MedEdPORTAL (Apr 2015)
Simulation Curriculum in Internal Medicine: Decision-Making Training for Interns Focusing on Acute Clinical Scenarios in Critical Care
Abstract
Abstract High-fidelity medical simulation has gained widespread use in medical education because it allows learners an opportunity to actively engage in experiential learning and deliberate practice in a safe learning environment. This resource is a six-case simulation curriculum that focuses on decision-making training in critical care clinical scenarios, designed for medical interns at the end of the first year of training. To our knowledge, this is the first such curriculum implemented within an internal medicine training program. The materials enclosed include individual case protocols and teaching handouts for each of the six cases, as well as a guide for the implementation of the curriculum. The critical care curriculum was implemented based on our experiences and lessons learned with the general medicine curriculum at our institution. The case protocols include information necessary for facilitators to conduct the simulation sessions including learning objectives, a description of the case narrative and progression, an instructor guide, and appendices including laboratory data, radiographic images, and electrocardiograms. The teaching notes, which are one-to-two page documents paired with each of the cases, review the most vital diagnostic and management principles to be learned from the case. While they were created as an independent study resource for the learners (to be distributed after each session), they can also serve as an additional preparation tool for the case facilitators prior to the sessions. The curriculum is delivered through three 1-hour sessions, covering two cases per session. We find that the learning is maximized when two-to-three intern learners work through the cases on one high-fidelity manikin. The cases are designed to be facilitated by two individuals, one acting as the manikin operator and the other as the nurse. Each scenario runs for approximately 15 minutes, followed by a 15-minute debriefing. Debriefings are conducted by one or two facilitators using a learner-centered model of debriefing.
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