Simulation is becoming more widespread in undergraduate medical education, expanding well beyond its original application to anesthesiology. This heightened interest in simulation is being driven by advances in learning theory as well as technology developments. However, introducing simulation into a medical education curriculum presents significant challenges. This article describes the simulation initiatives at two medical schools. Both are state schools with similar enrollments; however, their approaches to developing and maintaining a simulation program differ. Regardless of these differences, both institutions have developed a variety of applications within the curriculum. The cases and applications that they have developed should be applicable to many medical schools.
Anesthesiologists have long recognized that there is a sympathetic response to stimulation of the larynx, even in sedated patients. This response creates a rapid increase in blood pressure and heart rate in these patients. For the last 40 years, various simulation systems have been used to train anesthesiologists in the skills to be successful practitioners, simulating various disease states and crisis conditions. However, these systems do not contain this well-recognized sympathetic response to laryngoscopy and intubation. Using several experienced anesthesiologists as subject matter experts, we have developed a scenario that mimics this response for several types of patients. This scenario runs on the Medical Education Technologies, Inc. (METI) patient simulators; however, the methodology used to develop this scenario applies to other patient simulator systems.
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