient in the department.


SimLIFE-EM Challenge: Add to the conversation


Debriefings in medical simulation are meant to be the bow on top of the gift that is medical simulation. It is the ultimate delicious dessert, served after a grueling dinner course. All analogies aside, debriefings are meant to drive home the teaching points, to gain a deeper understanding of medical resuscitation as a group, and create mental frameworks of the approach to various patients. But this is often easier described than actually done. We here at ALiEM paired with Dr. Henry Curtis to come up with a creative way of developing debriefing skills and gain deeper understanding of mental frameworks.