MedEdPORTAL (Jan 2010)
Anesthesia Management: Subdural Hemorrhage and Difficult Airway: A Flat-Screen Simulation and Interactive Debriefing
Abstract
Abstract Introduction In this resource anesthesiology residents, who have previously been taught to use a screen-based anesthesia simulator, are instructed to manage a simulated case of a patient with a subdural hemorrhage and a difficult airway. Learners work individually and anonymously. Once the simulation has been completed, the residents are debriefed. The debriefing consists of a presentation which includes a number of clinical management decisions. The learners are asked to respond to the management questions using an audience response system. The anonymous responses are shared with the group; the instructor then discusses the correct, and incorrect, answers. Methods The educational philosophy is based on experiential learning. First the learner is stressed to make management decisions in the simulation. Then the learner again has to make specific decisions, and the learner's response is compared to that of other members of the audience, and finally the learner gets the expert answer. Because the experience is anonymous, learner embarrassment is minimized. This format can be scaled up to any class size. This material is designed primarily for formative assessment but may be used for summative assessment as part of an objective structured clinical exam. Results This simulation has been used repeatedly for residents in the department of anesthesiology at Penn State Hershey Medical Center, with very good satisfaction scores. No formal assessment of knowledge retention, or knowledge application, has been performed. Discussion The significance of this submission is that it includes not only the simulation, but also a structured debriefing. The authors hope that other teachers will be able to use this model of instruction effectively, and will prepare different debriefings to share.
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