Increasing Internal Medicine Resident Comfort and Knowledge treating Emergent Cardiopulmonary Situations Using High Fidelity Simulation (1090-004375) (Research Abstract Professor Rounds: Group 2)
Start time: Thursday, January 28, 2021, 10:00 AM End time: Thursday, January 28, 2021, 11:00 AM Session Type: Research Abstracts (Completed Studies)
Simulation offers an opportunity to learn about crucial patient-care scenarios in a low-stakes learning environment. Treating patients with cardiopulmonary arrest is a challenging situation in many physicians’ careers. While teaching rounds allow for real-time learning for non-acute situations, simulation offers an opportunity to mimic emergency scenarios in an environment that allows for the freedom for residents to practice independently. Simulation has been used to mimic emergency scenarios for training purposes.1 We implemented a high-fidelity simulation scenario across a longitudinal curriculum in a moderate sized academic Internal Medicine training program. We hypothesize that high fidelity simulation can improve Internal Medicine resident knowledge and comfort treating emergent cardiopulmonary situations.
68 Internal Medicine and IM-Pediatrics residents from PGY1-PGY4, underwent small group scenarios utilizing high-fidelity simulation mannequins in acute, unstable patient scenarios. The training rooms used contained a high-fidelity simulation mannequin, telemetry monitor, “crash cart” with defibrillator/pacer and emergency medications. 5 scenarios were presented including: Unstable Bradycardia, Unstable Wide-Complex Tachycardia, Narrow Complex Tachycardia, Stable Wide-Complex Tachycardia, and Anaphylaxis Leading to Shock. Learners were given short patient scenarios, and then were to treat the simulated patient. A voluntary survey was conducted and responses were collected anonymously and in aggregate by non-study personnel. Surveys utilized a Likert scale with 5 denoting the positive anchor that the participants would strongly agree that simulation exercise increased the comfort for tachyarrythmia, bradyarrythmias, shock syndromes, and cardiopulmonary resuscitations.
Simulations were conducted longitudinally over the academic 2018-2020 year. 20 of 68 participants responded to the voluntary survey (29%). The simulations were halted due to social distance requirements secondary to the SARS-CoV-2 pandemic in 2020. Survey results indicate that resident learners felt that this was an effective learning tool. The great majority of learners indicated that their knowledge and comfort regarding code scenarios was increased after participation in the simulation. The majority of resident learners also reported that they felt comfortable treating both tachyarrhythmias and bradyarrhythmias. There was overwhelmingly positive attitude towards future simulation scenarios.
The survey results support our hypothesis that high fidelity simulation can improve Internal Medicine Resident knowledge and comfort in treating emergent cardiopulmonary situations. Learners had overwhelmingly positive responses to surveys after their simulation experiences. This suggests that high-fidelity simulation can be used effectively for post-graduate medical training and can be a very helpful teaching tool. High fidelity simulation of emergent patient simulations can allow learners to operate in a low stakes environment with the freedom to practice independently. Many times, resident exposure to cardiopulmonary emergencies is either in ACLS training sessions or in real life code scenarios. Using high-fidelity simulation allows resident learners to increase their comfort and knowledge outside of those high-pressure situations.