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Simulation-Based Training

The simulation-based training at the Department of Internal Medicine is geared to enhance residents' skills and affect their attitudes and behaviors during patient care and when interacting with their families across the continuum of care, ranging from ambulatory setting though inpatient crisis events. Training is carried out at the local Simulation Center.

Training sessions are designed to improve performance and transform trainees' approach by creating a high-fidelity, immersive experience, coupled with a 3600-type debrief process and deliberate practice. The sessions focus on planning, teamwork, leadership, communication and execution of prioritized clinical tasks.

Key simulation sessions include acute respiratory failure, hemodynamic instability, cardiopulmonary arrest and family conference for an acutely ill patient. Separate task-specific training is provided involving placement of central venous catheters, mask-bag ventilation, and endotracheal intubation.   

The residents complete pre- and post-session (pre-debrief) self-assessment questionnaires addressing their performance and level of confidence.  

Because most key physician-patient interactions involve other healthcare professionals, simulation training consistently includes interprofessional interactions with nursing staff and team members, as appropriate. In addition, because perspectives on performance and priorities in patient care vary across healthcare professionals' background, debrief sessions routinely incorporate structured interprofessional interactive feedback. Similarly, sessions focusing exclusively on communication (i.e., patient and family counseling) include debrief feedback by simulated family members/patients, covering predetermined key performance domains. Structured post-session evaluations are completed by faculty for each resident, with input by simulation confederates and are included, along with their self-assessments, in resident's performance portfolio.  

The 3600 debrief approach has been shown to broaden residents' insight of the complexities involved in-team-based delivery of health care in crisis events and during routine care. The direct "lay person" input from simulated family members/patients offers residents a unique, generally unavailable, direct and timely perspective on their performance and means to improve, complementing faculty input. Following debrief, each resident is provided with a recording of his/her session allowing follow-up replay to facilitate deliberate practice.

 The simulation-based training program provides a state-of the art learning environment, with the training process and debrief remaining at the forefront nationally.

 
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