The University of Utah PEM Fellowship offers a robust simulation experience led by Stephanie Spanos, MD.
We view medical simulation as a key part of developing and maintaining resuscitation and teamwork skills. As such, all of our fellows participate in the Intermountain Simulation Facilitator Course. This 3-day course prepares participants to become leaders in teaching advanced resuscitation skills. Our fellows learn Crisis Resource Management Skills, optimizing team dynamics, and critical event debriefing strategies that will help them throughout their career. Our fellows have applied these skills in a variety of settings such as developing critical care curriculums, preparing trainees for global health rotations, teaching conflict management techniques, optimizing medical team dynamics, doing outreach education to general emergency departments, outreach education to tribal, rural, and underserved areas, and preparing pediatric residents for office based limited resource emergencies.
In addition to this unique training opportunity, our fellows participate in a variety of simulation experiences throughout their fellowship:
- PEM Division Simulations: These simulations provide the opportunity to work with a full team of ED nurses, techs, faculty, and respiratory therapists to optimize team dynamics and practice pediatric resuscitations.
- Fellow Driven Simulations: PEM fellows design simulations to prepare themselves and their colleagues to face clinical situations that they find challenging and learn how to overcome those clinical challenges with optimal team dynamics.
- High Stakes, Low Frequency Simulations: These simulations prepare fellows and faculty to confront high stakes, low frequency scenarios and focuses on preparing fellows to have an action plan for these situations while at the same time improving individual and team performance through Crisis Resource Management Principles. Simulations cover medical and trauma emergencies and include associated procedure training. We review our algorithms and literature review to assure care for these patients is maximized. Examples include obstetric, newborn, neonatal cardiac, massive transfusion protocol, burns, difficult airways, variety of trauma, ENT, and adult emergencies.
- Critical Procedures Practice: PEM physicians must be competent to perform critical resuscitation procedures emergently. CPP allows faculty and fellows the opportunity to learn, practice, and build competency. The procedure lab includes trauma chest tube placement, pleural catheter chest tube placement, needle thoracentesis, pericardiocentesis, IV/IO/CVL access, ultrasound guided vascular access, ultrasound techniques, difficult airway interventions (video assisted laryngoscopy, direct laryngoscopy, accessory tools), needle cricothyrotomy, surgical cricothyrotomy, and much more. Orthopedic procedure lab allows practice with knee aspiration, fractured pulseless SCF reduction, anterior and posterior elbow dislocation reduction, anterior and posterior shoulder dislocation reduction, relocation of fractured or dislocated toes and fingers, forearm fracture reduction, relocation of a posterior hip dislocation, and splinting techniques.
Fellows are supported to pursue simulation educational and research opportunities. Examples include algorithm development, curriculum development, outreach education globally, locally, and to our surrounding states to a variety of learners. Educational and research opportunities also include hospital staff, medical students, residents, fellows, and faculty. Fellows are supported to pursue their interests and their desired learning targets.