Mount Sinai St. Luke’s-West-ICAHN School of Medicine
New York, NY
Abstract Authors: Mirna Mohanraj, MD; Susannah Kurtz, MD; Joseph Mathew, MD; Andre Sotelo, MD; Keith Rose, MD and Hassan Khouli, MD
Program Director: Edwardine Mirna Mohanraj, MD
Type of Program: Pulmonary/Critical Care
BACKGROUND
Simulation-based medical education (SBME) can improve trainee competence in procedural skills, management of clinical scenarios, and team leadership. Scant resources exist to guide simulation curriculum design. We describe the development of an innovative longitudinal SBME curriculum for pulmonary and critical care fellows.
METHODS
The SBME curriculum was developed at the Center for Advanced Medical Simulation (CAMS) at Mount Sinai St. Luke’s-West (MSSLW) and includes four components. The first component is an ‘accelerated skills’ course, conducted since 2014 for first-year fellows across three fellowship programs in the Mount Sinai Health System. Multisite faculty lead fellows through task-training sessions in airway management, pleural procedures, and bronchoscopy. Additional components were subsequently implemented for fellows at the MSSLW site. The second component provides periodic training in procedures including advanced airway management, pleural procedures, medical code team training, and EBUS. Sessions are based on self-identified and faculty-identified fellow needs. The third component consists of rotating, biannual simulation of clinical scenarios. Several competencies are evaluated (medical knowledge, evidence-based decision-making, emergency resuscitation, communication, leadership) via advanced cases in pulmonary (ie poorly-controlled asthmatic) and critical care (ie postpartum pulmonary embolism). The fourth component is an innovative 6-month ‘mini-simulation fellowship’ offered to senior fellows with career aspirations as simulation-focused clinician educators. Fellows develop mastery level skills in several areas: design and programming of high-fidelity simulations; facilitation and debriefing of learners; simulation to reduce errors and improve patient outcomes. Fellows participate in group and independent simulation research activities. Fellows receive real-time debriefing and objective feedback via performance checklists and evaluator assessments. Mini-simulation fellows receive continuous feedback from mentoring faculty and present their research at academic meetings.
RESULTS
34 fellows have participated in the ‘accelerated skills’ course. Recent course evaluations were overwhelmingly positive with 100% of trainees agreeing that it would influence practice and should be repeated annually. All participants requested further advanced skills courses. Multisite participation leveraged faculty expertise and promoted camaraderie. At MSSLW, 9 fellows per year participate in periodic procedural training and biannual clinical scenarios. Our first fellow is currently enrolled in a 6-month ‘mini-simulation fellowship’. We plan to objectively demonstrate the value of these curricular components and implement a 4th-year clinician educator track.
DISCUSSION
This SBME curriculum provides an innovative approach to meet educational objectives in a constructive environment. We expect that future measures will demonstrate tangible improvements in fellowship education and patient outcomes. Selected fellows will graduate with unique career development opportunities as clinician educators.
