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Anesthesia & Analgesia: May 2008 - Volume 106 - Issue 5 - p 1581-1584. doi: 10.1213/ane.0b013e31816b9478. The scenarios will include one case with only physiologic monitors, one case with only echocardiogram recordings, and one combined case with recordings from both physiologic monitors and echocardiograms. The Department of Anesthesiology has a robust Oral Boards curriculum, with many faculty serving as ABA board examiners and one former President of the ABA on staff. This is particularly important for core cases and low-frequency, high-stakes procedures and encounters. Basic scenarios using high fidelity simulation (hypotension due to blood loss, hypoxia due to bronchospasm, etc.) Two pediatric anesthesiologists scored each scenario by key action checklist. The Anesthesia Simulation Program fulfills the training requirement for Part IV of the Maintenance of Certification in Anesthesiology Program (MOCA). This simulation was created as part of our core anesthesiology simulation curriculum for residents and fellows. the sig also maintains a standardized, national curriculum of disseminated simulation activities including within interprofessional education, crisis resource management training related to pediatric anesthesiology as well as the development of standardized scenarios, assessment tools and development of multi-institutional collaboratives in This committee at the ASA helps inform guidelines, initiatives, and collaborations within pediatric anesthesia at the ASA. This book helps prepare anesthesiology residents for safe practice of pediatric anesthesia. The program brings together experts from clinical and basic science disciplines related to pediatric medicine, anesthesia, and surgery. Format: 3 - Full day training sessions spaced out through the duration of the fellowship program. The three high-fidelity simulation scenarios were planned based on the identified goals and objectives and common pediatric emergencies seen in the PACU. 1 it is a relatively frequent complication that occurs with varying frequency dependent on multiple factors. The Simulation Program at Boston Children's Hospital is the first pediatric simulation center in United States to be endorsed by the American Society of Anesthesiologists (ASA). The scenario is used for practice, evaluation, and self-identification of weaknesses in the learner's knowledge base in regard to perioperative management of the pediatric patient. ADVANCED SIMULATION EXERCISE Title: Pediatric Massive Hemorrhage Protocol Creation date: March 2020 Contributors: Suzanne Beno (MPH Pediatric WG), Teresa Skelton (MPH Pediatric WG), Heather O'Reilly (Department of Anesthesiology and Pain Medicine, CHEO) Original Scenario: Devin Singh, J Pirie, Natasha Collia References: Pediatric MHP toolkit . We will also discuss practice and career management issues. On February 17, the Department of Anesthesia hosted the Fourth Annual Pediatric Anesthesia Winter Bootcamp for fellowship trainees at NC Children's Hospital. Simulation training is rapidly becoming an integral element of the education curriculum of anesthesia residency programs. Anesthesiology faculty actively participate in simulation training and many routinely train residents during the weekly Simulation Tactical Training sessions. . Reliability and validity of a scoring instrument for clinical performance during pediatric advanced life support simulation scenarios. Participants: 4 Pediatric Anesthesia Fellows (2 MOR, 1 ICU rotation, 1 Pain rotation). Program Director, Dr. Richard Cherry The Fellowship in Medical Simulation through the Department of Anesthesia and Perioperative Medicine at Western is designed to equip the clinician with the necessary knowledge, skills and attitudes to provide simulation based education curricula at the academic level and to appreciate the focus and direction that simulation based . New airway scenarios will be added regularly. . . This course is designed to act as a bridge between the non-clinical and clinical years of medical school, linking patient symptoms, exam findings, and management plans to students' basic science knowledge of anatomy, pathophysiology, and pharmacology. 2, -, 5 once the diagnosis has been made, the main goals are identifying and removing the 5 The 10 simulation scenarios were designed to reflect a range of ages of children who had cardiovascular, respiratory, and neurologic disease that had either not . Abstract. Duke Template to Design a Simulation Scenario Chinese Translation CSSALT Anesthesia Anesthesia Machine and Equipment Failure Allied Health Obstetric CCS Pediatric Anesthesia PALS ACLS Scenario Libraries The Center for Safety, Simulation & Advanced Learning Technologies (CSSALT) UF Academic Health Center University of Florida Sim Wars: A Pediatric Anesthesia Simulation Scenario with Audience Participation Upon completion of this presentation, the participant will have experienced an innovative approach to active learning and evaluation, learn about crisis- resource management during an acute