As a core educational facility for the VCU School of Medicine and the VCU Health System, the Center conducts a diverse range of courses for medical students, residents, nursing staff, fellows, attending physicians and other healthcare providers.
We work with faculty to develop and implement courses, and provide consultation with curriculum planning, scenario design, assessment, and rater training.
Apart from meeting the curricular objectives of our core constituencies, the Center staff's is committed to leveraging the value of simulation to promote effective teamwork and to strengthen quality improvement processes in the VCU Health System.
Procedural skills courses are opportunities for mastery learning of procedures required in a provider's scope of practice. Custom courses can also be created.
Central Line Insertion
Half day course covering safe practices for central line insertion, evidence for reducing catheter associated blood stream infections, and supervised practice inserting central lines with and without ultrasound guidance.
Fundamentals of Laparoscopic Surgery
We are a testing site for SAGES FLS certification. Faculty conduct sessions addressing cognitive content from the curriculum and supervised practice to proficiency in core technical tasks necessary for performance of abdominal minimally invasive surgery.
Gynecologic Surgical Skills
Weekly sessions for supervised instruction in basic surgical procedures in gynecology - covers laparoscopic skills with special focus on the constraints of pelvic geography, abdominal and vaginal hysterectomy, hysteroscopy, robotic surgery, and perineal repair.
Two hour courses focusing on indications for and safe performance of lumbar puncture, with supervised technical instruction.
Two hour courses offered approximately monthly for technical training in the use of advanced airway devices including indications for use, techniques for insertion, and management of patients requiring airway devices.
Two hour courses focusing on technical aspects of bronchoscopy performance.
Sessions throughout the academic year to address mastery of skills related to surgical and procedural performance. Includes Hand Sewn Anastomosis, Stapled Anastomosis, Microsurgical Techniques, Endovascular Surgery, Laparoscopic and Robotic Skills, Surgical Biopsy, Endoscopy, Thoracentesis, Chest Tube Insertion, Wound Care and Skin Flaps.
Foley Catheter Insertion, IV insertion, IM injection, Phlebotomy
One hour courses offered multiple sessions at the beginning of the academic year for medical students beginning their clinical rotations.
These courses address the acquisition or application of specific knowledge in the management of patients in the clinical setting.
Practice of Clinical Medicine
Core curriculum for preclinical medical students. A series of 16workshops with Center Standardized Patients addressing complete and targeted medical history taking and systems based clinical examination. Focuses on competencies of empathetic communication and diagnostic accuracy.
Scientific Foundations of Medicine
Case based series using Standardized Patients focused on discussions of disease processes, management, and prognosis with patients and family and drawing on basic science underpinnings of disease.
Code Training for Internal Medicine Residents
Eight week TBL course held annually at the beginning of the academic year for Internal Medicine R2's addressing the application of the ACLS guidelines to multiple specific patient situations likely to be encountered in a medicine inpatient service. Focuses on ACLS guidelines and team skills.
Neonatal Resuscitation Program
Four hour course resulting in AAP NRP certification. Course addresses scientific principles underlying neonatal physiology and resuscitation, and multiple opportunities for practice and reflection in a variety of potential delivery room scenarios in which resuscitation of the newborn is required - from simple bag valve mask ventilation to full code.
Neonatal Resuscitation Code
Monthly one hour sessions for Pediatrics residents rotating through the Neonatal ICU addressing airway management and cardiopulmonary resuscitation for newborns.
NRP Instructor Course
Eight hour course offered approximately annually for training NRP Certified providers to become instructors.
Emergency Medicine Skills
Three hour bi monthly sessions for residents in resuscitation, ultrasonography, chest tube insertion, and management of other emergency cases.
Two hour sessions for residents to manage stroke and seizure.
Offered in collaboration with the VCU Ceneter for Trauma and Critical Care Education.
Offered in collaboration with the VCU Center for Trauma and Critical Care Education.
Intern Orientation - Walk the Walk
Collaboration with the VCU Office of Graduate Medical Education. The simulation portion of the orientation introduces incoming interns to teamwork and safety culture at the VCU Medical Center, and addresses universal competencies required at PGY-1 for interns of all specialties - consultation, informed consent, escalation and handoffs. Conducted annually at the beginning of the academic year.
Integrated Critical Care Selective
Interprofessional course for students in the Schools of Nursing and Medicine. Four two-hour modules over the four week course addressing primary and secondary surveys of critically ill patients, respiratory failure, cardiopulmonary resuscitation and "putting it all together".
Two hour course for students and residents in Emergency Medicine focused on the identification and acute management of toxic exposures including chemical ingestion and environmental exposure.
One hour sessions for preclinical medical students addressing the application of pharmacology principles in the management of patients in acute care settings. Multiple sessions during the academic year addressing adrenergic and cholinergic pharmacology and behavioral medicine.
One hour session for preclinical medical students addressing the evaluation and management of patients with cardiac complaints, offered during the cardiopulmonary/renal module of the MS-2 curriculum.
Welcome to M-1 - Begin the Walk
One hour sessions during the orientation for incoming medical students. Scenarios are designed to introduce students to teamwork in the healthcare setting and use medically simple situations to illustrate the role of situation monitoring, supporting behavior, communication and leadership/follwership in successful clinical management.
Three to four hour sessions for M-4 students on Anesthesiology Rotation and M3 Clerkship. Skills are focused on both basic and difficult airway insertion as well as IV insertion and how to operate an anesthesia machine. Scenarios are designed to provide a simulated intraoperative experience on anesthetic induction and management of deteriorating patients under anesthesia.
