Practice makes perfect, or so the saying goes.
Educators within the division of pulmonary, critical care and sleep medicine further adopted that philosophy in July with a mini boot camp for new fellows, designed to build skills and facilitate patient safety before new fellows perform the first procedures of their training.
Joyce LaClair, fellowship program coordinator for the division, says that with the increase in requirements through the Accreditation Council for Graduate Medical Education, UC educators decided to enhance the training with simulation exercises.
"We partnered with Dr. Jonathan Bishop, medical director of UC’s Center for Sustainment of Trauma and Readiness Skills (C-STARS) and critical care trained pulmonologist, and gained access to cadavers and simulation resources within the center so that new fellows could practice intubation with laryngoscopy—an examination doctors use to look at the back of the throat—and various critical care procedures prior to performing procedures on live patients,” she says.
She adds that fellows also worked with Renee Hebbeler-Clark, MD, an assistant professor in the division of infectious diseases and critical care medicine and an expert in medical simulation, to conduct ultrasounds on real patients in the intensive care unit.
"These hands-on experiences took place in the first weeks of fellowship,” she says, adding that fellows were also given presentations from Jack Rubinstein, MD, in cardiovascular diseases, and pulmonologist Peter Lenz, MD, fully immersing them in their newly chosen multidisciplinary specialty.
Fellow Vishal Jivan, MD, said this program was a great introduction to the specialty and the work he will be doing over the next year.
"It was reassuring to be able to go through each procedure that we will encounter so we are confident and comfortable doing them on our patients,” he says. "It's like a past, present and future glance of medicine: We get the basics as well as the current practice and a glimpse of what the future holds, with sessions in advanced bronchoscopy and critical care ultrasound. The lectures were good exposure to what we will encounter every day and will allow us to be prepared for it.”
Lenz says this program was born out of an effort by pulmonologist Jennifer McCallister, MD, at Ohio State University.
"She won a best-practice award from the American Thoracic Society’s Best Practice Recognition for Education for a program she created in Columbus called ‘Pulmonary Mini Med School,’” says Lenz, who is co-director of the program along with Mitchell Rashkin, MD, Hebbeler-Clark and Sadia Benzaquen, MD. "We modeled our boot camp after her efforts and found it to be successful. In addition to the C-STARS simulation and ultrasound experience, the program concluded with a region-wide bronchoscopy course conducted at Ohio State.”
He adds that this program was implemented in only a month but received very favorable responses from new fellows like Jivan, and he hopes to further improve and grow the program next year.
"We hope to expand the ultrasound portion of the boot camp next year and formalize the curriculum so that we can continue to measure and teach clinically relevant objectives,” he says. "I was very pleased with the way that the program ran as well as the collaboration that occurred between specialists in various UC divisions.”
Frank McCormack, MD, a Gordon & Helen Hughes Taylor Chair of Internal Medicine and chair of the division, says this model could be used in other specialties, helping new fellows hit the ground running.
"The energy and experience that Drs. Rashkin and Lenz bring to the pulmonary fellowship is impressive,” he says. "Together with Dr. (David) Norton, director of the Medical Intensive Care Unit at UC Health University Hospital, they are building a culture of safety in the ICU and endoscopy suite that will lead to better outcomes for our patients.”