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Education, Research, and Quality Improvement |

Impact of Critical Care Procedure Simulation Training for Third Year Medical Students as Part of the Internal Medicine Clerkship

Andres Yepes-Hurtado*, MD; Kenneth Nugent, MD; Cynthia Jumper, MD; Raed Alalawi, MD
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Texas Tech University HSC, Lubbock, TX


Chest. 2012;142(4_MeetingAbstracts):534A. doi:10.1378/chest.1389244
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Abstract

SESSION TYPE: Teaching of Procedures

PRESENTED ON: Tuesday, October 23, 2012 at 04:30 PM - 05:45 PM

PURPOSE: Medical students need to be familiar with common procedures during their clerkships. This needs to be accomplished using safe and effective methods. In this abstract we report our findings from using a simulation-based training curriculum developed to enhance the students' experience performing critical care procedures during their internal medicine clerkship.

METHODS: The course covered four procedures namely endotracheal intubation (ETI), central line placement, chest tube placement, and lumbar puncture. The curriculum was broken down to a pre-training knowledge base, "hands on" practice, and a post practice test. Pre-training the participants reviewed videos and literature regarding the performance of procedures. The "hands on" practice was 1 hour per procedure with the students divided into small groups. The students were then evaluated by direct observation as well as a questionnaire assessing the learning experience.

RESULTS: We found a significant difference between Pre and Post intervention in the skills of: landmark identification for subclavian (SC) access 16.7% - 84%, landmark identification for internal jugular (IJ) access 20% - 76.9% , ultrasound blood vessel identification 36.7% - 96% the need for pre- oxygenation prior to an ETI 72% - 92%, anatomical identification of the landmarks for an ETI 43% - 100%, Increase familiarity with the use of alternative airway devices like the laryngeal mask airway 16.7% - 100%, use of AMBU bag as first ventilatory resource 20% - 76% tension pneumothorax decompression strategies 11% - 76%, and identification of the landmarks for a CT insertion 0- 100%. The course was positively evaluated by MSIII as an educational tool when used alongside traditional training. It also provided an alternative way for the MSIII to be actively involved and to retain knowledge while simulating "hands on" experiences.

CONCLUSIONS: A simulation based curriculum is an effective and efficient way to familiarize medical students with critical care procedures. This also provides for a more "hands on" internal medicine clerkship in a controlled environment.

CLINICAL IMPLICATIONS: Simulation provides a safe environment to teach medical students procedures before carrying over the experience to the bedside.

DISCLOSURE: The following authors have nothing to disclose: Andres Yepes-Hurtado, Kenneth Nugent, Cynthia Jumper, Raed Alalawi

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Texas Tech University HSC, Lubbock, TX

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