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

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Pre-EKG Post-EKG

©Bauman 2007

Mean ACLS pre- and posttest scoresby participant

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Pre-ACLS score Post-ACLS score

©Bauman 2007

Mean cognitive pre- and posttestscores by participant

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Mean pre-cognitive scores Mean post-cognitive scores

©Bauman 2007

Mean behavioral pre- and posttestscores by participant

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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