THE ACUTE CRISIS TRAINING WITH SIMULATION (ACTS) PROGRAM

THE PROGRAM RESOURCES

Course Materials:

JUNIOR DOCTOR 2018-19 Manual

STUDENT MANUAL

ACTS COURSE SLIDES

PUBLICATIONS FROM THIS PROGRAM

Non Technical Skills:

THE TEAM

RESOURCE MANAGEMENT

COMMUNICATION

Related Podcasts:

ANAPHYLAXIS

 SEPTIC SHOCK

Clinical Skills Handouts:

BLOOD GASES

ALTERED MENTAL STATE 

ARRYTHMIAS

BRADYCARDIA AND PACING

DEFIBRILLATION USING ‘COACHed’

ECG

HYPOTENSION

LIFE SUPPORT – SPECIAL CIRCUMSTANCES

SOB TOPICS

Since its establishment in 2012, Westmead’s Simulated Learning Environment for Clinical Training’ (SiLECT) has been providing courses to address the need for acquiring skills in Crisis Management.

SiLECT is directed by Dr Gerri Khong FRANZCA.

Our other 2018 faculty include Sandra Warburton, Nathan Moore, Andrew Coggins and Giles Miller.  Our Simulation fellows this year are Rochelle, James and Tom.

Our courses focus on the latest teaching in advanced life support, local clinical guidelines and the management of common emergencies.  Furthermore, we will openly discuss how to apply our skills in real life “Crisis” situations and look at some of the common issues with working in teams such as communication.

Our courses will also be offered to Medical Students in a modified form and be known as “Introduction to Life Support (ILS)“.

Early acquisition of non-technical skills using a blended approach to simulation based medical education

For the Junior Doctor real-life clinical experience in the wards is second to none in terms of professional development.  However, for training to manage time critical emergencies simulation has an increasingly important role.  Simulation is especially useful for applying skills, developing communication and effective teamwork.  The traditional ‘bigger’ simulation courses (e.g. ALS and ATLS) are important but so are regular “bite sized” experiences (e.g. in-house team training).

Access to simulation courses along with everyday reflective practice help develop the Junior Doctor’s ‘Crisis Management‘ skills.  Further brief simulations may help refresh these skills. A combination of formal/longer courses and brief or in-situ simulation are probably the best way to maintain important but rarely used skills.

With more interns than ever being trained in Australian hospitals (and in turn our trainees having less and less responsibility) we have an educational challenge. Regular simulation may help our junior doctors prepare to look after deteriorating patients.

Single Simulations v ‘Loading’ Dose with Regular Follow up

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Many institutions such as Stanford and UCLA are running ‘bootcamp‘ style programs based around the “just in time” and “last minute” readiness for internship concept.

At Westmead we aim to get our junior doctors through a newly refined ACTS program (4 hours) with weekly refresher sessions (1.5 hours for 6 Participants) on Wednesday (and some Thursday) afternoons:

What should you expect at an ACTS course or STAR program?

Above all the courses will be interactive and fun to attend.

Expect faculty to support your learning in a comfortable, ‘safe‘ and private environment.

During the full 4-hour “ACTS” course we will learn together using short case based discussions (no ‘death by power-point’) and through facilitated patient simulations.

While there will be no ‘formal assessment’, participants are expected to familiarise themselves with the selected pre-reading materials to get the most out of their allocated training time.

Faculty Objectives

• Ensure Participant Safety and Satisfaction
• Advance Patient Safety at Westmead Hospital and beyond

 Participants Objectives for the Overall Program

• Discuss when to call for help and who to call – Medical Emergency Teams (MET), Patient Activated Criteria for Escalation (PACE) and Advanced Life Support (ALS) Calls.
• Describe the Management of Common Medical Emergencies
  • Describe the use of a systematic approach in assessment of the deteriorating patient (A-G assessment)
  • Demonstrate Basic Life Support (revision)
  • Discuss Advanced Life Support Skills (an introduction)
  • Demonstrate ECG and Arrhythmia Interpretation
  • Discuss Arterial Blood Gas analysis
  • Demonstrate the Use of Checklists and Cognitive
• Discuss Working effectively Interdisciplinary Teams
  • Demonstrate effective Teamwork and Communication
  • Understand the concept of Crew Resource Management (CRM) and ‘Human Factors’
  • Demonstrate Safe Handover with appropriate brevity
  • Use of an I.S.B.A.R. handover
• Discuss the Local Guidelines for Common Emergencies
  • Describe the ‘Criteria for Escalation’ (MET, PACE and ALS calls)
  • Discuss Myocardial Infarction (e.g. STEMI) – this requires an immediate ALS Call at Westmead Hospital
  • Describe the Management of Acute Respiratory Distress (a leading indication for ALS calls)
  • Discuss Septic Shock – “Recognition, Resuscitate and Refer” (a leading indication for ICU admission)

We thank HETI for their past support and collaboration:  

The HETI JMO team provided funding support for the 2015 programs.