An emphasis on competence-based advancements have shifted a significant portion of surgical training from the operating room to the simulated laboratory. Under the former training model, Residents who previously learned skills in the OR or skills lab under faculty supervision were assumed to be competent after completion of a pre-determined number of cases. Rather than using metrics such as time or repetition as proxies, the most widely used assessment today has become the Objective Structure Assessment of Technical Skills (OSATS). Practice in a simulated environment using an OSATS-based expert assessment and a time/error score self assessment has been developed which show discriminative validity between novice, junior resident, senior resident and expert surgeons.
Proficient physical assessment skills are critical to providers working in the battlefield, pre-hospital environment, primary care clinic, Emergency Department, operating room, and throughout the evacuation chain. Physicians and non-physicians require these skills, including medics, paramedics, nurses, nurse practitioners, physician assistants, and others. With the new restriction on hours, greatly expanded fields of knowledge and decreasing exposure to hospitalized patients, schools of medicine and allied health often fail to provide opportunities for providers to practice and develop these critical skills during their training and certainly less opportunities their formal training has ended. The purpose of this pilot program is to develop curriculum around cardiac and respiratory exams that will focus on military and civilian medical and allied health specialties including pre-deployment healthcare workers.
The UW Patient Safety and Quality Committee has encouraged UW Medicine hospitals to engage in simulation-based training at the “point of care” (in situ training). This method lessens the gap between practice and reality, provides increased authenticity of scenario-based training, as well as allows the hospitals and service areas to evaluate their practice-based systems.
Complications due to Central Venous Catheter (CVC) placement cost UWMC hundreds of thousands each year. In addition, these costs are no longer coveredby Medicare. UWMC has developed and instituted CVC training and certification for all providers placing CVCs within the UWMC system. Certification and training at WISH employs industry leading simulated tissue for maximum fidelity.
The most common prelude to most obstetric emergencies is fetal intolerance of labor typically demonstrated by changes in the fetal heart rate. For a newly starting OB/GYN resident, this can be among the most stressful early experiences on the labor and delivery ward (L&D).
Proper interpretation and management of the fetal heart rate tracing (FHT) is a critical skill that is traditionally acquired through exposure to static images of FHTs and hands-on clinical experience on L&D. High fidelity trainers allow for the simulation of Intrapartum fetal heart rate patterns of multiple etiologies. This curriculum will uniformly educate obstetric providers in the evaluation and management of Intrapartum fetal heart rate patterns in a realistic fashion and setting.
This training program has been designed as an advanced curriculum for healthcare workers focusing on laparoscopic and endoscopic during times of reintegration following extended absences such as military deployment or upon return from extended leaves of absence. The curriculum project is unique in that it addresses the specific needs for re-acquisition of skills rather that initial learning and retraining for laparo-endoscopic skills, which are found to be substantially different for a fully trained physician than for the novice trainee.
Percutaneous catheter placement procedures - suprapubic bladder catheter placement, thoracentesis, paracentesis, epidural placement, and central venous line placement - are widely utilized for the care of pediatric and adult patients. Medical errors in the placement of these catheters contribute to significant patient morbidity. The placement of suprapubic catheter (PSC) is an important tool in managing battlefield trauma with perineal or pelvic injuries with disruption of the urethra. Project trainees typically perform the placement of percutaneous catheters after a discussion with the attending, perhaps little oversight. Thus we seek to create and validate a curriculum for the standardization of PSC placement for military and civilian health professionals.