Sim Case Series: Procedural Sedation

PSA PictureCase Writer:  Brent Thoma, MD MA
Case Editors: Teresa Chan, MD and Nikita Joshi, MD

This procedural sedation simulation case can be used to teach, evaluate or reinforce the skills needed to safely perform procedural sedation. It presents a new format for the ALiEM Sim Case Series: Teresa Chan (@TChanMD) has worked magic to amalgamate all of the materials into a cohesive, organized, easy to follow format that also happens to be pretty. The freely downloadable PDF below includes:


By |2016-11-11T19:17:48-08:00Dec 12, 2013|Simulation|

Simulation Trick of the Trade: Paper Mache

MoneyTreeMoney doesn’t grow on trees, and neither do simulation manikins, not even on simulated trees. So what to do when you are looking for a cheaper, more easily replicated solution to simulation dilemmas? This is the perfect time to fall back on skills developed in childhood during Arts & Crafts hour. Consider paper mache!  So easy to use, and guaranteed to bring back childhood memories!


By |2016-11-11T19:03:49-08:00Sep 20, 2013|Simulation, Tricks of the Trade|

Simulation Trick of the Trade: Blindfold the Leader

67f84c2b0bdcd2f857a9a230de27924593f1d40aSimulations are routine now in medical training. But sometimes routine can start to get boring! All learners now know, especially for high fidelity simulations, to prepare for the unexpected. The stable patient will inevitably crash, maybe when your back is turned; the confederate in the room may or may not be a friend or a foe, you may never know! But these twists have become so integral to the simulation case that most learners know how to deal with it, or at the least know to anticipate it. But here is an idea for adding a new challenge to a stale simulation case. Blindfold the leader!


Crisis Resource Management


CRM and SBT… just another set of acronyms in the world of medical education?  Don’t we already have enough??

Not quite!  Rather, Crisis Resource Management (CRM) is a complementary approach to Simulation Based Training (SBT). It can enhance current ongoing medical simulations or provide foundation for a vigorous curriculum when launching new simulation programs.


By |2016-11-11T19:02:50-08:00Aug 16, 2013|Medical Education, Simulation|

ALiEM Book Club: Difficult Conversations

Difficult Conversations

Debriefing is a difficult skill to acquire. It is a little to easy to ask accusatory questions when you witness things that went wrong, or in a direction not anticipated. It’s also hard when trying to keep your own horror and shock from what you just witnessed (how could you forget to get a fingerstick glucose??!!). But rarely these types of learning situations go well if we don’t learn how to develop high quality debriefing skills. Similarly without debriefing expertise, simulations that we conduct lose purpose and meaning. There are many ways to learn effective debriefing skills, and I want to share a reference that many of my simulation mentors gave me when I began building my niche in education. Reading the book “Difficult Conversations” by Douglas Stone, Bruce Patton, Sheila Heen of the Harvard Negotiation Project will help you gain understanding of how to approach debriefing and maximize learning in a safe environment.


By |2016-11-11T19:02:33-08:00Jul 19, 2013|Book Club, Simulation|

ALiEM Sim Case Series: Mass Casualty Building Bombing

disasterCase Writer:  Nikita Joshi, MD

Keywords: Mass casualty incident, building bombing, disaster, triage, ethics

Educational Objectives


  • Develop system of triage to optimize patient outcomes in prehospital disaster setting
  • Effectively utilize color coded tagging method to assist in categorizing patients
  • Develop treatment plans to address immediate emergency conditions per ATLS protocols


  • Maintain team and personnel safety precautions
  • Regularly provide updates to incident command center


By |2019-02-19T18:08:27-08:00Jul 5, 2013|Simulation|

Reflections on CMS Simulation Instructor Course

Screen Shot 2013-06-17 at 3.03.29 PMI just completed the 4 day intensive Center for Medical Simulation Institute for Medical Simulation Instructor Course.  The title of the course is a mouthful and just as intense and high yield as the actual course was itself.  The chief purpose of the course is to develop debriefing skills as a medical instructor. The structure and nature of the course seemed so effortless and fluid, and yet at the end of the 4 days, I knew that the debriefing skills I had learned were ingrained into my brain. I highly recommend this course to any medical educator with simulation interest.  In this post, I want to share with you a few of the highlights and encourage everyone to learn more. (more…)

By |2016-11-17T08:48:10-08:00Jun 22, 2013|Medical Education, Simulation|
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