Acting Intern On-Call Simulations

Abstract

OPEN ACCESSJanuary 11, 2012Acting Intern On-Call Simulations Norman Benjamin Fredrick, MD Norman Benjamin Fredrick, MD Pennsylvania State University College of Medicine Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.9076 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractThis resource provides instructors with three clinical scenarios for use in a simulation lab. The three cases are intended to be used by fourth-year medical students on their acting internship (subinternship) rotation. The cases all feature inpatient adults with acute undifferentiated complaints. The purpose of the cases is to provide acting interns with a realistic experience of fielding floor calls on their own until backup help arrives. Because the simulations run for only 10 minutes before backup appears, acting interns are placed in a position of having to assess a patient's acute complaints, order tests, and manage the undifferentiated issue. In this capacity, they are challenged to make clinical decisions on their own that have consequences for the patient. Through these experiences, acting interns develop a discomfort with having to make time-pressured patient-management decisions. This discomfort is useful in motivating them to develop personal learning objectives related to assuming increased clinical responsibility of patient care.Students routinely find this to be a valuable experience, albeit uncomfortable. They regularly report that they have never had this kind of experience before and did not realize what it would feel like to be an intern on call. The students also realize the need to begin view medical conditions from a new perspective, namely, that of having to manage patient care. They are forced to step outside the observer role they typically assumed in third year. As an intern on call, they need to know medication names, doses, and routes of administration. For example, they realize that while they may know about atrial fibrillation, they have not paid attention to the management of an acute episode. Educational Objectives By the end of these simulation cases, learners will be able to: Demonstrate increased assumption of clinical responsibility for patient care, similar to the responsibilities of an intern on call.Demonstrate advanced clinical thinking, including the independent development of differential diagnoses, evaluation, and management plans appropriate to the clinical scenarios.Appraise their decision-making skills in the initial management of patients with acute-onset undifferentiated problems.Recognize the importance of good communication during patient handoff at sign-out.Properly evaluate the acute issue by obtaining an adequate history, performing targeted physical exam, reviewing the sign-out sheet, and correctly interpreting vital signs, lab results, EKG, and chest X-ray.Prioritize diagnoses, develop an action plan, and commit to a course of action to stabilize the patient. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Simulation Instructor's Guide.doc Nurses Responses for All Three Cases.doc Parameters and Guidelines for Simulation Technician.doc Photos of Folder.doc Sign-out Sheet.doc Simulation Set-up and Preparation.doc To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. CitationFredrick NB. Acting Intern On-Call Simulations. MedEdPORTAL. 2012;8:9076. https://doi.org/10.15766/mep_2374-8265.9076 Copyright & Permissions© 2012 Fredrick. This is an open-access article distributed under the terms of the Creative Commons Attribution license.KeywordsActing InternSeizuresSub-InternInternship and ResidencyCongestive Heart FailureEpilepsy Disclosures None to report. Funding/Support None to report. Loading ...