Board 258 - Program Innovations Abstract Implementing a Simulation- ased Curriculum for On-Unit Use

Abstract

Introduction/Background The University of Michigan Department of Obstetrics planned to institute a new classification system for cesarean section urgency. Specific protocols for paging clinical teams when an urgent or emergent event occurs do exist but compliance had been inconsistent and there was little shared understanding of the levels of urgency. Recent adoption of a more defined prioritization scheme for urgency led to the need to educate our clinical staff of the new protocols. These protocols included specific definitions for urgent, emergent, add-on and scheduled cases. We designed and implemented a program to educate a large number of learners from multiple disciplines in a short time interval about these levels of urgency and the requisite paging protocol for each level of urgency. Our secondary goal was to introduce faculty and staff to the use of in-situ simulation. Methods A curriculum was designed with a three-pronged approach: 1) Web based educational model, 2) On-unit simulations and 3) Evaluation for sustainability. A web based power point presentation was created that reviewed each of the new urgency classifications. All participants were instructed to complete the module, which included a post-test evaluation. A simulation curriculum was created with 12 cases representing clinical cases for each of the 4 categories. Over a six month period, bi-weekly simulations were run with participants from Obstetrics, Anesthesia, Nursing and OR staff. Debriefing exercises were performed to address agreement on the level of urgency, the use of simulation for learning a new protocol and attitudes toward the new paging protocol. Participants included faculty, residents, nurses and scrub technicians from the both obstetrics and anesthesia (N=72). The level of agreement in urgency for emergent vs. urgent cases was congruent (p<0.000, t-test). Overall, simulation was rated a valuable activity. (See Table 1). The new paging system overall was rated as positive. (See Table 2) Results: Conclusion A simulation-based curriculum can be used to educate a large multidisciplinary team to a new protocol. The University of Michigan successfully used a simulation–based curriculum prior to a policy change as a means of reaching all members of the team. For many participants, this was their first simulation experience. For all participants, this was their first exposure to in-situ simulation. Overall both the use of simulation and the attitude toward the new paging protocol was positive. After completion of all faculty participation (this program continued beyond the six month study period), the University of Michigan Department of Obstetrics and Gynecology has made participation in obstetric simulations a mandatory requirement for maintenance of privileges. Simulation was a useful tool to publicize the policy change and educate participants through hands on, in-situ learning. This program innovation can serve as a means to implement new protocols across disciplines. Disclosures None.