Simulation in the Shared Discovery Curriculum Dept. of Pediatrics and Human Development Sept. 16, 2015 Robin DeMuth, M.D.

How will this fit? MTuWThFSa AM Clinical activity: Nutrition GIL Rotational small group: Nutrition Clinical activity: Nutrition GIL PMGIL Team small group Large group (TBL or similar) Simulation or Workshop GIL GIL= Guided Independent Learning

What types of Simulation? Skill Building Validation of Knowledge/Skills Clinical reasoning Simulated Patient Experiences High fidelity mannequins Integrative Often a mix of these!

Skill Building Helping students learn the clinical skills needed for the settings they will be in Interviewing Physical exam Office skills: UA, strep test, Ages & Stages scoring, foot exam Writing health records Oral presentations Procedural skills Advanced interactional skills: motivational interviewing, shared decision making, breaking bad news Specific physical exam skills: Pneumatic otoscopy, sensitive exams

Validation of Knowledge/Skills Minor “assessments” Allows progression to clinical tasks Confirmation from a skilled person that the student is acceptable to be involved in patient care in this arena Taking reliable BP Setting up a breathing treatment Performing med reconciliation Scribing an HPI

Clinical Reasoning Interactive experiences focused on clinical reasoning Faculty has a case scenario Group of students working together to ask questions about hx and physical exam Using skills in diagnostic reasoning Faculty providing feedback, guidance

Simulated Patient Experiences Students gain experience interviewing, examining, interacting with patients with particular presentations Faculty create cases and associated materials, checklists/feedback forms for SPs May watch cases to validate or augment SP feedback Specific C3 topics Diversified experiences Make sure all see important presentations

High Fidelity Mannequins Students interact with scenario that includes a patient mannequin Mannequin allows examination of abnormal and/or acute physical findings Faculty develop or “run” cases Critical care Emergency dept. scenarios Often may interact with other health professionals

Integrative Necessary science and clinical skills together May have post-encounter tasks relating explicitly to basic science, social science, or bioethics Interactions with faculty to explain thinking, discuss Explain the mechanism for the medicine you just prescribed. What changes occur in the GI tract due to this condition? Explain how you did (or did not) consider cost effectiveness in choosing the test you ordered in this case, and why.

Faculty in Simulation Opportunity for a sim-focused teaching assignment – Willing to play different roles in sim arena – Recurring time schedule – Faculty development – Medical education scholarship opportunities Learning Society faculty also will have some involvement

Another Faculty Opportunity: Rotational Small Groups in the MCE MTuWThFSa AM Clinical activity: Nutrition GIL Rotational small group: Nutrition Clinical activity: Nutrition GIL PMGIL Team small group Large group (TBL or similar) Simulation or Workshop GIL

Rotational Small Groups in the MCE Students who are on a specific rotation will meet together once weekly in small group of 6-8 students Prepared to discuss the assigned C3 topic Example: Students in Newborn Nursery for 2 wks 1 st week: Normal newborn exam, jaundice, nutrition 2 nd week: Floppy infant, selected congenital issues Small group facilitated by a faculty with expertise

Rotational Small Groups in the MCE Faculty would likely take this on as a recurring teaching assignment – Two faculty trading off could generally do 2 wks of teaching, then 2 wks off throughout the 30 weeks of the MCE – Develop expertise in teaching this – Allows for faculty to work out trades for conference dates, conflicts, vacation, etc.