pediatric perioperative event, discuss the importance of communication . Fellows also provide simulation instruction. The scenarios created for the study are similar to premorbid conditions that have led to clinical deterioration prompting a RRT call at other tertiary care pediatric hospitals. The main goal is to establish a safe learning environment for the learner [9, 13]. a) . The Multidisciplinary Pediatric Airway Course is designed to teach the basics of airway management as well as advanced skills to manage different airway scenarios for pediatric patients to all disciplines of medicine involved in the care of children. Dr. Over the years, the use of simulation has gone from low fidelity to high fidelity models that mimic human responses in a startlingly realistic manner, extremely life-like mannequin that breathes, generates E.K.G, and has pulses, heart sounds, and an airway that can be programmed . At the end of each simulation session, a pediatric anesthesia faculty member with debriefing expertise facilitated the debrief along with the PACU nurse educator. I have taught simulation scenarios for both anesthesia residents and pediatric anesthesia fellows for pediatric emergency scenarios. Despite remarkable progress, pediatric anesthesia-related mortality remains 2 to 30 times higher than in adults. Simulation-based assessment of pediatric anesthesia skills. . Sponsored Content: Kaiser Permanente Healthcare Simulation Trigger Films In this project, we used simulation technology to assess pediatric anesthesia skills in trainees in anesthesiology who are learning to administer anesthesia to children. All Anesthesiology residents rotate through the Division of Pediatric Anesthesiology for a minimum of three months throughout their training continuum. Sally is having frequent, strong to palpation contractions that are extremely uncomfortable. SATURDAY, MARCH 24, 2018 simulation with other common learning modalities Lectures Online lectures Small group discussions/ PBLDs Practice quizzes Fellow topic presentations 1. There have been colossal technological advances in the use of simulation in anesthesiology in the past 2 decades. : Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium. The American Board of Anesthesiology (ABA) requires certain quality improvement (QI) activities as part of the current Maintenance of Certification in Anesthesiology . 2011; 115(6):1308-15 (ISSN: 1528-1175) . The Introduction to Patient Simulation course is OHSU's first simulation-based elective for second year medical students. 8.1 Cardiovascular Collapse During Laparoscopic Appendicectomy . BP 100/p, HR 120, deformity and laceration to R mid forearm noted - bandaged and splinted. 20 brand new scenarios in anesthesia, midwifery, pediatric, disaster, and other . Effective, targeted simulation training can help reduce the gap between the text book and reality. Dorfling, McLarney, and Sloan 3 developed a simulation scenario for one-lung ventilation, but it was not specific to pediatrics. In addition, CA-2 and CA-3 residents create and direct training scenarios for these sessions. No grading is based on simulation and none of the simulations are recorded. After each simulation, resident performance will . Division of Pediatric Anesthesiology 505-272-2610 JDillow@ salud.unm.edu Hi - I am a pediatric anesthesiologist who is triple boarded in anesthesiology, pediatric anesthesiology, and pediatrics. He has a history of hay fever and a penicillin allergy, so there is a slightly increased risk for an allergic reaction. . . Methods: Ten simulation scenarios were designed to reflect situations encountered in perioperative pediatric anesthesia care. Anesthesiology residents and fellows consented to participate and were debriefed after each scenario. Participants will be exposed to and become comfortable using various ventilation and intubation . Our first goal was to design and construct a set of simulated scenarios that a resident who was board-eligible in anesthesiology would be expected to manage capably. General topic areas include anatomy, pathophysiology, anesthetic phar- macology, sedation, pain management, patient safety, and child advocacy issues. Simulation in pediatric anesthesiology . Pediatric and Adult Anesthesiology Simulation Education is designed to be used by both academic programs and private . Scenario Set-up Room configuration - OR set-up Equipment Needed: Anesthesia machine with pediatric circuit, pediatric drug cart, pediatric airway equipment, IV setup and equipment, drugs in syringes (atropine, epinephrine, glycopyrrolate, propofol, rocuronium, fentanyl) Mannequins/task trainer/standardized patient needed - child sized mannequin Participants were . Anesthesia SimSTAT is a powerful virtual simulation used to help physicians learn about anaesthesia, patient monitoring and managing anaesthesia-related emergencies. Dorfling, McLarney, and Sloan 3 developed a simulation scenario for one-lung ventilation, but it was not specific to pediatrics. The tools and strategies specific to this scenario include: brief, huddle, situation 