Kanbar Center for Simulation and Clinical Skills Education

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1 Kanbar Center for Simulation and Clinical Skills Education Kanbar Facility and Programs The current facility represents the first of a two phase development project at UCSF and supports activities for the School of students, residents, as well as interprofessional programs. Phase II of the project will involve migration of our programs into a campus-wide center, which will include mannequin, task and virtual simulation, clinical skills and telemedicine training. The new Kanbar Center for Simulation and Clinical Skills Education will be located on the second floor of the Kalmanovitz Library and will serve all of the UCSF professional schools. Visit the Simulation Center Since the July 2008 opening, the Mount Zion Facility has focused on undergraduate and graduate medical education, with opportunities for interprofessional exercises. Medical students encounter the full-body human simulator early in their education, and have additional curriculum scheduled to reinforce and augment that exposure throughout their course of study. The center provides an impressive array of skills development and simulation sessions at the Mount Zion facility. While the Mt. Zion facility, at 2200 Post Street, cannot accommodate the training needs of all of the professions, it will prioritize interprofessional education as an area of institutional offerings. Educational leaders from all the professional schools are invited to visit the Facility and participate in demonstrations of training facilities and programs, and are welcome to engage in planning instructional offerings. Please contact us to arrange a visit at kanbar@ucsf.edu or What First Year Medical Students are Saying about Simulation Education at the Kanbar Center: [The experience] was challenging and realistic. I felt I learned a lot not only about the medicine but about team dynamics. What I liked about the course...it illustrates the gravity of what we are learning and provide a context for our learning that is tangible. What I liked about this course.being able to test my knowledge about the material and under the stress of dealing with a patient in a simulated emergency.

2 Page 2 Priorities for Health Professions Simulation Education Development of simulationsupported learning opportunities for our health professions students is a central priority. We have Curriculum formed a cross school committee that is Planning charged with developing a program plan for use of the Kanbar Center for Simulation and Clinical Skills education that serves individual school curricula and interprofessional education goals. The committee will offer consultation and prioritize curricular programs for the center through The Interprofessional full potential for Development interprofessional development will be realized during phase II of the project. The existing Simulation and Clinical Skills Centers will be augmented to include all aspects of a true virtual care center, containing specialized training laboratories that support teaching and practice of essential diagnostic and care delivery skills. The permanent simulation center design has been finalized, and current information is available for review on the library s website: The center Key Elements will include the following key elements: 1) training laboratories using standardized patients, actors trained to respond as patients with particular illnesses but able to provide the human interaction aspects of care; 2) training laboratories using computerized systems with mannequins to support learning using invasive techniques not possible to practice with human subjects (simulation laboratories); 3) telemedicine training facilities, including state -of-the-art telecommunication systems, and 4) staff offices and support rooms, including equipment holding and maintenance, and the necessary computer and telecommunications support. Finally, the Educational center will be a site of educational re- Research search and development. Projects will include examining the best ways to care for patients and developing novel tools for teaching, such as real-time three-dimensional imaging that can be used to better Features of the Kanbar Simulation Center 2200 Post Street, Suite C322, Mount Zion Campus The Kanbar Simulation Center, temporarily at UCSF s Mount Zion campus, supports the School of s educational mission of teaching, learning, assessment and research through realistic simulations and interprofessional team training for routine and complex situations, thereby improving patient care and safety. The facility features: Five Part-Task Training Rooms. Each room can be set up for a number of different scenarios using varying part-task simulators, including IV injection arms, respirators, or CPR; Operating Room/Emergency Trauma. This area can accommodate team-based trainings using our Laerdal Sim- Man or our NOELLE Maternal and Neonatal Birthing Simulator. The OR/Trauma area can be video and audio recorded for playback by learners and educators Conference Debriefing Room (shown right) that provides learners and educators space and equipment to debrief using video and audio recordings; post simulation skills debriefing.

