Residents

Central Line Review with Ultrasound Guidance
Lumbar Puncture Review with Ultrasound Guidance
Critical Care for Interns
Advanced Cases in Critical Care
Resuscitation Skills Refresher
Airway Management
Cases in Obstetrics
Arterial Access

Our goal is to create competent, confident doctors. We encourage the use of simulation to teach basic skills, yet also to expose our residents to difficult procedures and skills, and teach them how to problem solve. Using simulation, we create critical scenarios that require quick problem solving and rapid intervention. Our residents learn how to manage these problems in the safe environment of the SimCenter, and are then more equipped to deal with the real thing when they encounter it in clinical practice.

Central Line Review with Ultrasound Guidance

A comprehensive curriculum, including didactics and hands-on practice. Topics include indications/contraindications of line placement, site selection, sterile preparation, procedural skills and the assessment and treatment of complications. Techniques and tips for torso lines are included. The use of ultrasound guidance for line placement and arterial puncture is demonstrated and practiced. Pre- and post-testing is included to challenge the residents and facilitate knowledge retention.
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Lumbar Puncture Review with Ultrasound Guidance

A review for those familiar with the procedure. Specific topics include the following:

Anatomy and positioning
Informed consent
The difficult patient: how to deal with obesity, scoliosis and arthritis
Ultrasound guidance – using ultrasound to detect the spinous processes and the intervertebral space
Complications and how to treat them
Teach the teachers – teaching residents to teach

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Critical Care for Interns

“It’s 2 a.m. and I don’t know what to do!”—Designed to provide the tools to enable recognition and early management of critically ill patients. Based on real cases of the most common middle-of-the-night medical emergencies, including CHF, sepsis, MI and respiratory failure. Conducted monthly during intern report.
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Advanced Cases in Critical Care Management

Recognition and treatment of emergent patients, with both common and uncommon diseases and presentations. Past cases include hypothermia, sympathomimetic overdose, respiratory failure and many others. Cases are tailored to individual training levels, and emphasize teamwork, effective communication and resource management, as well as provide a review of pathophysiology and treatment options. Sessions are held twice a month, so each resident has several opportunities to participate each year.
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Resuscitation Skills Refresher

Internal medicine residents on inpatient rotation at GW participate in resuscitation skills refresher course (3 hours) designed to reinforce the effective use of resuscitation technology and team performance. Typical code scenarios are practiced; teaching is tailored to level of experience. Members of the team take turns “running” the codes. Junior residents practice rhythm recognition, medication selection, airway and intubation skills, CPR and algorithm use. Senior residents practice team management, situational awareness, communications skills and cognitive skills. Cases and debriefing sessions are guided by the teaching goals. This teaching opportunity is provided monthly to the residents in a 3-hour block.
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Airway Management

Practice management of difficult airways using a variety of devices, including fiberoptic scope, lighted stylet, bougie, nasal intubation, cricothyrotomy and LMA. Use of bag-mask-valve is essential!
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Cases in Obstetrics

The recent acquisition of a Noelle maternal and childbirth simulator allows our residents to practice their abilities to identify and treat potentially life-threatening obstetric complications. Overall goals include the ability to:

Demonstrate normal and abnormal labor
Understand pathophysiology of common obstetric problems
Recognize warning signs of maternal-fetal compromise
Identify critical actions for neonatal resuscitation
Develop a basic understanding of critical care priorities and the essentials of teamwork
Teach the teachers – teaching residents to teach

Residents are presented with realistic clinical cases, such as shoulder dystocia or fetal distress. Cases can be tailored to resident capabilities by adding or deleting complications. Cases are augmented with maternal and fetal monitors, lab results, and digital ultrasound video, cardiac and uterine tracings. Critical actions and teaching points are provided for each case.
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Arterial Access

Arterial access skills are required for students and residents working in the hospital and ICU, both to obtain blood gases and to insert monitoring catheters. Students learn indication and contraindications to arterial access, Allen’s test, sterile technique, the use of various arterial line catheter kits and ultrasound guidance. We manufacture ultrasound-compatible models with pulsatile vessels that students can palpate and access via needle or catheter to demonstrate skills. Use and troubleshooting of arterial line pressure monitoring equipment is also a part of the curriculum.
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