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Simulation Anesthesia

Program Director, Dr. Richard Cherry

The Fellowship in Medical Simulation through the Department of Anesthesia and Perioperative Medicine at Western is designed to equip the clinician with the necessary knowledge, skills and attitudes to provide simulation based education curricula at the academic level and to appreciate the focus and direction that simulation based health education is taking in the broader context of health education. As simulation emerges as an integral component of competency based undergraduate, postgraduate and continuing professional development initiatives, leaders who are familiar with the educational rationale as well as the practical components of this educational modality will be vital in shaping the ongoing development of this field.

Fellowship Structure

• Duration: the fellowship training program will be undertaken over twelve consecutive months and includes four weeks of vacation time.
• Number of fellowship positions: 2
• Location: Fellowship training will take place at the University Hospital.
• Service commitment: 100 days per year (subject to change according to department fellowship policies). This service commitment may be in subspecialties unrelated to medical simulation. The remainder of the weekdays is subspecialty time. Academic time may be granted depending on the academic productivity of the fellow.

Simulation Responsibilities 

Anesthesia Resident Simulation Session (supervisor Dr. R. Cherry)

• Participation in anesthesia resident simulation teaching (these sessions generally occur Thursday 0900 - 1600)
• Includes Adult, pediatric, thoracic and OB insitu sessions
  • This will include set-up of simulation area, mannequin preparation, ensuring video, computers and speakers are functioning
  • Ensuring a cardiac arrest teaching is available in the simulation area (as well as any other required items for scenarios)
  • Running simulation scenarios
  • Providing review, feedback and teaching to residents with respect to cases after scenarios are complete
  • Ensuring that all equipment is properly stored and electronics turned off after session, and that resident have completed their evaluations

CanNASC Testing (supervisor Dr. A. Antoniou)

• Canadian National Anesthesia Simulation Curriculum
• Fellows will participate in the set up and delivery of the standardized scenarios to be carried out in the academic year
• Two full days of formal assessment

Junior ICU Resident Sessions (supervisors Dr. R. Butler, Dr. L. Champion)

• Participation in junior resident simulation teaching (these sessions occur every second week on Tuesdays from 12 – 3 pm)
• Responsibilities similar to Anesthesia resident simulation session

Senior ICU Fellow Sessions (supervisor Dr. L. Champion)

• Quarterly full day sessions for ICU fellows
• Focus on Crisis Resource Management
• Responsibilities similar to Anesthesia resident simulation session

Medical Student Year 3 Anesthesia Bootcamp: (supervisor Dr. A. Antoniou)

• Full day sessions roughly every 2 weeks for new clerks who will be coming on the city wide anesthesia rotation
• Introductory curriculum for anesthesia in 5 modules
• 1 fellow (may be from other clinical fellowship streams) will deliver the session. Occasional support from senior residents of teaching faculty

Additional simulation activities and training sessions frequently arise during the course of the academic year. Fellow participation is highly encouraged.

"I recently completed my Anesthesia Fellowship in Simulation and had a wonderful experience throughout my training. To have an incredible learning atmosphere through simulation and debriefing is simply outstanding to achieve within this discipline.  I learned to appreciate the important aspects needed to run simulation scenarios in a continuous basis, in order to enhance all clinical skills, to reinforce knowledge, to manage resources and to be aware of safety precautions inside the operating room. Overall, it has been a fantastic program for several reasons: it lets you perform as a teacher and a learner at the same time; it enhances your communicative and leadership skills under crisis management scenarios; and it lets you build a solid foundation of clinical experience through simulation-based practice." - Dr. Luis Velasco, Mexico