3 Page 3 Features of Clinical Skills Center Education 1515 Scott Street, Mount Zion Campus The Clinical Skills Education accommodates a variety of clinical skills programs for medical students throughout the four-year curriculum. With the use of standardized patients (SPs) students can practice hands on skills in a safe and realistic ambulatory setting. The facility, designed to resemble a typical outpatient medical clinic, features eight model clinical stations and two training rooms. Rooms are equipped with digital video recorders and monitors to enable students and instructors to review and refine techniques and communication skills Simulation Trainers NOELLE Maternal and Neonatal Birthing Simulator is designed to provide a complete birthing experience before, during, and after delivery. and SimBabyare portable and advanced patient simulator for team training. Standardized Patient Program The Standardized Patient Program is dedicated to promoting better health outcomes by improving the quality of health education training through the use of - a dynamic educational resource. What is a Standardized Patient? A healthy person trained to portray the personal history, physical symptoms, emotional characteristics and everyday concerns of an actual patient A dynamic educational tool for a variety of settings such as interactive teaching environments, group demonstrations, formative clinical exercises and summative exams are trained to provide constructive feedback to learners at all levels of training. It reinforces positive as well as improvable aspects of the learner s performance by using I statements (avoiding the accusatory you ) Our aim is to help course, clerkship and residency directors enhance the outstanding clinical training they provide in the UCSF environment. Simulation-based training can address gaps in clinical experience and allow deliberate practice of important skills. Manuel Pardo, MD. Kanbar Center Director and Professor of Clinical Anesthesia

4 Page 4 Partial Task Trainers Simulaids Advanced Injection Arm Is a revolutionary training arm that provides complete venous access for IV therapy and phlebotomy, plus sites for intramuscular and intradermal injection The Little Annie Adult CPR Is used for widespread CPR training IV Arm, 2 Vein system Is used to practice venipuncture, or drawing blood from the vein Multipurpose Venous Training Arm Is used to practice venipuncture, intramuscular and subcutaneous injections Simulaids ABG Arm Is used for arterial stick, blood collection and suturing exercises IV Torso Is designed for realistic practice of central IV access to the neck and femoral regions RespiTrainer including QuickLung Provides EMS and respiratory care education and training Fetal Simulator Is designed to allow teaching early detection of fetal hypoxia Heart Simulator ECG rhythm simulator designed to teach basic and modified adult and pediatric rhythms SonoSite Titan Ultrasound A high resolution modular ultrasound for teaching clinical skills involving ultrasound Branched Vessel Ultrasound Tissue Is designed to develop the hand eye coordination necessary for using ultrasound Spinal Injection Provides realistic demonstration and practice of spinal injections Lumbar Puncture II Is designed to allow students to both collect CSF fluid and measure CSF pressure under clinically realistic conditions Obstetric Susie Is used to demonstrate normal or breach deliveries, Leopold maneuvers, Intrauterine manipulation, Cord prolapse, Placenta previa, Fundal massage, and Postpartum care Neonatal Intubation Is designed to allow teaching of intubation skills on the new born baby Pediatric Intubation Is pediatric torso designed for teaching the differences in pediatric and adult anatomy for airway management procedures Adult Intubation Is designed to allow teaching of intubation skills on a male adult Cricothyrotomy Simulator Is designed for learning and practicing the technique necessary to perform an emergency cricothyrotomy Peter PICC Line Is designed to tech IV catheter placement featuring palpable ribs to allow measurement of proper catheter length externally Thoracentesis Trainer Is designed for teaching ultrasound guided thoracentesis as well as placing large and small bore chest tubes without ultrasound guidance Infant IO Leg Is designed for training students to master infant intraosseous infusion techniques Infant IV Leg Is designed for training extremity venipuncture procedures and intravenous fluid administration in the superficial veins of the foot Baby Umbi Is designed for the practice of umbilical catheterization Intraosseous Is designed for training in infant intraosseous infusion techniques Infant Arterial Arm Is designed to allow students to master infant radial artery puncture techniques Pediatric Multi-Venous IV Arm Is designed to allow student o master peripheral intravenous techniques Heavy Duty BSE model Is designed for realistic breast examinations Clinical Female Pelvic Trainer Is designed for accurate anatomical and tactile representation of the female pelvis for 'hands on' examination and diagnosis of pathologies and abnormalities Central Line / Nerve Block Is designed to teach the skills necessary for ultrasound guided central venous access and peripheral nerve block training Visit our website kanbar for more information about our services and facilities.

