Table of Contents

ANESTHESIA
EMERGENCY MEDICINE
INTERNAL MEDICINE
MEDICAL STUDENT TRAINING
NURSING
OBSTETRICS AND GYNECOLOGY
OPHTHALMOLOGY
PHYSICIAN ASSISTANT TRAINING
SURGERY
UROLOGY
INTERDISCIPLINARY OFFERINGS

ANESTHESIOLOGY

Advanced Cardiac Life Support (ACLS) for Anesthesia
This course aims at providing the learner with the knowledge and skills needed to evaluate and manage the first 10 minutes of an adult ventricular fibrillation/ventricular tachycardia (VF/VT) arrest. Providers are expected to learn to manage 10 core ACLS cases: a respiratory emergency, four types of cardiac arrest (simple VF/VT, complex VF/VT, PEA and asystole), four types of prearrest emergencies (bradychardia, stable tachycardia, unstable tachycardia and acute coronary syndromes) and stroke. The course may be taken in a formal class room setting or done at a computer station. Utilizes ACLS simulator.
Learners: Practicing physicians, residents, students, nurses
Didactic: Yes
Laboratory: No
Simulator: Low fidelity

Anaphylaxis
This course teaches Anesthesiology residents the appropriate management of an anaphylactic drug response. The patient first reacts with a bronchospasm followed by profound hypotension and an elevated pulse. Following treatment of the anaphylaxis, the residents must correctly identify and treat a tension pneumothorax that ultimately causes the patient’s condition to deteriorate once again.
Learners: Anesthesia Residents
Didactic: Yes
Laboratory: Yes
Simulator: High fidelity

Basics of Airway Management
This course teaches the basic principles of airway management. Students first attend a lecture, followed by hands on training on airway simulators. Students will learn about the anatomy of the airway, proper management before, during and after surgical procedures and emergency management. A number of different airway courses are offered and include courses for Anesthesiology residents, Family Medicine residents, Surgery residents, Otolaryngology residents and medical students.
Learners: Residents, medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Difficult Airway Management
This course teaches the principles of airway management on a patient with a difficult airway. The steps involved are assessing and recognizing a potential difficult airway, selecting the proper equipment and then performing the intubation on the patient. Separate courses with the same course content are offered for anesthesiology residents, family practice residents, surgery residents, otolaryngology residents, and medical students.
Learners: Residents, medical students
Didactic: Yes
Laboratory: Yes
Simulator: High fidelity

O2 Line Failure
This course teaches emergency patient management skills in a scenario where an oxygen line fails during a procedure. The course is designed for Anesthesiology residents.
Learners: Anesthesia Residents
Didactic: Yes
Laboratory: Yes
Simulator: High fidelity

Anesthesia Machine Failure
This course teaches emergency patient management skills in a scenario where a power outage occurs and the anesthesia machine fails to work. The course is designed for Anesthesiology residents.
Learners: Anesthesia Residents
Didactic: Yes
Laboratory: Yes
Simulator: High fidelity

Intra-Op Courses
These situational courses familiarize the learners with the correct way to handle complications during an operation. The courses include Intra-Op Bronchiospasms, MI, Embolisms and hypotension.
Learners: Anesthesia Residents
Didactic: Yes
Laboratory: Yes
Simulator: High fidelity

Conscious Sedation
This course is taught two to four times per year and is for nurses. This review class covers a number of important scenarios and emphasizes teamwork and communication skills.
Learners: Nurses
Didactic: Yes
Laboratory: Yes
Simulators: High fidelity

Fiber Optic Dexterity
This course teaches Anesthesia residents appropriate methods for using a fiberoptic scope. The course utilizes an airway simulator that is internally comprised of a series of branching passageways and pictures that can be reconfigured however the instructor sees fit. The residents are taught how to manipulate the scope and navigate the simulated airway passages while maintaining the appropriate orientation and correctly identifying the images.
Learners: Anesthesia Residents
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity

