The use of simulation is expanding in medical education. Simulation scenarios can be used for orientation to new procedures, technical training, exposure to uncommon clinical scenarios, and assessment of knowledge. The use of simulation for training/assessment of critical skills is useful because the natural course of the simulated event can be allowed to play out with the trainee on the “hot seat” and responsible for case management, something that is not safe to do in the patient care environment. The debriefing that follows the simulation session is an opportunity for the trainee to review the scenario with the instructor. The debriefing is a formative assessment and critically important component of simulation that allows the instructor to help the trainee understand their decision making processes, review pertinent evidence from the medical literature related to the simulation, and answer any questions the trainee may have pertaining to the scenario just completed.  In addition, it is possible to perform a “do over”, as needed, to reinforce the management principles highlighted during the simulation experience.

The mission of the Jefferson Anesthesia Simulation Division is to develop a training and assessment system based on evidenced-based management protocols for anesthesia personnel that can be objectively assessed using simulation technology. These protocols will be designed to meet the needs of the target audience which will include medical students, anesthesiology residents, and anesthesiologists. Simulated scenarios will include technical training, case management, orientation to procedures critical to patient care, and the management of common and not so common critical events, patient assessment and communication skills.

Residents can expect to participate in over 10 simulations during their residency.  Residents beginning their CA-1 year will participate in a basic airway workshop, anesthesia equipment workshop, and a basic induction simulation during the first month of residency.  Starting in August, four residents/week will each participate in a one hour simulation using the SIMMAN® 3G patient manikin. Simulation scenarios include the management of the difficult airway, anaphylaxis, laparoscopy, intermediate and advanced airway workshop, cardiac arrhythmias, one-lung ventilation, malignant hyperthermia and separating from cardiopulmonary bypass, to name a few.  All CA 3 residents have the opportunity to participate in OSCE stations similar to those encountered in the ABA APPLIED examination, taken after completion of residency.  In addition, a senior elective in simulation is available for the trainee interested in developing expertise in the design and evaluation of simulation scenarios. Opportunities are provided for those participating in this elective to publish their work.

The Jefferson Anesthesia Simulation Program is actively involved in research involving simulation and in the development and evaluation of critical event protocols. The recent donation of a new Apollo anesthesia machine by Drager and the acquisition of a sophisticated lung simulator provides a platform for investigating aspects of mechanical ventilation in various simulated intraoperative environments. Residents interested in such projects are encouraged to participate.