Long before they are admitted to medical school, students have well-honed studying and testtaking skills. But they often lack the skills needed to apply what they’ve learned in the classroom to the clinical setting. Emmanuelle D. Williams, M.D., director of gastroenterology training for second-year medical students for Penn State Milton S. Hershey Medical Center’s Division of Gastroenterology and Hepatology, is working to change that.
“At Penn State Hershey, all of our second-year medical students (currently more than 140) are required to participate in handling initial intake of a simulated ‘patient’ who presents to the emergency department with a gastrointestinal bleed,” said Williams. The case builds directly on classroom lectures about obtaining a medical history, monitoring vital signs and differential diagnosis.
“It’s usually a very emotional experience for the students,” said Williams. “The clinical routine begins to fall apart; they don’t get a proper history, they struggle with differential diagnosis, and professionalism is lacking. It opens their eyes to the difference between book learning and applying that knowledge in the clinic.” Continue reading
“Simulation is a technique, not a technology, to replace or amplify real experiences with guided experiences, often immersive in nature, that evoke or replicate substantial aspects of the real world in a fully safe, instructive, and interactive fashion.” 1
Matthew T. Moyer, M.D., M.S.
The limitations of standard classroom didactics and “on-the-job-training” for the initial training of residents and fellows in their procedural skills are well recognized and have helped fuel the growing emphasis on simulation training for medical students, residents, and support staff by the governing bodies of medical education such as the ACGME. For residents and fellows at Penn State Milton S. Hershey Medical Center, simulation training in gastrointestinal (GI) procedures has just taken a large leap forward. A recent multimillion dollar investment in renovating simulation facilities and technology has resulted in the nationally recognized Penn State Hershey Simulation Center, now under the direction of Elizabeth Sinz, M.D., professor of anesthesiology and associate dean for simulation. New generation simulators for diagnostic and therapeutic upper endoscopy, colonoscopy, and ERCP are available and are light-years ahead of what was available just a few years ago. For fellows in the GI-hepatology training program, Matthew T. Moyer, M.D., M.S., the new director of endoscopic education, is incorporating these technologies and training techniques to increase the depth of the curriculum. Moyer explains, “Simulation is becoming important, perhaps even mandatory, in the early instruction of our residents and fellows. This process allows them to have initial exposure to certain high-risk procedures (such as ERCP), or crisis situations (such as ACLS), during simulated sessions, prior to practicing on actual patients. This gives new trainees an opportunity to achieve a certain level of comfort and technical proficiency in a safe environment with continual feedback prior to entering the busy workflow of patient care.” Continue reading