5 Page 5 Sample Courses offered at the Center Program/Course Anesthesia Interest Group: Introduction to Anesthesia procedures including intubation/lma insertion, manual ventilation, arterial puncture and IV placement Trainers Intubation Heads, Respitrainer, ABG Arms, IV Arms Instructor and Department Name Audience Martin Bogetz, Department Anesthesia Intern Simulation: Simulation scenarios on hypoxemia or hypotension, or basic induction of general anesthesia. Partial task training sessions include airway management, IV placement, arterial line placement., Anesthesia Machine, IV Arms Manny Pardo, Department Residents Bedside Ultrasound: This course teaches ultrasound image interpretation using portable bedside ultrasound units and simulated tissue Blue Phantom selected tissue and ultrasound Spencer Yost, Department Fellows Emergency Simulation: Simulation focused on advanced cardiac scenarios, including 12-lead ECG interpretation Jackie Nemer, Department of Emergency Residents ICU Code Blue Simulation: Simulation focused on interdisciplinary teamwork using advanced cardiac scenarios in an ICU setting. Spencer Yost, Department Interprofessional, MD, RN MEPN- Auscultation: Nursing students practice central line dressing changes as well as identifying heart, lung and bowel sounds with a stethoscope IV Torso, Student Auscultation Manikin Paul McCosh, School of Nursing Nursing Students MEPN- Central Line Dressing & Auscultation: Nursing students practice central line dressing changes as well as identifying heart, lung and bowel sounds with a stethoscope IV Torso, Student Auscultation Manikin Paul McCosh, School of Nursing Nursing Students MEPN- Foley Catheters & IV Cannulation: Students practice foley catheter insertion for monitoring urine output, and IV cannulation for infusion, IV Arms Paul McCosh, School of Nursing Nursing Students ObGyn 110 Clinical Skills: Course concentrates on developing skills for the ObGyn clerkship, including pelvic and breast exam technique and how to assist in delivery Noelle, OB Pelvic Trainer, Breast self-exam Patty Robertson, Chris Herndon, Department of Obstetrics & Gynecology Organs Block- Coronary Simulation: Simulation focused on teaching cardiac physiology and patient history skills to first-year medical students. Adam Collins, Department Organs Block- Pulmonary Simulation: Simulation focused on teaching pulmonary physiology and patient history skills to first-year medical students. Adam Collins, Department

6 Page 6 Sample Courses continued Program/Course Pediatric Procedures Skills: Pediatric interns practice oneon-one with attendings and fellows to develop critical care skills focusing on Neonatal ventilation & intubation; Phlebotomy & IV placement; Arterial puncture; IO placement and Umbilical line placement. Trainers Pediatric intubation, IV arm, ABG, Umbilical line, IO access Instructor and Department Name Audience Sandrijn van Schaik, Residents Department of Pediatrics PICU Fellows Orientation: Session focused on central line Central Line Sandrijn van Schaik, Fellows access and airway management, including chest tube insertion Manikin, pediatric Department of Pediatrics with a custom-made trainer intubation Teaching Scholars Program: Tour of Clinical Skills education and Simulation Center with SP encounter training and simulation case demonstration. Manny Pardo, Department Faculty Transitional Clerkship 2009: procedures skills training and practice to develop critical care skills focusing on CPR airways management; suturing, Phlebotomy & IV placement; Arterial puncture. IV arms, ABG, Little Anne CPR manikins Anna Chang. Foundations OSCE (Objective, structured, clinical exercise): with SP interview, Physical exam, feedback and assessment Carrie Chen, Foundations Clinical Performance Exam: Mini CPX 1: students work in groups of three. Each student interviews a SP while the other two students observe in the room, filling out checklists and preparing their own feedback to give to their peer. After a feedback session with peers, the SP, and a clinician faculty, the three students rotate to a different SP, and the next student takes the role of interviewer. Karen Hauer, Department of Clinical Performance Exam: Mini CPX 2: students will see three patients independently in a clinic setting and receive feedback on your clinical skills directly from the patients. There will also be a teaching session with faculty after the encounters. Karen Hauer, Department of Clinical Performance Exam: CPX Exam: is a high stacks exam for all UCSF students at the end of the core clerkships. Karen Hauer, Department of FPC: Medical History Taking: lecture with a SP interview during the lecture. Anna Chang, Foundations FPC: Communications: formative learning with a SP including feedback. Anna Chang, Foundations FPC: Integrated Exercises: Back pain; Abdominal; Pulmonary; Cardiovascular; with a SP interview, physical exam and feedback. Anna Chang, Foundations