Detailed regulations in Department of Medical Simulation:
What are we going to do during the classes ?
We will run together high-fidelity medical simulation scenarios in pediatrics. So You are going to be the team member (always a physician, not a nurse) who is going to work on the Emergency Department / Medical Unit at the Childrens' Hospital. The students are going to act as the medical team members with the child with some severe complaints in a real time. After the scenario You are going to discuss the case with Your tutor. This is called 'debriefing' and it is constructed as the positive (not negative) emotional feedback. After the scenarios we will conclude our effords and look for future perspectives in Your medical education. During the classes we are going to run 3-4 scenarios with full debriefing.
What do You need for practical classes:
- read/repeat the knowledge in topics listed below
- wear an apron
- bring Your stethoscope
- change the schoes
- tie Your hair
Topics for practical classes in pediatrics – medical simulation:
- Asthma.
- Dysrhythmias in children (atrioventricular block, tachycardia, fainting, long QT)
- Fever, seizures, status epilepticus, sepsis.
- Congenital heart disorders (transposition of the great arteries, ventricular septal defect, atrial septal defect, Tetralogy of Fallot))
- Congenital metabolic disorders (congenital adrenal hyperplasia, congenital hypothyroidism).
- Cerebral edema
- Foreign body in digestive tract
Sample questions for the initial test before classes:
- List common causes of respiratory disorders in a child of preschool/school age.
- Describe the treatment regimen for exacerbation of bronchial asthma in children.
- Briefly describe the treatment of anaphylactic shock in children.
- List the tests needed to diagnose pneumonia in children.
- What are the most common arrhythmias in children?
- Diagnostics of fever and infections in infants and little children.
- List and describe meningeal symptoms in children.
- Briefly describe the treatment of sepsis in children.
- List the causes of a brief loss of consciousness in children.
- Describe the listed heart defect.
- Differential diagnosis of the listed water-electrolyte or acid-base imbalance (hyperkalaemia, acidosis).
- Treatment of bradycardia in children.
- List cyanotic heart defects / List heart defects without cyanosis.
- Initial diagnosis and treatment of cerebral oedema in a child.
- Proceedings in cases of a foreign body in the gastrointestinal tract in a small child.
- List the current screening tests for newborns in Poland or Your country.
Obligatory textbook:
Tom Lissauer and Will Carroll, Illustrated Textbook of Paediatrics, 6th Ed.
The presentations, lectures and knowledge from practical classes in all departments of pediatrics would be useful.
Non-technical skills:
You will need SBAR protocol for communication with Your consultant:
PARENTS protocol - for communication with parents:
Assessment of non-technical skills:
Scheme of the day:
1. Short test before the classes (see topics above)
2. Detailed regulations during high-fidelity medical simulation.
3. Simulators and medical equipment.
4. Medical scenario.
5. Debriefing, discussion, conclusions.
We are going to run three-four scenarios of high-fidelity medical simulation in pediatrics during the classes.
Novelties in this Year
- control lists will be available for students (in English), but remember about confidentiality rule
- summary of the conclusions from each scenario for students in written
- more focus on non-technical skills than procedures, doses and technical aspects
It is very difficult to assess soft skills objectively, therefore the scale should be treated as a kind of guidance, not rigid rules for passing classes.
The most important elements of soft skills - summary:
- stress management
- communication with team members, giving clear instructions
- using closed loop (team manager: “pass...”, team member: “I passed...”; etc.),
- listening to the team members
- professionalism towards the patient and accompanying persons (information about procedures, obtaining consent, respect, support, etc.)
- action summary ("we have a patient with ..., parameters: ..., results: ... we performed ... ... we delivered ... reaction ... etc.), getting a global perspective
- avoidance of fixation / attitude error (fixation error = persistent lack of verification or correction of the diagnosis or therapeutic plan in the face of clear evidence that such correction is necessary)
- using consultations, calling for necessary help
- professional patient reporting (e.g. over the phone: who is calling, from where, for which patient, what are the ailments, parameters, results, what have we done so far, what are we asking for, how urgent is required help, etc.)
- conducting complete documentation;
New - Infusion pump:
The ability to operate an infusion pump is not required for classes at ZSM.
To obtain a pass, we clearly inform about the administered dose of the medicine without dissolution and volume, saying, for example, units for an hour or mg / ug per minute or per hour.
As an example, however, I am posting the method of dissolving the medicine (for those interested):
1. 50 units of insulin (0.5ml) are dissolved in a syringe with 50 ml of 0.9% NaCl, we have a concentration of 1j/1ml, sample dose - 4 units per hour, this means setting 4 ml of solution / hour in the pump
2. 500 ug Prostin (1ml) are dissolved in a syringe 50 ml 0.9% NaCl, we get 10 ug / 1ml, the initial dose of the drug is 0.1 ug/kg/minute, for a weight of 3 kg, i.e. 0.3ug/min, i.e. 18 ug/hour -> proportion - 1.8 ml / hour. So the whole ampoule of Prostin is enough for 24 hours of infusion :) Of course, we change the doses depending on the effect up to a maximum of 0.4 ug / min / kg.
Technical aspects of simulation scenarios - read before the classess
Intoduction to the simulation room and high-fidelity pediatric simulator (remember to turn on the subtitles :))
General regulations and legal provisions for the final exam in Pediatrics