The Department of Anesthesiology Simulation Center services medical students, residents, fellows, advanced practice providers, nurses, and faculty. The UTSW Anesthesia Patient Safety Simulation team utilizes a state-of-the-art High Fidelity Simulation lab, trained confederates (actors), and seasoned simulation instructors to create a dynamic, interactive, and safe learning environment. Using a video-assisted debriefing model, our certified instructors enable the participant to self-reflect on their ability to navigate an emergent situation.

PATIENT SAFETY FOCUS

Our anesthesia simulation team is currently the driving force on the UTSW medical campus behind patient safety simulation.Since the initiation of our simulation lab, our simulation team’s focus has been on horizontal and vertical integration of simulation resources across the UTSW campus. We have sought to align the needs and resources of all groups currently conducting simulation at UTSW.

Being the leaders in team training on campus, with special certification in the AHRQ TeamSTEPPS® curriculum, we hope to empower the various departments conducting simulation with “Train the trainer” sessions on the AHRQ TeamSTEPPS® crisis resource management training. Currently, we conduct team training with the departments of medicine, obstetrics and gynecology, as well as the emergency medicine department.

Patient Safety Courses that we currently offer:

1. Perioperative consultant and patient safety course (ABA approved)

The Specific course objectives include:

• Communication: We will discuss strategies for promoting effective communication in group settings such as SBAR, call outs, check backs, and closed-loop communication

• Human Factors: Participants will appreciate the fundamentals of Human factors engineering and display an understanding of incorporating redundancies and checks and balances into systems. There will also be a focus on developing methods to standardize protocols

• Epidemiology of Errors: Participants will learn the background of the national patient safety movement, as well as a discussion on differences between latent and active failures

• Systems-Based Practices as they relate to Patient Safety: We will dissect the key components of the system-at-large, discuss each element’s role in the system, as well as discuss how a breakdown in one of these elements can affect patient safety

• Methods and Tools to Evaluate Safety Events: We will discuss risk assessment, root cause analysis, and failure modes and effects analysis.

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2. Central Venous Access and Complications Course

At the end of this course, the participant will be able to:

• Obtain central venous access in the Internal Jugular and Subclavian Venous locations

• Manage and Treat common central venous access related emergencies

• Demonstrate an algorithmic approach to the diagnosis of unstable hemodynamics

• Recognize and apply Crisis Resource Management principles in emergent settings

• Demonstrate proper sterile technique for central venous access placement

 

3. Sedation for the Non Anesthesiologist Course

At the end of this course, the participant will be able to:

• Understand the pharmacokinetics of fentanyl, midazolam, ketamine, and propofol

• Demonstrate basic airway management skills, including bag mask ventilation, LMA placement, and tracheal intubation

• Exhibit the ability to assess ventilation and oxygenation

• Display knowledge of ASA standards for Monitoring and Sedation outside the OR

 

4. AHRQ Team STEPPS Train the Trainer Course

At the end of this course, the participant will be able to:

• Demonstrate the necessary skills of an effective team approach to an emergent situation using CRM principles

• Utilize enhanced communication techniques to optimize team dynamics

• Implement brain-based learning strategies to facilitate alignment of a multi-disciplinary team to patient care

 

SIMULATION METHODOLOGY

Multi-disciplinary Approach to Simulation: We incorporate a multi-faceted approach to simulation designed to enhance patient safety in the peri-operative period. We aim to engage all types of adult learners—auditory, visual, kinesthetic, experiential--by including multi-media, high-fidelity and medium-fidelity simulation, didactics, and group dynamic problem-based learning discussions.

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• Realism: We take special measures to insure the “fidelity” or “realism” of the participant encounters in the simulation lab-- in everything from the yellow food coloring in the foley bag, to live on-demand media streaming projected on flat screens (TEE imaging, video laryngoscopy, etc.). We utilize live confederates with scripted roles, and on occasion, standardized patients to insure fidelity when needed

• Hybrid Model Simulation: We define ourselves as a team by the novel use of a hybrid model simulation, whereby we integrate medium fidelity task trainers into the high fidelity environment. This unique blending of simulation modalities allows us to develop a unique opportunity for episodic memory to develop

 

GRANTS & RESEARCH

• 2013 University of Texas Patient Safety Committee Grant. Critical Decisions: Improving Patient Safety and Healthcare Delivery Effectiveness through Serious Gaming Technology

• 2013 Application of Simulation in Large Group Settings Integrating Automated Response Systems (Dr. Bhoja)

• 2014 Biometric Validation of the AHRQ Team STEPPS Curriculum (Dr. Ambardekar)

MOCA CERTIFICATION
We are endorsed by the American Society of Anesthesiology (ASA) as a national simulation center that administers the Part IV Maintenance of Certification in Anesthesiology. The ASA has recognized the invaluable benefits behind simulation in medical education, and has now mandated simulation for re-credentialing of all board-certified anesthesiologists. 

UTSW Texas Clinical Safety and Effectiveness integration of the AHRQ TeamSTEPPS® Curriculum which is also integrated into the UTSW CS&E Course.

Dr. Bhoja sits on the UTSW Simulation Steering Committee. They have offered their vision and simulation experience to the committee on resource allocation and specifically, on Vertical Integration—the alignment and collaboration of needs and resources within the bodies of UME, GME, CME, and Quality, with a unifying vision for the future of simulation and immersive learning here on campus.