1 Radiologic progress and interventions have revolutionized the field to include caring for children in remote sites outside of the operating theaters. Expertise Level: Novice - Intermediate Simulation Developers: Michael Chen, MD; Alice Elder, MD, MA (education), MPH; Samuel Wald, MD; Yue . Basic knowledge of thoracic and pediatric anesthesia is required, but specific experience with pediatric lung isolation is not. This event was created to facilitate the transition from trainee to faculty by providing the learners the opportunity to experience independent practice. recordings. This chapter describes the practical management of some clinical scenarios in pediatric anesthesia. (MOCA Simulation Course) Course Description Simulation in Anesthesia for the Practicing Anesthesiologist is a one-day, immersive, experiential learning course that fulfills the Maintenance of Certification in Anesthesiology (MOCA) Part IV (Practice Performance Assessment and Improvement) simulation education requirement. TeamSTEPPS 2.0 Specialty Scenarios - 105 Specialty Scenarios L&D Scenario 86 Appropriate for: L&D Setting: Hospital Sally Rodgers, a 25-year-old nullip in labor at term who is dilated 3 cm. 1 , 2 Current ethical practice allows for adult patients with decision-making capacity to refuse blood . Committee on Pediatric Anesthesia, American Society of Anesthesiologists (ASA), Committee member (2018-2023). . Non-technical skills rather than a lack of expertise were identified to be the main cause of errors in medicine, particularly in emergency situations. This resource is a case-based simulation on anaphylactic reaction. We perform formal Mock Oral exams about 4 to 5 times per year. Thus, to the best of our knowledge, this is the first report of an educational . PEDIATRIC PATIENT SCENARIOS . review, edit, and update the critical event checklists, checklist simulation scenario; Research Committee . . Below is a collection of donated scenarios for you to use or modify. . It features 26 index cases, which are classic clinical scenarios - all covering a spectrum of pediatric anesthesia, neuro-anesthesia, cardiac anesthesia, regional anesthesia, and anesthesia and critical care medicine. The patient may also be somewhat dehydrated and have an increased risk . EMS report: 10 -year-old riding on ATV was thrown off at about 30mph when the driver hit a log in tall grass, crying, complaining of pain to the R forearm and R hip area and nausea. It features a 22-year-old healthy male presenting for appendectomy. Pediatric Anesthesia Call Residents are assigned to take one week of night shift per month 3 p.m.to 11 p.m. To find our simulation sets and supporting curricular materials, search under "Airway Management Education Center." When you see The Difficult Airway Course logo, you'll know you have the right ones! Gain exposure to resources available for a simulation scenario content development; Acquire an appreciation for the role of guided debriefing . Hence, it can be used as an adjunct to improve both cognitive and technical skill acquisition for perioperative transplant anesthesia. Pediatric . Simulation Anesthesia. Free. Abstract. Other goals could also be scaffolded onto this scenario as deemed appropriate by the simulation instructor, including breaking bad news to family member or a simulated hot debrief with the team. Students are assigned to simulation lab for 8 hours each semester and by graduation time, students have completed 20 different clinical scenarios. OBJECTIVE:. The purpose of this study was to develop a set of relevant simulated pediatric perioperative scenarios and to determine their effectiveness in the assessment of anesthesia residents and pediatric anesthesia fellows.Ten simulation scenarios were designed to reflect situations encountered in perioperative pediatric anesthesia care. There are one or two weekend shifts per month from 7 a.m. to 7 p.m. SICU Below are tips to help the facilitator conduct the simulation. Instruction comes in a variety of forms: Monthly Journal Club; Pediatric Intra-operative Lecture Series; Simulation-based pediatric scenarios; A didactic program for those in Clinical Anesthesia . CONCLUSIONS: A multiple-scenario, simulation-based assessment of pediatric perioperative care was designed and administered to . 2010; 81 (3):331-6 . How simulation education is applied in pediatric anesthesiology is reviewed by describing its uses for learning and training in residency and fellowship programs, and its applications to improve patient safety and patient care. Reliability and validity of a scoring instrument for clinical performance during pediatric advanced life support simulation scenarios. Blike GT, Beach M, et al. Several anesthesia residents participated in this scenario, with frequent revisions and updates made based on feedback. Rating scale 0-100 2. However, assessment is critical to improve patient safety. Sim Wars - A Pediatric Anesthesia Simulation Scenario with Audience Participation Upon completion of this presentation, the participant will experience an innovative