beth israel deaconess medical center a harvard medical school teaching hospital

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Medicine Simulations

Residents assess a mannequin patient in the ICU

Code Team Leadership Training

The Shapiro Simulation and Skills center utilizes state of the art, high fidelity mannequins to provide cardiac arrest training to our medical residents. These sessions are multi-disciplinary, meaning the resident will be running each code session with real members from our medical facility. This unique approach allows the medical resident to challenge not only his or her knowledge base, but to also focus on team training and resource management skills as well. The use of our high fidelity mannequins is essential in performing code team training scenarios. The ability to realistically recreate patient conditions allows us to immerse the learner in the situation, thus recreating the feel of a real cardiac arrest situation. The simulated patient room, or intensive care unit, is outfitted with all of the same monitoring equipment and medical devices used throughout our medical center.

Central Line Training

Lifelike partial task trainers provided in the simulation and skills center at BIDMC are utilized to train the medicine residents in proper technique used in central venous catheter insertion. A didactic session is followed by a hands on one on one session with an experienced instructor. Training is focused on proper sterile technique, anatomical landmark identification, and proper insertion technique. Ultrasound use in central venous line insertion is also covered during each session.

Triggers

When patients outside of the ICU acutely decompensate, they also comprise a particularly vulnerable population. If they need ICU admission, they have exceptionally high mortality rates compared to patients admitted from the emergency department, surgery, or the recovery room. More importantly, ward patients who deteriorate to critical illness typically have a period of several hours of clinically obvious physiologic instability before their catastrophic decompensation. Failure to act on these signs of decompensation can result in suboptimal care and delays in ICU transfer that are associated with marked increases in mortality rates.

The triggers simulation is designed to place the learner in situations in which specific changes in a patient’s condition requires them to evaluate and treat the change(s). By diagnosing and treating these changes in a rapid and accurate manner the patients condition will return to a nominal state, thus preventing undesired outcomes. Simulating trigger situations enables the learner to perform the above tasks in a safe, non-judgemental learning environment. Peer review and one to one instruction by an attending physician are commonly employed to improve the learner’s knowledge and performance. It is hoped that by using simulation to introduce the learner to situations they may commonly see on the wards will, their ability to rapidly diagnose and treat these situations will improve, thus improving patient outcomes.

The use of our high fidelity mannequin is essential in performing the trigger scenarios. The ability to realistically recreate patient conditions allows us to immerse the learner in every situation. This level of realism is key to improving the learner’s knowledge base. We also employ the use of the same equipment and materials that the learner will use on the wards, including the same style code cart and defibrillator. Furthermore, the use of a professional, highly experienced nursing staff during triggers training sessions carries the realism of the situation to an unparalleld level.