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Simulation Curriculum

At PPMC, internal medicine residents serve as primary leaders of the rapid response teams within the hospital, including for code blue, code stroke, and code sepsis. This requires residents to make real-time decisions in fast-moving and high-stakes clinical situations, and the simulation curriculum is designed to allow residents to hone their clinical reasoning and team leadership abilities in a safe and protected learning environment.

Intern Simulations
During orientation week, new interns participate in a half day of simulations to introduce them to the rapid response systems in the hospital. Using our high-fidelity manikins, with participation from nursing, pharmacy, and respiratory therapy, we assemble the full multidisciplinary teams to simulate patient scenarios and create robust and realistic learning experiences for residents. Special emphasis is placed on communication and team building for this fun and interactive session.

Longitudinal Simulation Curriculum
As part of the iBlock curriculum, residents participate in 3 half-day simulation workshops per academic year. Sessions are facilitated by our chief resident, along with faculty from the departments of hospital medicine, critical care, and neurology, and are organized around a central topic or condition, combining didactic information and hands-on simulation. Recent sessions have focused on the topics listed below:

  • Cardiac and respiratory arrest
  • Acute dyspnea
  • Unstable arrhythmias
  • Patient-directed discharges
  • Medical and psychiatric holds
  • Code stroke

Code Blue 'in situ' Simulations
Residents participate in monthly code blue simulations 'in situ' that take place on the nursing units as part of a hospital-wide interprofessional training initiative. These so-called 'mock codes' are announced overhead and proceed in identical fashion as a real code, except that the team is called to a room with a high-fidelity manikin experiencing a cardiac arrest, rather than a real patient. The full team assembles at the bedside and proceeds through a case scenario, which is followed by a short debrief. As team leaders, residents are primarily responsible for clinical decision-making, role assignment, and facilitate the debrief. Faculty physicians from the department of critical care and hospital medicine provide formative feedback to the team.