A discussion detailing the Resuscitation and Crisis Management Curriculum at the University of Wisconsin - Madison. This presentation outlines the advantages of including residents as teachers for medical students, faculty and staff.

1. Developing a Simulation Based
Resuscitation Curriculum
Med4’s, Faculty, Staff, Residents
March 2010 University of Florida - Gainesville
Eric B. Bauman, PhD, RN
Department of Anesthesiology
University of Wisconsin School of Medicine & Public Health

2. Course & Program History
• Our Current Resuscitation Program has
undergone several revisions
• The current incarnation revolves around a
Med4 Elective Clerkship
w w w .pamelaheath.com/Cartoons4.htm

3. Resuscitation & Crisis Management
• One-week immersive simulation-based elective for
Med4’s
• Small Group setting: Six Students
• Much of the didactic information are provided via the
University’s Web-based educational interface
Learn@UW
• Didactic Content is reinforced in small group
discussions led by faculty, staff and Residents
• Didactic and small group discussions prepare
students for simulation
• This course meets and exceeds all AHA
Requirements for AHA ACLS Provider status
– Students successfully completing the course
receive an ACLS Provider Card

4. Simulation Pathway
Bauman 2007

5.  Didactic and Web-based learning
 Small Group
Discussion
Simulation-based

Experiential Learning

6. w w w .pamelaheath.com/Cartoons4.htm

7. Advantages of our Approach
• The Resuscitation & Crisis Management
Course has been one of the top ranked
electives since its inception!
• Faculty and Staff model professional
academic practice for Residents
• Provides a Novel Approach to Resident
Education

8. More on our Resident’s Role
• All CA1’s become AHA ACLS Instructors and
complete a teaching with simulation seminar
• AHA ACLS Instructor Status supercedes
ACLS Provider Status
• ACLS Provider Status is required for Hospital
Credentialing and Residency Program
Requirements
– Residents maintain their ACLS Instructor status by teaching
in the Crisis Management & Resuscitation Elective
– Residents must teach in 4 courses every 2 years and be
Monitored by AHA Training Center Faculty every 2 years

9. Promotes the Clinician as Teacher Perspective
• Fosters teaching skills of our residents in
accordance with the ACGME core
competencies
• Students relate well to Residents who are
just a few years ahead of them in their
training, promoting peer-to-peer learning
w w w .pamelaheath.com/Cartoons4.htm

10. Mentoring
• As Residents are learning how to teach they
are paired with more experienced Faculty or
Staff Instructors
• Residents often assist with assessment and
debriefing during simulation sessions
• Faculty & Staff Mentor the Residents
modeling important aspects of professional
practice and acculturation.

11. Other Resuscitation Education
• Our Resuscitation Program provides
training opportunities for all faculty
within our department
• Residents often instruct their peers and
attending/supervising faculty (on
occasion sometimes even the Chair)

12. Essential Elements for
Success
• Must have top down & lateral
buy in!
• See Resident teaching
opportunities as part of your
Residents’ essential graduate
medical education experience
• Residents must have
adequate time to prepare for
teaching and their role as
teacher must be valued.
Richard Kyle

13. High Fidelity Simulation in the
Health Sciences
©Bauman 2007

14. Intervention
Didactic presentation of content
immediately followed by situated
immersive learning experiences in a
high-fidelity simulated environment with
extensive use of debriefing

15. Testing/Evaluation
One and only one posttest per measure
for each participant!

16. Results
• Increased Cognitive Gain on two (2) written measures
– EKG Posttest Exam
• (T = 818.5, p < .001)
– Multiple Choice Posttest Exam
• (T = 820, p < .001)
• Increased Cognitive Gain on Practical Post-test Exam (T = 820, p
< .001)
• Increased BEHAVIORAL gain on Practical Posttest Exam (T =
820, p < .001)
*Statistical analysis based on 1-tailed matched pair Wilcoxon exam
©Bauman 2007

17. Mean EKG pre- and posttest scores by
participant
Pre-EKG Post-EKG
100
90
Mean Percentage Correct
80
70
60
50
40
30
20
10
0
Individuals
©Bauman 2007

18. Mean ACLS pre- and posttest scores
by participant
Pre-ACLS score Post-ACLS score
100
Mean Percentage Correct
90
80
70
60
50
40
30
20
10
0
Individuals
©Bauman 2007

19. Mean cognitive pre- and posttest
scores by participant
Mean pre-cognitive scores Mean post-cognitive scores
3
2.5
2
Mean Score
1.5
1
0.5
0
Individuals
©Bauman 2007

20. Mean behavioral pre- and posttest
scores by participant
Mean post-behavioral score
Mean pre-behavioral Mean post-behavioral score
3
2.5
2
Mean Score
1.5
1
0.5
0
Individuals
©Bauman 2007

21. Table 1
Descriptive statistics for pre- and posttest measures of cognitive and behavioral ability
M SD Median Low Score High Score
c
EKG
Pre 63.30 14.99 64.00 32.00 100.00a
Post 94.70 9.30 100.00 60.00 100.00
ACLSd
Pre 62.28 8.24 62.50 45.00b 79.00
Post 95.48 3.82 97.00 88.00 100.00
Cognitivee
Pre .54 .52 .33
Post 1.93 .42 2.00
Behaviorale
Pre .84 .43 1.00
Post 1.94 .35 2.00
a
The next highest score for this exam was an 80.
b
Two students scored 45% on this exam.
c
Calculated p-value for pre- to posttest differences for this test was .00000003.
d
Calculated p-value for pre- to posttest differences for this test was .00000008.
e
Calculated p-value for pre- to posttest differences for this test was .00000004.
©Bauman 2007

22. Including research is essential to a
successful simulation program
• Provides you with feedback on your progress
• Provides a showcase for your accomplishments
• Provides opportunity for networking and collaboration
• Provides you with justification for continued and
future funding opportunities

23. Contact Information
Eric Bauman, PhD, RN
Department of Anesthesiology
University of Wisconsin School of Medicine and Public Health
ebauman@wisc.edu
http://www.linkedin.com/in/ericbbauman
Department: 608-263-8100
Cell: 608-469-6200