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SIMULATION CASEBOOK - MyCourses

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Gilbert Program in Medical Simulation<br />

Simulation Casebook<br />

Harvard Medical School Draft of the 1 st edition (2011), updated 3/2/12<br />

Pulmonary Embolism<br />

I. Target Audience: Medical Students, Residents<br />

II.<br />

Learning and Assessment Objectives<br />

Participants are expected to understand the scientific and humanistic issues underlying the disease<br />

assessment and treatment plan, and to critically consider and deploy the therapeutic options described<br />

Participants should provide a concise presentation of the patient to each physician consultant who<br />

participates in the exercise. Debriefing sessions by on-site clinical faculty is essential to discuss critical<br />

thinking and knowledge pathways, and to provide a forum for individual and team reflection on learning<br />

and practice goals. While the case descriptions are written with medical terminology, it is important that<br />

the provider and patient (i.e. the simulator) engage in authentic dialogue with lay terminology to reflect<br />

an actual patient encounter<br />

Critical Actions Checklist:<br />

DONE CRITICAL ACTION<br />

Telemetry monitoring<br />

Patient history<br />

Physical examination<br />

Supplemental O 2<br />

IV Access<br />

Obtain laboratory studies: cbc, chemistries, troponin, coagulation studies<br />

Obtain imaging: chest xray, Chest CT angiogram<br />

Administer anticoagulant<br />

III.<br />

Environment<br />

A. Simulation room set up: Part I in emergency department, Part II on medical floor or<br />

emergency department<br />

B. Manikin set up:<br />

1. High fidelity patient simulator<br />

2. No moulage needed<br />

3. Lines needed<br />

C. Props:<br />

1. Code blue cart<br />

2. Lab values (see Appendix A)<br />

3. Images (see Appendix B)<br />

D. Distracters: none<br />

IV.<br />

Actors<br />

A. Nurse: facilitate scenario<br />

B. Consultants (optional for higher level residents who can provide interpretation on their<br />

own)<br />

1. Radiologist: reads chest x-ray<br />

2. Cardiologist: reads ECG, recommends treatment plan<br />

42

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