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28 08, 2018

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.

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15 04, 2015

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

2016-12-19T11:02:01+00:00

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.

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4 08, 2014

SimLIFE-EM Challenge: Add to the conversation

2016-11-07T12:40:10+00:00

simLIFE-EM

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.

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3 06, 2014

Simulation Trick of the Trade: Bleeding Cricothyroidotomy Model

2016-11-11T19:21:07+00:00

One advantage of simulation as an educational tool is the re-creation of cognitive and emotional stresses in caring for patients. Doing this for a high fidelity scenario is relatively easy – add additional patients, make a them loud, combative, or otherwise cantankerous, and add interruptions for good measure. However, when training for procedures in the simulation lab, we practice the procedure in isolation on a “task trainer” without cognitive and emotional stress for context. An off-the-shelf task trainer can do a superb job of teaching the mechanics of performing a procedure, but they lack complexity necessary to train for performing the procedure under stress. (more…)

17 05, 2014

Improving debriefing skills: Two-column case and learning pathways grid

250px-teammeeting1ExpertPeerReviewStamp2x200Being a learner in a medical simulation case can be tough. But equally challenging, is the role of the Debriefer. This person has to balance the important task of debriefing the small group, provide feedback, and still maintain a positive and open learning environment. A 2013 paper by Rudolph et al attempts to show methods how to balance these demands while improving as a Debriefer through the use of 2 Column Case Analysis and Learning Pathway Grid.

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25 01, 2014

Simulation: A tool for non-clinicians

2016-11-20T12:54:09+00:00

Medical Student SimulationThought simulation is only for doctors and nurses? Think again! More and more, people are reconsidering the notion that medical simulation has only application in the clinical setting. By rethinking the narrow mind set, educators are learning that simulation can be used almost anywhere for anyone! Even to teach sexual health to teenagers!

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