M. T. FLANNERY, S. ZAHORSKY
OPEN ACCESS
Another area for investigation is monitoring outcome mea-
surements which should be undertaken as a part of the quality
review process. This would be applicable not only to the quality
of the simulation training but the study of the evidence that may
support improved patient outcomes. It would seem reasonable
to this author that some basic ACLS and medical emergencies
are on a continuum from the student’s clinical UME to their
GME experiences. These basic skills can then be further rein-
forced during their residency training. Certain procedures, such
as central venous line placement, thoracentesis, paracentesis,
arthrocentesis and lumbar puncture can be practiced in the si-
mulation lab at the beginning of their PGY1 year and then re-
peated at the end of the year before approval to do such proce-
dures independently as a PGY2 supervisor. This would be ac-
complished via faculty participation at key points and during
the debriefing process. In between, ongoing checklists can be
utilized on real patient procedures to insure procedures that are
done correctly and minimize error and stress. Future studies are
necessary to determine how many procedures need to be ac-
complished for each given resident with minimal numbers set
between 6 - 10 based on prior studies before advancing to the
PGY2 year and perhaps higher prior to graduation. Obviously,
some residents may need additional training in specific clinical
dilemmas or procedures so one number does not equal compe-
tency for all.
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