approach to active learning and evaluation, learn about crisis-resource management during an acute pediatric perioperative event, discuss the importance of communication during and . The first simulation set, Pediatric Airway 1 - Core Principles, is now available on the SimStore. It features 26 index cases, which are classic clinical scenarios - all covering a spectrum of pediatric anesthesia, neuro-anesthesia, cardiac anesthesia, regional anesthesia, and anesthesia and critical care medicine. We report a case of successful resuscitation of bupivacaine-induced . When employed as a substitute for real clinical time, simulation scenarios have proven effective in bridging the gap between theory and practice. The case will involve managing pediatric status epilepticus and including escalating anti-epileptics, intubation, and handing over to pediatrics. Anesthesiology. It features 26 index cases, which are classic clinical scenarios - all covering a spectrum of pediatric anesthesia, neuro-anesthesia, cardiac anesthesia, regional anesthesia, and anesthesia and critical care medicine. Scenario Name: Pediatric Sedation. The scenarios will include one case with only physiologic monitors, one case with only echocardiogram recordings, and one combined case with recordings from both physiologic monitors and echocardiograms. 1 Radiologic progress and interventions have revolutionized the field to include caring for children in remote sites outside of the operating theaters. Simulation Scenarios Contents Adrenal Insufficiency 1 Blunt Abdominal TraumaHypovolemic Shock 4 Cardiogenic Shock Due to Congenital Heart Disease 8 Altered Mental Status 10 Diabetic Ketoacidosis and Cerebral Edema 12 Hyperthermia 15 HypothermiaNear Drowning 18 Iron Overdose 22 MyocarditisCardiogenic Shock 25 Anesthesiology residents and fellows consented to participate and were debriefed after each scenario. The program included an enhanced workshop in pediatric anesthesia and simulation as well as high fidelity simulation scenarios that were performed in the University's Patient Simulation Center. You will be presented with 3 separate scenarios. mannequin-based HFS scenario. The infant has a prolonged seizure shortly after the session begins. 2010; 81 (3):331-6 . This training is particularly important in preparing for pediatric anesthetic crises because a child's condition can change rapidly compared to an adult, and team members may be less familiar with children and their management during a crisis . Debriefing is conducted in informal group settings. Sim Wars: A Pediatric Anesthesia Simulation Scenario with Audience Participation Upon completion of this presentation, the participant will have experienced an innovative approach to active learning and evaluation, learn about crisis- resource management during an acute pediatric perioperative event, discuss the importance of communication . Abstract Abstract This resource is a pediatric simulation scenario featuring a seizing infant in the postanesthesia care unit (PACU). Pediatric and Adult Anesthesiology Simulation Education is designed to be used by both academic programs and private . Medical School. Learners are asked to interact with the team and simulation mannequins as if these cases were actual children. The Pediatric Anesthesiology Fellowship program aims to: To train proficient pediatric anesthesiologists by providing opportunities to advance their medical knowledge, clinical and interpersonal skills, professional attitude, system and practice based learning while offering a wide variety of cases and health learning environment. Thus, to the best of our knowledge, this is the first report of an educational . Simulation-based assessment of pediatric anesthesia skills. . This acclaimed text for nursing faculty provides detailed, step-by-step guidance on all aspects of clinical s . U of M is 1 of 7 centers in the US offering the MEPA course. Crisis Resource Management The principles of Crisis Resource Management (CRM) can affect care as much as medical knowledge. Venue: OR Procedural Simulation Suite (ORSIM) and Hospital PACU Room (In-situ) Frequency: Each module 4 times per year (12 sessions per academic year). Overall, I find simulation to be a useful learning modality. perioperative laryngospasm is an anesthetic emergency that is still responsible for significant morbidity and mortality in pediatric patients. Anesthesiology residents and fellows consented to participate and were debriefed after each scenario. Sim Wars - A Pediatric Anesthesia Simulation Scenario with Audience Participation Upon completion of this presentation, the participant will experience an innovative approach to active learning and evaluation, learn about crisis-resource management during an acute pediatric perioperative event, discuss the importance of communication during and . The MEPA course is a series of literature based expert peer-reviewed scenarios followed by presentations. Texas Children's Hospital Simulation Center 19 th floor Feigin Tower 1102 Bates Avenue Houston, Texas 77030 . Medical ethicists have studied patient objection to blood transfusion, specifically in regard to the Jehovah's Witness faith. Basic knowledge of thoracic and pediatric anesthesia is required, but specific experience with pediatric lung isolation is not. Throughout this scenario, participants will be tasked with identifying opportunities to apply effective communication and efficient teamwork skills, such as the ones recommended by TeamSTEPPS. MEPA aims to give anesthetic trainees the opportunity to develop management strategies for emergencies in pediatric anesthesia using high-fidelity simulation. al. Some of the scenarios describe urgent situations, while others are less urgent but commonly seen and have the potential to become serious problems if mismanaged. . . 