Category Archives: Medical Simulation

Simulation with Double Large Monitors

20130804_164055

 

I usually do scenario simulation with two large TV monitors.

The size of those TV monitors is about 50-inches.

One is used for sharing patient’s information(above; skin of burn patient) and the other is for showing vital signs such as HR, BP(ABP or NBP), SpO2, BT and etCO2.

This method is quite useful. All trainees can share information at a glance vividly and easily.

In order to get them immersed into scenario, I  gather real patient’s data from EMR or photos taken at bedside and then attach them on PPT slide.

Real data, real monitor sounds and dynamic changes of patient’s vital signs can make trainees perform seriously.

I love this method very much. I can’t help but doing this!

Instructor Competency

IMG_1881Recently I’ve read this book. It tells us how to build our competency as an instructor in various settings such as face-to-face, on-line and blended one.

Obviously every domain is applicable to our any kind of education. Especially I strongly agree with the first domain called “PROFESSIONAL FOUNDATIONS”

  1. Communicate effectively
  1. Update and improve one’s professional knowledge and skills
  1. Comply with established ethical and legal standards
  1. Establish and maintain professional credibility

Those are core, vital and fundamental abilities to be an effective instructor. Furthermore, an emotionally disciplined instructor will be able to have huge influence on learners.

ECMO and AHFS simulation

Today, I completed the 14th ECMO simulation and the 13th acute heart failure syndrome(AHFS) simulation of this year.

ECMO simulation: 9:00 am – 0:30 pm

AHFS simulation: 1:30 pm – 5:30 pm

A participant came from Sapporo and another one came from Hamamatsu, both are far from Sendai City.

In this year, the total number of participants of ECMO Sim is 118(mean 8.4) and those of AHFS Sim is 93(mean 7.1).

I really want all of those learners to show much much better performance with confidence than the past in the real clinical settings of both ECMO and AHFS practice.

AHFS CS1AHFS CS5 pulmonary embolism CTECMO circuitECMO cannulation

SimNight 20150224

“SimNight”  is one of my special and free simulation seminars for any healthcare providers at SIMSTAR.

SIMSTAR is an abbreviation of our simulation center;

SImulation center for Medical Skills Training And Reserch

On Feb 24, more than 10 learners including young doctors and ICU nurses working at a certain city hospital came to our simulation center voluntarily.

The first and the second scenarios were made to have them experience common circulatory collapse happened to ventilated patient in ICU.

Scenarios are as follows;

1. 70 years old man
In ICU, on ventilator, SIMV(PC)
Diag. ARDS caused by pneumonia
a. hypotension due to rapid A-fib(HR≒180)→syncronized cardioversion
b. rt tension pneumothorax→needle decompression then chest drainage

2. 66 years old man
CC: severe shock, abdominal pain, diarrhea
PH: n.p.
By ambulance
Condition: AOSC, septic shock→intubation, EGDT, EST/ENBD→admission in ICU

DIY Low Cost ECMO Circuit

This is the short movie that introduces how to make an imitated vascular circuit for ECMO simulation.

I made this circuit in order to help us perform ECMO training in much more practical way.

I’ve already shared some movies using this circuit for practical ECMO training.

DIY is a great way to break through the status quo and make simulation training efficient and exciting.

The day full of simulation

Feb 5 was a tough day for me because it was full of simulation.
I held three different kinds of seminars in one day.

No.1: ECLS/ECMO related simulation in the morning from 9:00-12:00am
No.2: Acute Heart Failure Syndrome simulation in the afternoon from 1:30-5:30pm
No.3: CVC hands-on training in the evening from 6:00-8:30pm

That day I had been dedicated to simulation for 8.5 hours in total.

Even though that day was a weekday, about 10 healthcare providers joined these simulation seminars.

In Japan, traditionally off-the-job training is supposed to be held on weekends, and then this tradition often causes huge loss of free time of educators, tiredness or exhaustion both mentally and physically, moreover disagreement of family members.

Despite of these disadvantages, Japanese disciplined educators devote themselves into some sort of simulation seminars and get fulfilled with the achievement of learners.

I hope these weekday seminars will be more common and simulation instructors will have more free time on weekends.

Preparation for ECMO sim acute heart failure sim Preparation for CVC training

SimNight 20150203

 

20150203_SimNight

 

“SimNight” is one of my original simulation seminars.

As you notice, the name comes from “Simulation at Night”.

I have been doing this scenario-based simulation since 2012 in my simulation center.

Literally this seminar would be held from 7pm to 9pm mostly on Tuesday.

Participants who are healthcare providers like doctors and nurses come voluntarily from both my hospital and other institutions.

Surprisingly this seminar is free in charge, therefore it is very easy to apply and join.

Every time I provide 2 or 3 comprehensive scenarios related to the emergency medicine such as cardiovascular failure, respiratory failure, sepsis, trauma, poisoning and environmental disorder. Realism is the strongest point of my seminar.

Yesterday, I did “SimNight” seminar for the first time in about 2 months.
Participants who joined today’s seminar flew from Shizuoka that is far from my city.
I was surprised at the level of performance which they did as a team in these scenarios.
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SimNight scenarios on 2015/2/3

53M
CC: pyrexia, rt leg swelling,pain & erythema
PH: DM not treated
by ambulance
Condition: NSTI of rt. leg with abnormal gas, septic shock/DIC→EGDT, ABx, CECT, debriedman to amputation

53M
CC: organophosphate poisoning
PH: HT, HL, depression
by ambulance
Condition: miosis, fasciculation, airway emergency by secretion → intubation, atropine + PAM

19M
CC: blunt trauma, rt. chest pain
PH: n.p.
by ambulance
Condition: rt tension pneumothorax, lung contusion, aortic injury, hepatic injury → needle decompression, chest tube, CECT, intubation, Angio

57M walk-in
CC: rigidity of muscles around mouth and neck, swallowing disorder
PH: alcoholics
Condition: tetanus,trismus, difficult airway→emergent cricothyrotomy