Education, Teaching, and Quality Improvement |

A Unique Hybrid Simulation Used to Train General Surgery Residents in the Cognitive and Procedural Aspects of Emergency Department Thoracotomy FREE TO VIEW

William Watson; Michael Macko; Brian Zeno, MD; Angie Wade; Jennifer Moreland; Jason Zigmont
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OhioHealth, Columbus, OH

Chest. 2014;146(4_MeetingAbstracts):488A. doi:10.1378/chest.1982812
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SESSION TITLE: Education and Teaching in Critical Care Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Emergency department thoracotomy (EDT) is a rare occurrence and training general surgery residents in this procedure is challenging.1,2,3,4,5 Presented here is a program designed to teach residents the cognitive as well as the technical aspects of EDT. A hybrid simulation was developed and implemented to train residents to (1) recognize the indications for an EDT—the cognitive aspect—and (2) train them in the trauma environment to conduct the EDT procedure—the technical aspect.

METHODS: This simulation-based education program was divided into two scenarios: Scenario #1 utilized a high-fidelity patient simulator to represent a patient with an epigastric gunshot wound. The resident was required to make a cognitive decision about whether or not to proceed with an EDT based on the patient’s clinical situation. Scenario #2 shifted to an actual trauma bay in the emergency department (ED) where a cadaver simulated the same patient. Here, the resident in charge performed the technical aspects of EDT. Participants completed an evaluation. Their educational satisfaction was measured and analysis of open-ended comments conducted.

RESULTS: Sixteen residents participated in this educational program. A senior resident functioned as the team lead and a trauma surgeon functioned as a preceptor. Over 90% of resident participants agreed that this program enabled them to (a) better recognize the indications for an EDT and respond appropriately, and (b) utilize system assets to manage an EDT. Open-ended comments showed a preference for a fresh cadaver and residents agreed the simulation met their educational needs.

CONCLUSIONS: Using a hybrid simulation, general surgery residents were trained in cognitive and technical aspects of EDT. Scenario #1 afforded residents the opportunity to assess the clinical situation in order to make cognitive decisions. Scenario #2 enabled residents to learn the technical aspects of EDT.

CLINICAL IMPLICATIONS: All general surgery residents were able to participate, ensuring each individual was exposed to the EDT procedure during resident training.

DISCLOSURE: The following authors have nothing to disclose: William Watson, Michael Macko, Brian Zeno, Angie Wade, Jennifer Moreland, Jason Zigmont

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