2011; 115(6):1308-15 (ISSN: 1528-1175) . In this scenario, the candidate is called to see a 6-month-old, 15-pound male infant who has just arrived in the PACU. Our simulation courses can range from procedural skills training, to mannequin-based scenarios for anesthesiologists, all the way to interprofessional team sessions in situ. Due to the COVID-19 pandemic, many of our in-person education sessions have been moved to virtual platforms. At Villanova University, College of Nursing pediatric clinical learning experiences for undergraduate learners are augmented with these four formative simulation scenarios offered during the 7-week pediatric clinical experience, along with a summative clinical scenario conducted after the 7-week clinical practicum. The "basic assumption" - that everyone is present METHODS: Ten simulation scenarios were designed to reflect situations encountered in perioperative pediatric anesthesia care. Journal Clubs. You will be presented with 3 separate scenarios. 8:30 am Case Scenario #1 and debriefing 9:30 am Break 9:45 am Case Scenarios #2 and #3, each followed by debriefing 11:45 am Lunch (Q&A, airway tools, additional discussion) 12:15 pm Case Scenarios #4 and #5, each followed by debriefing 2:15 pm Break (optional) 2:30 pm Case Scenario #6 and debriefing 3:30 pm Wrap-up, Course Evaluation, Review . . We recruited 4 raters (2 faculty pediatric anesthesiologists and 2 senior pediatric anesthesia fellows) from the study institution to score the study scenarios. Experience a hands on appendectomy in a simulated setting. Resuscitation. This is a change from 2 cm over the previous 90 minutes. The simulation features high-fidelity scenarios that will challenge you and enhance your competency in solving . The "fiction contract" is reviewed, addressing the limitations and 'believability' of the simulation scenario. The scenarios take place in various settings around UNC Children's Hospital including the sedation suite and Pediatric Intensive Care Unit (PICU). Scenarios the simtech Scenarios Medical Simulation Scenarios are text documents outlining the various details of a simulation - everything from patient simulator settings to debriefing notes. Address e-mail to torsher.laurence@mayo.edu. al. Simulation provides a safe environment where learning is enhanced through the deliberate practice of skills and controlled management of a variety of clinical encounters. Abstract The field of pediatric anesthesia has become increasingly subspecialized, with unique challenges that demand high-quality teaching and training. Simulation provides low-stakes exposure to the high-stakes skills required in the operating room. Anesthesiology. We recruited 4 raters (2 faculty pediatric anesthesiologists and 2 senior pediatric anesthesia fellows) from the study institution to score the study scenarios. Purpose . The goal of simulation training at the UK College of Medicine Department of Anesthesiology is to provide innovative clinical case scenarios that will test the practice of anesthesia. The goal of these simulation programs is to improve patient outcomes and produce more capable anesthesiologists. Each scenario will begin with a short case description. 3 . . BACKGROUND: Assessment of pediatric anesthesia trainees is complicated by the random nature of adverse patient events and the vagaries of clinical exposure. Pediatric anesthesia is a subspecialty that has become increasingly refined and technically advanced, with the advancement of complex surgical techniques and patients with a low tolerance for error. 272-3666 or Pediatric Specialties (877) 607-5280. PART 1: Simulation in our Pediatric Anesthesia World: An Introduction to Techniques and Tools for Improving Clinical Practice and Teaching (sponsored by the SPA Simulation SIG) . recordings. The study's primary purpose was to compare clinical competency scores among nurse I have also Competency-based medical education has seen widespread adoption in the field along with ongoing work in the areas of . Duke Template to Design a Simulation Scenario Chinese Translation CSSALT Anesthesia Anesthesia Machine and Equipment Failure Allied Health Obstetric CCS Pediatric Anesthesia PALS ACLS Scenario Libraries The Center for Safety, Simulation & Advanced Learning Technologies (CSSALT) UF Academic Health Center University of Florida