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A discussion detailing the Resuscitation and Crisis Management Curriculum at the University of Wisconsin - Madison. This presentation outlines the advantages of including residents as teachers for medical students, faculty and staff.
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Developing a Simulation BasedResuscitation Curriculum
Med4’s, Faculty, Staff, ResidentsMarch 2010 University of Florida - Gainesville
Eric B. Bauman, PhD, RN
Department of AnesthesiologyUniversity of Wisconsin School of Medicine & Public Health
Course & Program History• Our Current Resuscitation Program has
undergone several revisions• The current incarnation revolves around a
Med4 Elective Clerkship
www.pamelaheath.com/Cartoons4.htm
Resuscitation & Crisis Management• One-week immersive simulation-based elective for
Med4’s• Small Group setting: Six Students• Much of the didactic information are provided via the
University’s Web-based educational interfaceLearn@UW
• Didactic Content is reinforced in small groupdiscussions led by faculty, staff and Residents
• Didactic and small group discussions preparestudents for simulation
• This course meets and exceeds all AHARequirements for AHA ACLS Provider status– Students successfully completing the course
receive an ACLS Provider Card
Simulation Pathway
Bauman 2007
Didactic and Web-based learning
Small GroupDiscussion
Simulation-basedExperiential Learning
www.pamelaheath.com/Cartoons4.htm
Advantages of our Approach• The Resuscitation & Crisis Management
Course has been one of the top rankedelectives since its inception!
• Faculty and Staff model professionalacademic practice for Residents
• Provides a Novel Approach to ResidentEducation
More on our Resident’s Role
• All CA1’s become AHA ACLS Instructors andcomplete a teaching with simulation seminar
• AHA ACLS Instructor Status supercedesACLS Provider Status
• ACLS Provider Status is required for HospitalCredentialing and Residency ProgramRequirements– Residents maintain their ACLS Instructor status by teaching
in the Crisis Management & Resuscitation Elective– Residents must teach in 4 courses every 2 years and be
Monitored by AHA Training Center Faculty every 2 years
Promotes the Clinician as Teacher Perspective• Fosters teaching skills of our residents in
accordance with the ACGME corecompetencies
• Students relate well to Residents who arejust a few years ahead of them in theirtraining, promoting peer-to-peer learning
www.pamelaheath.com/Cartoons4.htm
Mentoring• As Residents are learning how to teach they
are paired with more experienced Faculty orStaff Instructors
• Residents often assist with assessment anddebriefing during simulation sessions
• Faculty & Staff Mentor the Residentsmodeling important aspects of professionalpractice and acculturation.
Other Resuscitation Education• Our Resuscitation Program provides
training opportunities for all facultywithin our department
• Residents often instruct their peers andattending/supervising faculty (onoccasion sometimes even the Chair)
Essential Elements forSuccess
• Must have top down & lateralbuy in!
• See Resident teachingopportunities as part of yourResidents’ essential graduatemedical education experience
• Residents must haveadequate time to prepare forteaching and their role asteacher must be valued.
Richard Kyle
High Fidelity Simulation in theHealth Sciences
©Bauman 2007
InterventionDidactic presentation of contentimmediately followed by situated
immersive learning experiences in ahigh-fidelity simulated environment with
extensive use of debriefing
Testing/Evaluation
One and only one posttest per measurefor each participant!
Results• Increased Cognitive Gain on two (2) written measures
– EKG Posttest Exam• (T = 818.5, p < .001)
– Multiple Choice Posttest Exam• (T = 820, p < .001)
• Increased Cognitive Gain on Practical Post-test Exam (T = 820, p< .001)
• Increased BEHAVIORAL gain on Practical Posttest Exam (T =820, p < .001)
*Statistical analysis based on 1-tailed matched pair Wilcoxon exam
©Bauman 2007
Mean EKG pre- and posttest scores byparticipant
0
10
20
30
40
50
60
70
80
90
100
Individuals
Me
an
Pe
rce
nta
ge
Co
rre
ct
Pre-EKG Post-EKG
©Bauman 2007
Mean ACLS pre- and posttest scoresby participant
0
10
20
30
40
50
60
70
80
90
100
Individuals
Me
an
Pe
rce
nta
ge
Co
rre
ct
Pre-ACLS score Post-ACLS score
©Bauman 2007
Mean cognitive pre- and posttestscores by participant
0
0.5
1
1.5
2
2.5
3
Individuals
Me
an
S
co
re
Mean pre-cognitive scores Mean post-cognitive scores
©Bauman 2007
Mean behavioral pre- and posttestscores by participant
0
0.5
1
1.5
2
2.5
3
Individuals
Me
an
S
co
re
Mean post-behavioral score Mean post-behavioral score
©Bauman 2007
Mean pre-behavioral score
a The next highest score for this exam was an 80.
b Two students scored 45% on this exam.
c Calculated p-value for pre- to posttest differences for this test was .00000003.
d Calculated p-value for pre- to posttest differences for this test was .00000008.
e Calculated p-value for pre- to posttest differences for this test was .00000004.
©Bauman 2007
Table 1
Descriptive statistics for pre- and posttest measures of cognitive and behavioral ability
M SD Median Low Score High Score
EKGc
Pre 63.30 14.99 64.00 32.00 100.00a
Post 94.70 9.30 100.00 60.00 100.00
ACLSd
Pre 62.28 8.24 62.50 45.00b 79.00
Post 95.48 3.82 97.00 88.00 100.00
Cognitivee
Pre .54 .52 .33
Post 1.93 .42 2.00
Behaviorale
Pre .84 .43 1.00
Post 1.94 .35 2.00
Including research is essential to asuccessful simulation program
• Provides you with feedback on your progress• Provides a showcase for your accomplishments• Provides opportunity for networking and collaboration• Provides you with justification for continued and
future funding opportunities
Contact InformationEric Bauman, PhD, RN
Department of AnesthesiologyUniversity of Wisconsin School of Medicine and Public Health
ebauman@wisc.eduhttp://www.linkedin.com/in/ericbbauman
Department: 608-263-8100Cell: 608-469-6200
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