Medical Error Disclosure
This course is designed for fourth year Anesthesia residents and ties in directly with another Anesthesia course. After assisting either R2s or R3s with one of a small subset of Anesthesia simulations, the R4 will be given a script detailing that it had been a specific error on their part that caused the complication that was managed in the preceding simulation. The R4 must then go in and disclose their error to an actor who is playing the role of a close family member of the patient.
Learners: Anesthesia Residents
Didactic: Yes
Laboratory: No
Simulator: Actor simulating family member

Obstetric Bleeding
This course teaches how to manage a bleeding emergency in labor and delivery. Opening with a spinal anesthetic for the woman in labor, this scenario proceeds to a management of uterine atony and acute post-partum hemorrhaging. Focus is given to administration of appropriate drugs, management of hypotension, identification of bleeding emergency and, ultimately, the necessity of a hysterectomy. This course is designed specifically for Anesthesia residents.
Learners: Anesthesia Residents
Didactic: Yes
Laboratory: Yes
Simulator: High fidelity

Venous Air Embolism
This course is designed to teach proficiency with complex and invasive monitor systems, recognition of a venous air embolism as well as appropriate management and leadership of the OR team during its treatment. Anesthesia residents will take over a case where the patient is already anesthetized, surgery is already underway, and then recognize and respond appropriately to the clinical presentation of the embolism.
Learners: Anesthesia Residents
Didactic: Yes
Laboratory: Yes
Simulator: High fidelity

Basics of Interventional Ultrasound
This course teaches basic ultrasound principles with a specific focus on identification of different forms in a tissue block and accurate needle placement. An introductory lecture is given and followed by a practical session with a simulated block of tissue that has a number of foreign bodies of different shapes and material compositions. One of the foreign bodies uses a novel method of determining accurate 3D placement of a needle in the tissue block for interventional training. This course was designed to train Anesthesia residents and will be extended to other specialties (e.g. Surgery, Ob/Gyn, etc.) in the future.
Learners: Residents
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Malignant Hyperthermia
This course teaches identification and management of MH. Anesthesia residents must accurately diagnose the problem and perform steps unique to resolving a case of MH as well as appropriate management and leadership of the OR team during its treatment. This course is designed for Anesthesia residents.
Learners: Anesthesia Residents
Didactic: Yes
Laboratory: Yes
Simulator: High fidelity

EMERGENCY MEDICINE

Emergency Medicine Procedures & Resuscitation
These courses teach the basics for performing a lumbar puncture and managing a few different ACLS situations, including PEA, bradycardia, asystole and ventricular fibrillation. An instructional lecture is given prior to any of the practical portions and ACLS reference handouts are given to aid the ACLS scenarios that are run in the virtual OR. This course has been used to teach both medical students and Emergency Medicine residents.
Learners: Residents, medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

INTERNAL MEDICINE

Airway Skills
This course teaches the basics of performing intubations and cricothyrotomies. The class starts with a short overview of the procedures including an introduction to the anatomy, tools used and technique, followed by hands on training. Intubation and cricothyrotomy mannequin simulators are used to provide lifelike anatomy and feel.
Learners: Residents, medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Lumbar Puncture
This course teaches the basic principles and techniques behind a lumbar puncture. Learners attend a lecture, review situations in which a lumbar puncture is performed and then perform a lumbar puncture on a mannequin.
Learners: Residents, medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Thoracentesis
This course teaches the basic principles and techniques behind thoracentesis. Students attend a lecture, review situations in which a thoracentesis is performed and then perform the skill on a mannequin.
Learners: Residents, medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

