Pediatric Clinical Simulation At Clinical Simulation Center of Las Vegas Samrat U Das MD FAAP

1. Pediatric Clinical Simulation At Clinical Simulation Center of Las Vegas Samrat U Das MD FAAP Assistant Professor and Pediatric Hospitalist UNSOM Las Vegas

2. Pediatric Clinical Simulation Clinical Scenarios-1st Tuesdays and 3rd Wednesdays of each block 1.30- 3.30 pm Clinical Skills Lab – Ist Tuesdays of each block 3.30- 5pm Participants UMC Wards UMC PICU UMC NICU UMC Nursery

3. Goals and Objectives • Goals • Promote learning in a safe, controlled,non-clinical environment using state of the art equipment. • The pediatric simulation program enables the pediatric residents to acquire and demonstrate knowledge and skills relevant to pediatric practice.

4. Goals and Objectives • Objectives • Improve teamwork and build leadership skills • Improve communication skills • Develop and improve critical thinking skills • Improve patient assessment and bedside decision making • Enhance procedural skills • Teach medication administration safety

5. Clinical Skills Lab • Lumbar Puncture • Intubation • Chest Tube Placement • Central Venous Catheter Placement • Intravenous and Intraosseus Placement • Pelvic Examination • Laceration Repair • Urinary Bladder Catheterization • Nasogastric Tube Insertion • Bag-Valve Mask

6. Clinical Simulation Center of Las Vegas • The Clinical Simulation Center of Las Vegas (or CSCLV) is a 31,000 sqft facility that opened at the Shadow Lane Campus in August 2009 • Is shared among the University of Nevada - Las Vegas School of Nursing, Nevada State College School of Nursing, and University of Nevada School of Medicine. • The Health Sciences System (HSS) of the Nevada System of Higher Education (NSHE) is working to ensure Nevada has a highly trained health care workforce to meet the state's current and future needs.

7. Clinical Simulation Center of Las Vegas • The simulation center is equipped with mannequins that can simulate a variety of conditions, from wheezing to a heart murmur to cardiac arrest, enabling residents to learn how to react to the unexpected in a no-risk environment. • The mannequins can be programmed to present pathology on demand according to the curriculum.

8. Simulation • “ The technique of imitating the behaviour of some situation or process by means of suitably analogous situation or apparatus, especially for the purpose of study or personnel training.”

9. Benefits of Simulation • Risks to patients and learners are avoided • Undesired interference is reduced • Tasks/Scenarios can be created to demand • Skills can be practiced repeatedly • Training can be tailored to individuals • Retention and accuracy are increased • Transfer of training from classroom to real situation is enhanced • Standards against which to evaluate resident performance and diagnose educational needs are enhanced

10. Movements promoting modern medical simulation • Resuscitation Movement • Patient simulator • Medical education reform

11. Features of Modern Simulators • Complete human body • Capable of “speech” • Complete integrated physiology/pharmacology model( high fidelity) • Open/close mouth • Trismus • Realistic airway • Pharyngeal oedema • Respiratory chest movements

12. Features of Modern Simulators • Appropriate anatomical landmarks • Lungs capable of spontaneous, assisted or mechanical ventilation • Difficult airways • Synchronised breath sounds • Bowel sounds

13. Features of Modern Simulators • Monitoring • Pulses palpable • Synchronised with heart sounds • Blood pressure measurable • Variety of physiological outputs to standard monitors e.g CVP Temperature Pulse oximetry

14. Features of Modern Simulators • Procedures • Defibrillation • Pneumothorax decompression • Cardioversion • Venepuncture • Chest drain insertion • Cannulation • Intramuscular administration

15. The Curriculum • The curriculum is resident-centered. • Faculty and instructional methods show respect for the resident • The learning environment is designed to support resident needs • Residents are active and critical learners

16. The Curriculum • The curriculum comprises a context-framed educational plan • Case-based learning is used to stimulate learning and promote application of basic biomedical and clinical sciences. • Clinical presentations with simulated and real patients are used to stimulate learning • Curriculum flows from a list of basic clinical presentations that provide the foundation for exposure to clinical areas necessary for preparing the undifferentiated residents for all possibilities for post graduate training. • The coursework is integrated within years and across years of the program.

17. Curriculum • The curriculum is based on the following measurable competencies: • Professionalism • Interpersonal and Communication Skills • Medical Knowledge • Practice- Based Learning and Improvement • Patient Care • Systems-Based

18. Rules of Simulation • 1. Participate !!!! • 2. What happens in sim, stays in sim • 3. It’s OK to make mistakes • 4. Treat patient and scenario with respect • 5. Turn off cell phones • 6. Keep the room tidy

19. Thank You !!! • Questions ???

20. Clinical Simulation Center of Las Vegas Tour • http://csclv.nevada.edu/csclv/index.cfm