An Emergency Medicine Milestone-Based Simulation Curriculum: Acute Ischemic Stroke

Introduction The emergency medicine (EM) resident's ability to make independent decisions in the setting of acute ischemic stroke has been reduced as a result of the involvement of multidisciplinary teams. This simulation was created to give EM residents the opportunity to independently manage...

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Autores principales:	Danielle Turner-Lawrence, Bophal Sarha Hang, Payal Shah, Kelly Levasseur
Formato:	article
Lenguaje:	EN
Publicado:	Association of American Medical Colleges 2019
Materias:	Simulation Professionalism Stroke Standardized Patient Emergency Medicine Communication Skills Medicine (General) R5-920 Education L
Acceso en línea:	https://doaj.org/article/820bc971c2c645a1b904b6982d158003
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spelling	oai:doaj.org-article:820bc971c2c645a1b904b6982d1580032021-11-22T13:57:53ZAn Emergency Medicine Milestone-Based Simulation Curriculum: Acute Ischemic Stroke10.15766/mep_2374-8265.108292374-8265https://doaj.org/article/820bc971c2c645a1b904b6982d1580032019-06-01T00:00:00Zhttp://www.mededportal.org/doi/10.15766/mep_2374-8265.10829https://doaj.org/toc/2374-8265Introduction The emergency medicine (EM) resident's ability to make independent decisions in the setting of acute ischemic stroke has been reduced as a result of the involvement of multidisciplinary teams. This simulation was created to give EM residents the opportunity to independently manage the early stages of ischemic stroke and its complications. Methods A solo learner was presented with a 55-year-old male with complaints consistent with an acute stroke. The resident had to calculate stroke severity; coordinate hospital resources; discuss risks, benefits, and alternatives to thrombolysis; and deal with subsequent complications. The learner had to keep a broad differential for sudden change in mental status and consider alternative interventions. Strategies to decrease intracranial pressure needed to be implemented while obtaining neurosurgical consultation. Debriefing included discussion of expected actions in the context of the Accreditation Council for Graduate Medical Education (ACGME) milestones. Residents' review of their video performance added additional self-reflection. Results A total of 69 PGY 3 EM residents independently participated in this simulation over a 5-year period. Thirty-two completed a postsimulation evaluation. Nearly all learners felt that this case reflected an actual patient encounter and increased their confidence in managing stroke. The milestone-based feedback tool was completed with all learners. Anticipated actions linked to Level 1 and 2 milestones were regularly achieved while acquisition of Level 3 and 4 actions varied. Discussion Case actions were uniquely characterized by the ACGME milestones, which helped to delineate learners' knowledge gaps and provided concrete areas for improvement.Danielle Turner-LawrenceBophal Sarha HangPayal ShahKelly LevasseurAssociation of American Medical CollegesarticleSimulationProfessionalismStrokeStandardized PatientEmergency MedicineCommunication SkillsMedicine (General)R5-920EducationLENMedEdPORTAL, Vol 15 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Simulation Professionalism Stroke Standardized Patient Emergency Medicine Communication Skills Medicine (General) R5-920 Education L
spellingShingle	Simulation Professionalism Stroke Standardized Patient Emergency Medicine Communication Skills Medicine (General) R5-920 Education L Danielle Turner-Lawrence Bophal Sarha Hang Payal Shah Kelly Levasseur An Emergency Medicine Milestone-Based Simulation Curriculum: Acute Ischemic Stroke
description	Introduction The emergency medicine (EM) resident's ability to make independent decisions in the setting of acute ischemic stroke has been reduced as a result of the involvement of multidisciplinary teams. This simulation was created to give EM residents the opportunity to independently manage the early stages of ischemic stroke and its complications. Methods A solo learner was presented with a 55-year-old male with complaints consistent with an acute stroke. The resident had to calculate stroke severity; coordinate hospital resources; discuss risks, benefits, and alternatives to thrombolysis; and deal with subsequent complications. The learner had to keep a broad differential for sudden change in mental status and consider alternative interventions. Strategies to decrease intracranial pressure needed to be implemented while obtaining neurosurgical consultation. Debriefing included discussion of expected actions in the context of the Accreditation Council for Graduate Medical Education (ACGME) milestones. Residents' review of their video performance added additional self-reflection. Results A total of 69 PGY 3 EM residents independently participated in this simulation over a 5-year period. Thirty-two completed a postsimulation evaluation. Nearly all learners felt that this case reflected an actual patient encounter and increased their confidence in managing stroke. The milestone-based feedback tool was completed with all learners. Anticipated actions linked to Level 1 and 2 milestones were regularly achieved while acquisition of Level 3 and 4 actions varied. Discussion Case actions were uniquely characterized by the ACGME milestones, which helped to delineate learners' knowledge gaps and provided concrete areas for improvement.
format	article
author	Danielle Turner-Lawrence Bophal Sarha Hang Payal Shah Kelly Levasseur
author_facet	Danielle Turner-Lawrence Bophal Sarha Hang Payal Shah Kelly Levasseur
author_sort	Danielle Turner-Lawrence
title	An Emergency Medicine Milestone-Based Simulation Curriculum: Acute Ischemic Stroke
title_short	An Emergency Medicine Milestone-Based Simulation Curriculum: Acute Ischemic Stroke
title_full	An Emergency Medicine Milestone-Based Simulation Curriculum: Acute Ischemic Stroke
title_fullStr	An Emergency Medicine Milestone-Based Simulation Curriculum: Acute Ischemic Stroke
title_full_unstemmed	An Emergency Medicine Milestone-Based Simulation Curriculum: Acute Ischemic Stroke
title_sort	emergency medicine milestone-based simulation curriculum: acute ischemic stroke
publisher	Association of American Medical Colleges
publishDate	2019
url	https://doaj.org/article/820bc971c2c645a1b904b6982d158003
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An Emergency Medicine Milestone-Based Simulation Curriculum: Acute Ischemic Stroke

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