MEDICAL STUDENT TRAINING

Anesthesia Medical Student Skills Training
This course is designed to teach basic airway principles and give an introduction to managing both a general anesthetic and code situation. Students begin the day with a lecture followed by instruction in airway management and an introduction to the operating room equipment and anesthesia machine. The students move into the OR where they are guided through a general anesthetic on a human patient simulator and then allowed to go through it again on their own. The final simulated anesthetic will also include a code situation that will have to be managed appropriately.
Learners: Medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Basic OB/GYN Skills
This course is designed for medical students beginning their OB/GYN clerkship. The class introduces them to instrumentation, anatomy, terminology and basic techniques and procedures including pelvic exam, standard vaginal delivery, and episiotomy.
Learners: Medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Capstone 1
ISIS provides procedural training in a variety of specialties for 2nd year medical students as part of the year-end practicum. Each grouping reviews essential skills learned throughout medical school training as they make their transition to wards.
Learners: Medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Capstone 2
Much like Capstone 1, ISIS provides procedural training in a variety of specialties for 4th year medical students as part of the year-end practicum. Students review essential skills learned throughout medical school and clinic based training as they make their transition to residency.
Learners: Medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Suturing and Wound Management for Medical Students
This course teaches the essential elements of suturing. The student will learn a variety of suturing techniques and practice on a variety of artificial tissues that provide realistic texture and suture support.
Learners: Medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

SVT to VFib Simulation
This course provides instruction on how to manage unstable SVT and Ventricular Fibrillation events. Geared towards team training, a number of different groups have trained with this course, but it was initially designed as a review for medical students at the conclusion of their 4th year.
Learners: Medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

NURSING

Obstetrical Bleeding & Neonatal Resuscitation for Nursing
These courses separately teach team communication in management of an OB bleeding emergency, and appropriate techniques for neonatal resuscitation. The bleeding emergency takes place in the real ORs in labor and delivery where a large group of OR nurses are given different roles and focus on teamwork, communication, and following appropriate hospital pathways as they resolve the emergency. The neonatal resuscitation utilizes a mannequin that turns blue with hypoxia and will only revert once appropriate techniques are used.
Learners: Nurses
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

OBSTETRICS AND GYNECOLOGY

OB/GYN Dry Lab
This course is comprised of a number of procedural and skills based stations. Simulators are set up for practicing episiotomy repair, hysteroscopy, and urethral sling procedures. Additionally, laparoscopic workstations are set up that allow for practice on a wide variety of general surgical skills. This course is designed for OB/GYN residents.
Learners: Residents
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Hysteroscopy
This course is designed for OB/GYN residents and shows the proper use of a hysteroscope during a hysteroscopy. The class runs for four hours and is attended by residents in all four years of training.
Learners: Residents
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Shoulder Dystocia
This course demonstrates the proper way to deal with shoulder dystocia during delivery. The class is attended by residents in all four years of training.
Learners: Residents
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

OPHTHALMOLOGY

Microsuturing Skills
This course teaches Ophthalmology residents skills and principles specific to microsuturing. Using a microscope the residents get to spend one-on-one time with the instructor to develop their skills.
Learners: Residents
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

PEDIATRICS

NRP Certification
This course provides instruction and (re)certification for Neonatal Resuscitation Program providers in the Northwest. Detailed instruction sessions are alternated with simulations that use a newborn mannequin and focus on both the resuscitation procedures and the equipment involved. This course is designed for NRP providers from all throughout the community.
Learners: All NRP providers
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Neonatal Mock Resuscitation
This course provides instruction in the management of neonatal respiration and resuscitation. Designed for pediatric residents, the course provides detailed instruction sessions, alternated with simulations that use a newborn manikin and focus on both the resuscitation procedures and the equipment involved.
Learners: Residents
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

PHYSICIAN ASSISTANT TRAINING

PA MEDEX Suture & Procedures Workshop
This course is for teaching the MEDEX Northwest division of Physician Assistant Studies students a variety of different suturing skills. They practice their suturing on foam tissue pads that were specifically designed to meet the needs of this course.
Learners: PA students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity

