University of Virginia School of  Medicine
Curriculum Committee
Minutes
09.22.05

Surgery Conference Room, 4:00 p.m.                       

Present (underlined) were: Reid Adams, Eve Bargmann,  Daniel Becker, Robert Bloodgood,  Gene Corbett, John Gazewood, Jennifer Harvey, Donald Innes (Chair),  Howard Kutchai, Marcus Martin, Chris Peterson, Jerry Short, Bill Wilson,  Anthony DeBenedet, Sixtine Valdelievre,  Debra Reed (secretary) 

1. Human Patient Simulation.  (Marcus Martin)  Dr. Martin provided an update on the Life-Saving Techniques Workshop added to the UVA Medical School Curriculum and an overview of the emerging utilization of simulation in medical education.   The Life-Saving Techniques workshop accommodates 36-40 students at one time and occurs four times per year at the present time.
   
   The objectives of the Life Saving Techniques workshop are to:
               Recognize common life threats
               Prioritize actions
               Utilize resources appropriately
               Take immediate critical actions
               Understand other important actions needed to effectively manage the patients
               Introduce life saving techniques
   
   The Learning Module Includes:
               Seven simulated cases
               Discussion of common life threats for each case
               Discussion of immediate critical actions for each case
               Discussion of other actions for each case
               Outline of basic management principles
               List of common emergency life saving procedures
               Video of thoracotomy technique
               Video of cricothyroidotomy technique
   
   Dr. Martin gave a brief history of the Development of Mannequin Simulators for Clinical Education.
   
   Advantages of use of the HPS include:
               Patient safety:  practice without risk
               Early exposure and competence
               Education on demand
               Standardization of curriculum
               Mitigate time and chance
               Efficiency in a new era:  acceleration of the experience curve
               Problem based learning/teaching by the case method
               Bring the cases to life
   
   Patient Care Simulation Examples
               Acute myocardial infarction/thrombolic drug use
               Obstructed airway/cricothyrotomy
               Ventricular fibrillation/cardiac arrest
               Anaphylaxis
               Acute Shortness of breath:  congestive heart failure, pulmonary embolus, asthma
               Shock:  septic, cardiogenic, hypovolemic
               Resuscitation of multiple patients, mass casualties due to trauma
               Weapons of mass destruction, chemical terrorism
   
   Students show statistically significant improvement in quality of team behaviors and reduction in the clinical error rate and improvement in attitudes towards teamwork through simulation training.
   
   Uses of HPS:
   
   

   ACGME Competencies Board Certifications and Re-certifications Undergraduate (Med Schools) Nursing Schools ACLS

   ATLS PALS Paramedic Training Lay Public Education Disaster Preparedness

   
   Student evaluation of the course has been positive with each of the six stations receiving the following scores:
   
   Please rate each station:  1=Poor, 2=Fair, 3=Average, 4=Good, 5=Excellent
         S1-Chest tube and DPL:  4.58
         S2-Airway Intubation:  4.66
         S3-Cricothyrotomy:  4.52 
         S4-IV/IO Access:  4.54
         S5-Advanced Airway Skills:  4.61
         S6-ECS Demo in ER:  4.79
   
   
    
   Student perception of their own skill level:
   
   
   Dr. Martin noted that there are many types of simulators available:
   
   

   Human Patient Simulator (HPS) Emergency Care Simulator (ECS) Cardiac Cath Sim Endoscopy Sim Bronchoscopy Sim Ultrasound Sim Peds Sim Baby Sim Surgical Sim (Laparoscopy)

   Airway Simulator Central Cath Sim TraumaMan SimMan Endovascular Skills Sim Anesthesia Delivery Sim Resuscitation Drug Recognition System Pelvic Exam Sim Dysrhythmia Generator Sims

   
   
   At present, finding rooms to accommodate the Life Saving Techniques sessions is very difficult and much time spent setting up and removing the equipment from various rooms.   The new medical education building will have a permanent site for the Simulation and LSL Center which should alleviate this problem. Funding for permanent staff to maintain and operate the equipment must also be found.
   
   Dr. Martin, when asked if he had a preference for the day of the week that the LST workshops occur, replied that Friday might be preferable because of the decreased volume in the ER on that day.
   
   Dr. Martin also noted that once there is a permanent facility for the HPS, workshops can be expanded to include disaster preparedness, pediatric patients, as well as many other topics.

Donald J. Innes
dmr