Cardiac Tamponade: Innovative Sternotomy Simulation Model for Training Pediatric Cardiac Intensive Care Team

Introduction: Cardiac tamponade occurring after cardiac surgery is rare but life threatening and requires simultaneous resuscitation and emergent sternotomy by the intensive care team. A simulated scenario using innovative mannequin with sternotomy wound has the capability of reproducing cardiac arrest associated with postoperative tamponade. We evaluated the face validity of this innovative mannequin, the confidence level and crisis resource management skills of the team during sternotomy to manage postoperative cardiac tamponade. Methods: The simulation case scenario was developed using innovative sternotomy mannequin for children’s hospital cardiac intensive care unit (CICU) teams. The case involved a 3-year old male, intubated, mechanically ventilated after surgical repair of CHD, progressing to cardiac arrest due to cardiac tamponade. We conducted a structured, video debriefing following each scenario. We conducted a formative learner assessment before and after each scenario and analyzed the data using student t-test. Results: Of the 72 CICU providers, a statistically significant proportion of providers (p \u3c 0.0001) showed improved confidence in assessing and managing cardiac arrest occurring following postoperative cardiac tamponade. All the providers scored ≥ 3 for impact of the scenario on practice, teamwork, communication, assessment skills, improvement in CPR and opening the chest and their confidence in attending similar clinical situation in future. Most (96–100%) scored ≥ 3 for perception on realism of mannequin, the scenario, re-opening the sternotomy and level of stress. Conclusions: Innovative adaptation of a high-fidelity mannequin for cardiac tamponade simulation can achieve a realistic and reproducible training model with a positive impact on multi-disciplinary team training

Assessment of teaching curriculum in anaesthesiology for undergraduate medical students- A questionnaire based cross sectional study

Background of the study:The life- saving skills like airway management,artificial ventilation, establishing an intravenous access along with fluid management and oxygen therapy devices are clearly taught by fellow Anesthesiologists in a simple manner to theundergraduate medical students. As a medical teacher it is very important to assess the students’ fund of knowledge, procedural skills, interest in learning and systems based approach in a periodical manner. Aim and objectives:To establish the insight about Anesthesiology to theundergraduate medical students and periodical assessment at the end of clinical posting. Materials and methods: The second part of III MBBS students (a total of 99 students) were enrolled in our study. A formulated teaching module was followed during their posting in our Anesthesiology department. At the end of clinical posting feedback was obtained from the students using questionnaire consisting of six questions. The data were analyzed using appropriate statistical methods Results:All the students who were enrolled in our study responded that the posting was interesting. 85% of students have told the practicaldemonstration was adequate and gave an insight into the subject of anesthesiology. 50% of the students felt that the period of posting was inadequate. 22 students gave some suggestions to improve our teaching curriculum. The top most suggestions from our study were extended duration of posting and more practical demonstration with hands on training