M4 Elective for students matching in surgical specialties. One month course including suturing, knot tying and laparoscopic technical skills training, recognition and management of perioperative complications, teamwork in the operating room, and ethical considerations in the practice of surgery.
M3 Pediatric Clerkship: Two hour sessions on diagnosis and management of respiratory distress using a 5year old simulator as the patient; plus two hour skills sessions (HELP) include using the heart, ear and infant lumbar puncture simulators.
Team training uses high fidelity or hybrid simulation and critical events as a context for practicing and reflecting on the use of skills required for expert teamwork. We use Guided Team Self Correction (which maps teamwork behaviors onto the domains of Situation Monitoring, Supporting Behavior, Communication and Leadership/Followership) as the framework for debriefing.
Interprofessional Code Team Training
Monthly two hour course applying Guided Team Self Correction teamwork framework and debriefing in the context of resuscitation of patients with cardiorespiratory failure. Offered for VCUHS teams involved in code response including Internal Medicine, Anesthesiology, Nursing, Respiratory Therapy and Pharmacy.
Perioperative Team Training
Quarterly four hour course including didactic discussion of crisis resource management and team dimensional training applied to healthcare, and simulations of perioperative critical events for deliberate practice of application of these skills. For General Surgery and Anesthesiology residents and OR nursing. Similar courses offered as custom courses for specific perioperative teams, e.g. cardiothoracic surgery.
Simulations applying Guided Team Self Correction teamwork framework and debriefing in the context of managing obstetrical emergencies such as hemorrhage, nonreassuring fetal surveillance, maternal decompensation, shoulder dystocia. Offered in the Center and In-Situ in Labor and Delivery.
Neonatal ICU Team Training
Simulations applying Guided Team Self Correction teamwork framework and debriefing in the context of managing NICU emergencies and very complex treatments such as ECMO. Offered In-Situ in the Neonatal ICU.
Monthly simulations applying Guided Team Self Correction teamwork framework and debriefing in the context of managing pediatric emergencies such as respiratory distress, cardiac arrest, and septic shock. Offered In- Situ on the Pediatric units.
Various simulation methods and levels of fidelity have been used to uncover latent safety threats, enhance leadership and decision planning, and facilitate the prototyping process for introducing new health information technology or biomedical devices into systems of care. Simulation allows individuals to actively test work processes and interventions as solutions are developed and refined to optimize human-system integration.
The CHSPS can apply simulation approaches to enhance quality improvement projects and/or research on multiple levels. Regardless of the type of simulation, evidence based methods for designing scenarios, optimizing debriefing effectiveness, and facilitating quality improvement or systems planning is important to realize the most value from simulation. CHSPS staff can offer consultation and expertise in the areas of quality improvement and patient safety science, resilience engineering, and human factors and is interested in building collaborations with VCU faculty and other individuals conducting work in quality improvement.
If you are interested in a quality improvement project or are working on developing a quality improvement innovation, health information technology, and biomedical device, contact Cathy Grossman, Medical Director, or Moshe Feldman, Assistant Director for Research and Evaluation.
The Center has developed and implemented specific quality improvement programs in conjunction with medical services in the VCU Medical Center. These are custom projects but contain common elements in addressing latent failures and resiliency. Each project highlights how simulation was used to identify needs, design interventions, implement rapid QI cycles, and use data to inform effectiveness and design. A resiliency framework is used to complement traditional safety approaches.
Project: Obstetrical Services Failure Mode and Effects Analysis
This is a simulation enhanced FMEA process implemented over fifteen months during L&D renovation at VCU Medical Center. It involves process mapping of clinical processes, simulations for workflow changes to identify latent failures in proposed work process alterations during a construction project, and testing of processes and rapid cycle process improvement testing in new facilities prior to opening the new unit for patient care.
Project: Surgical Patient Handoffs in the Pediatric ICU
This project was a collaboration between the PICU, CHSPS, School of Medicine, VCU Performance Improvement office, and Office of continuing medical education as part of a grant to develop an interprofessional and integrated CME-Quality Improvement toolbox. Simulation was used at two levels as the PICU team completed their PDSA quality improvement cycle. First, a core simulation scenario was designed around a pediatric surgical transfer case and the team conducted a cognitive walk through simulation to identify information needs and failure modes. Next, a more elaborate mannequin based simulation was conducted to implement and test solutions.
Project: Designing Training and Systems for Biohazard Preparedness
Simulation can provide a useful tool for working with scenarios which are rare, but have exceptionally high consequences for public health such as bio hazard risks associated with a case of Ebola. Simulation offers a tool to better understand critical system and training gaps that might be addressed to improve overall patient safety. The CHSPS works with the health system to identify potential risks, develop a preparedness plan, and deliver simulation based training to address gaps in preparedness and PPE skills.
Project: Gesture Control Interfaces To Support Ebola Response Preparedness
Managing biohazard scenarios such as a patient with Ebola requires specialized and complex procedures and can prone to errors and potential contamination. Guides, protocols, and other information sources are often difficult to access because of the challenge of maintaining a sterile field preventing an individual from actually touching paper based or electronic interfaces. This project explores the potential of a gesture control device called the LeapMotion to allow individuals to access instructional media, videos, protocols, and other information important for biohazard preparedness. Simulation is used with other usability tools to develop, refine, and evaluate the usability of the device and effectiveness supporting practice of evidence based isolation guidelines and protocols.