SURGERY

CVES Courses
The CVES (Center for Videoendoscopic Surgery) lab trains residents in a number of laparoscopic and endoscopic procedures. The classes offered cover a variety of surgeries including laparoscopic chole procedures and Hernia repair. Courses in electrosurgery safety and wound closure are also offered. The CVES is a valuable resource available to ISIS under the leadership of Dr. Brant Oelschlager.
Learners: Residents, medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Electrosurgery Safety for Residents
This course teaches the basic physics principles for practical safety in OR electrocautery and other operating equipment. This educational offering is designed for the physician practicing surgical and invasive procedures. This will address the art and science surrounding electrosurgical technology and techniques and include the principles of electrosurgery, clinical applications, potential complications and recommendations for their avoidance will be discussed. Upon completion of this workshop, participants will be able to, relate the properties of electricity to the clinical applications of electrosurgery; Discuss the relationship between current concentration and tissue effect; Differentiate between the clinical effects created by the cutting and coagulation waveforms; Describe four of the variables the surgeon controls that impact surgical effect; Identify potential patient injuries related to electrosurgery and technological advances designed to eliminate these problems. The resident must complete the web-based Electrosurgery Skills Module and Test at
Electrosurgery module
Trainees should then submit a Valleylab certificate of completion.
Learners: Residents
Didactic: Yes
Laboratory: Yes
Simulator: Animal lab

Fundamentals of Laparoscopic Surgery
Using the laparoscopic trainers mentioned above, learners do a wide variety of exercises ranging from using the mirror trainers, which help the user with spatial recognition, instrument dexterity and improved motor control, to advanced computer simulators which simulate surgical procedures.
Learners: Residents, medical students
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Laparoscopic Cholecystecotomy
This course covers work-up and indications for cholecystectomy, surgical anatomy, routine versus selective cholangioraphy (interpretation), risk areas and pitfalls, recovery and long term outcome, and troubleshooting.
Learners: Residents
Didactic: Yes
Laboratory: Yes
Simulator: Animal lab

Suturing and Wound Management for Surgery Residents
This course teaches the essential elements of surgical suturing. The student will learn a variety of suturing techniques and practice on a variety of artificial tissues that provide realistic texture and suture support.
Learners: Residents
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity

Web-based Knot-Tying Curriculum

Wound Vacuum Principles
This course, designed for R1s, teaches the principles of wound management with vacuum technology. y the end of the course the residents should understand the proper techniques and situations in which to use VAC therapy. He or she should be able to demonstrate proficiency in an animal model using the actual device on simulated wounds.
Learners: Residents
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, animal lab

UROLOGY

MIMIC DaVinci Simulation
Designed for resident, fellows and attendings, this course provides training on the virtual reality MIMIC DaVinci robot simulator with haptic feedback.
Learners: Residents, fellows, attendings
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Suprapubic Catheter Placement
This course covers all of the steps involved in the insertion of a suprapubic catheter. Urological residents fill out pre- and post-tests around a lecture, as well as running through the placement of a suprapubic tube on a simulator that inserts into the lower abdomen of a full patient simulator.
Learners: Residents
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

INTERDISCIPLINARY OFFERINGS

Central Venous Catheter Placement
This course teaches the basic principles and techniques for placing a central venous line into a patient. Students first complete an E-Learning cognitive training module and training with a mannequin before attending the certification testing session. At each skills session, learners review situations in which a central line would be used, are instructed in ultrasound use and finally, practice central line placement using the Simulab’s Central LineMan™. UWMC has mandated CVC certification for all incoming residents placing lines in the hospital by 2010.
Learners: Residents, Nurses, eventually anyone who will be placing central lines
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Code Blue
Medical Emergency Response Teams will be taught principles in interdisciplinary team communication and function in simulated full scale patient emergency scenarios.
Learners: Residents, Nurses, Emergency Response Team participants
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity

Team Training
This course teaches the principles of crew resource management during a critical event in any medical setting. The class focuses on the development of communication skills, the prioritization of tasks, leadership skills and task assignments during the critical event. The class is taught with at least two, but preferably more, disciplines present so as to create a more realistic interaction environment. All are done in the Virtual Operating Room using the SimMan and/or the METI HPS.
Learners: Residents, Nurses, Anestesiologists, Surgeons, medical students, others
Didactic: Yes
Laboratory: Yes
Simulator: Low fidelity, high fidelity