Eligibility Requirements for Canadian and Foreign Medical Graduates

• Candidates must possess a medical degree from a University recognized by the Medical Council of Canada (MCC)
• Candidates must have completed an anesthesia residency that is recognized by the College of Physicians and Surgeons of Ontario (CPSO)
• International Medical Graduates do not need to write additional exams, but must be approved by the PGE Office at Western University
• English Language Requirement for IMGs: TOEFL-iBT required to achieve an overall score of no less than 93 with a minimum score of 24 in speaking; IELTS required to achieve a minimum score of 7 in each category. 
• All non-Canadian trained anesthesiologists will be required to pass an assessment period taking place over the first 4 - 8 weeks in order to continue with the fellowship (‘PEAP’ – Pre-entry assessment period).
• Please refer to the Application and Requirements page for a more detailed description

Goals and Objectives

Educational

Personal Development in the Field of Simulation

• The fellowship will encourage personal development in simulation through didactic and experiential learning. Regularly scheduled core teaching sessions will cover the fundamental methods of simulation and simulation debriefing in healthcare. Practical application of these topics will occur in the multiple educational and research simulation programs running throughout the academic year.
• Attendance at supplementary simulation instructor courses will be permitted but is not mandatory. The expenses for such supplementary course attendance would fall to the individual fellow. If such course attendance is desired, some potentially applicable courses are listed in Section 8.
• Membership participation in the Society for Simulation in Healthcare

Knowledge Acquisition

The Fellow will develop knowledge in the following areas:

• History and theoretical basis of simulation in medical education
• Operation and programming of a variety of medical simulation technologies, including:
  • High-Fidelity Human Patient Simulators
  • Partial Task Simulators
  • Computerized Simulation Technologies
  • Virtual Reality Simulators
  • Simulation Audio-Visuals
• Using simulation modalities for assessment
• Formative assessment / teaching using simulation technologies

Development of Simulation Based Educational Curricula

• The fellow will acquire skills to conceive, design, document, script, program and debrief clinically relevant simulation scenarios using the Laerdal LLEAP interface.
• Development of standardized scenarios will include:
  • learning needs assessment strategies
  • creating learning objectives
  • relevant patient profile, history and presentation
  • instructions for participants with respect to roles and scenario
  • developing laboratory values, ECGs, radiographs etc. as required for the case
  • simulator scenario programming
  • instructions for tutors/facilitators with respect to scenario debriefing
  • expected management of scenario
  • additional resources, references and reading material relevant to case
  • evaluating the effectiveness of a simulation based learning experience

Delivery of Simulation Based Educational Curricula

• The simulation fellow will experience mentored and graduated participation in the delivery and debriefing of simulation programs provided to a diversity of participants and trainee levels. This may include medical students, residents, fellows, attending physicians, nurses, and other allied health professionals. During the course of the fellowship, the simulation fellow will regularly record debriefing sessions for future presentation, review and feedback with staff.

The fellow will develop expertise with respect to:

• Simulator use including set-up, programming of case scenarios, use of simulator during scenario delivery
• Providing effective feedback and performance debriefing
• Organization of a simulation lab:
  • ensuring that additional supplies are available, and storage organized
  • staging and set-up of simulation scenarios as required for scenarios (intubation equipment, arrest cart, medications, syringes, scenario ‘props’ such as radiographs etc.)
  • take-down and storage of supplies after sessions are complete

Research 

• A minimum of one scholarly project is to be successfully completed and submitted for publication or presentation during the fellowship. Additional projects and research are strongly encouraged. Fellows may also be given the opportunity to join existing simulation research projects from within the core or affiliated faculty
• Assistance with education / simulation research may be arranged with the staff at Center for Educational Research and Innovation CERI (Drs. Lingard, Cristancho, Watling).
• Development of simulation programs targeting practicing professionals can be facilitated with support from the Schulich School of Medicine and Dentistry, Continuing Professional Development (Dr. Richard Cherry, Associate Dean CPD)

Clinical 

• Given that simulation activities and instructors must retain clinical relevance, the fellows will be encouraged to seek out and explore methods and techniques that can further integrate simulation into ‘real world’ practice. This may include:
  • In-situ simulation projects
  • Integrating simulation debriefing techniques into the clinical teaching environment
  • Simulation of existing hospital processes

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