King Saud bin Abdulaziz University of Health Science College of Medicine - Jeddah Clinical Affairs a Sumulation Center. Simulation Center Manual

Transcription

1

2 King Saud bin Abdulaziz University of Health Science College of Medicine - Jeddah Clinical Affairs a Sumulation Center Simulation Center Manual

3 Table of Content Introdaction 6 Core Value 8 Vision 8 Mission 8 Section I: Simulation Center Facilities 10 Simulation Venues 14 Human Patient Simulators (HPS) 16 Clinical Skills Laboratory 24 Basic Skills 26 Training lab 26 IV/Injection 30 Training Laboratory 30 Airway 34 Managements Lab 34 Harvey Tee 38 Training Lab 38 OB/Gyne/ 40 Urology lab 40 Procedure 46 Training Lab 46 Clinics 50 Section II: Blocks 54 Medical Program (Phase II) 3rd Year 57 Musculoskeletal 64 Respiratory 66 Hematology 74 Cardiovascular 76 Medical Program (Phase II) 4th Year 83 Neurosciences 84 Endocrine, Nutrition & RH 88 Urology and Renal 92 Oncology 96 Gastroenterology 100 Clinical Clerkship Program (Phase III) 5th Year 105 Medicine I 106 Surgery I 114 Pediatrics 122 Clinical Clerkship Program (Phase III) 6th Year 129 Obstetrics & Gynecology 130 Special Sense and Mental Health 134

4 CSC-J FACILITIES Clinical simulation center Jeddah (CSC-J) was established on September It provides a safe experiential learning with hands-on educational activities to medical students to promote successful understanding of clinical education. Introdaction The CSC-J laboratories provide state of art equipment, simulators, and anatomical models which allow medical students to practice basic skills such as recognizing cardiac sounds (i.e. normal and pathologic), suturing, central and peripheral vein access, pelvic exam, prostate exam, etc. prior to entering the clinical setting. These learning experiences are planned and supervised by the Clinical Affairs Department at College of Medicine with help from different clinical departments in king Abdulaziz Medical City-Jeddah. The CSC-J faculty and administration core value is to benchmarking student s clinical experience and enlightening it to serve the best interest of the students. We will attempt to include all environmental factors to make student s learning experience realistic and authentic. 7

5 Clinical Affairs Vision Achieve the global excellence in medical simulation education by providing high quality cutting edge education, multidisciplinary training and assessment to enhance the healthcare and quality patient safety. Mission Clinical simulation center (CSC-J) provides high standard, excellent internationally recognized academic opportunities. Moreover, it focuses on integrated simulation-based medical education through creating safe learning environment, high quality medical research and full commitment in serving community to promote health in the society. Core Value - High Ethical Standards - Relevance - Respect & Culture Sensitivity - Excellence/High Quality - Leadership/ Teamwork & Collaboration - Ingenuity/Scientific Creativity - Integrity - Trust 8

6 CSC-J FACILITIES CSC-J facilities are distributed in three floors (appendix1). 1. Simulation venues 2. Human Patient simulators (HPS) 3. Clinical skills laboratories 4. Clinics Section I: Simulation Center Facilities 11

7 Clinical Affairs CSC-J FACILITIES CSC-J facilities are distributed in three floors (appendix1). Simulation Venues Clinical Skills Laboratory Are in the third floor that include OR recovery rooms, NICU, Adult ICU, in-patient adult, in-patient pediatric, virtual reality room, labor and delivery and. Each venue contains an advanced high fidelities manikins, task trainers, series of medical equipment and diagnostic tools to be used in different simulation scenarios and procedural demonstrations. Located in fourth floor. Each lab contains an advanced task trainers, series of medical equipment and diagnostic tools to be used in different clinical skills procedure. Human Patient Simulators (HPS) Clinics Are distributed in simulation venues. Total of 9 human patient simulators (manikins) are classified into three categories: High fidelity such as siman3g, Simman essential and Noel, Medium fidelity such as mega code Kelly and a nursing Anne, Low fidelity such as CPR airway manikins. 12 Located in the ground floor. There are 21 Clinics comprise Examination tables, Medication trolley, Blood pressure measurement apparatus, Otoscope and Ophthalmoscope to conduct an objective structured clinical examination (OSCE) and sessions that require setting of clinical environment. 13

8 CSC-J FACILITIES The simulation venues are learning environment that are fully equipped to simulate a hospital setting in order to enhance the Simulation Venues setting of clinical situations and simulation scenarios development. Simulations and case scenarios can replicate clinical situations that help learners to develop basic and advance clinical skills and critical thinking strategies. Our simulation venues are fully equipped with all required equipments such as walled oxygen (O2) sources, ventilators and anesthesia machines. They contained also different types of simulators, full body simulators (high, mid, low fidelity for adult, pediatric and pregnant patents) and part task trainers A total of seven simulation venues existed that include all environmental factors to make simulation scenarios realistic and they are: Recovery Room NICU, Room Adult ICU Room In-patient adult Room In-patient pediatric Room Virtual reality Room Labor and delivery Room Operation room 15

9 CSC-J FACILITIES Human Patient Simulators (HPS) High fidelity Human Patient Simulator (HPS) is a realistic, full-body patient simulator that has an advanced clinical functionality to teach the critical skills such as airway, breathing, cardiac and circulating management. The importance of high fidelity (HPS) is that it delivers human physiological recourses that needed to prepare and execute the simulator scenario such as vital signs normal heart and lung sounds and physiological airway A high-fidelity (HPS) is being computerized operated by both educational and simulation technical staff during the session to immerse learners into a realistic clinical setting. 17

10 Clinical Affairs Human Patient Simulator SimMan 3G NOELLE S575 An advanced HPS (Sim man 3G) is a high fidelity manikin that can be used to create various complex Scenarios in order to support training of Basic and Advanced Life Support and help to assess learner s skills based on a realistic clinical situation such as difficult airway management cases, teamwork and communication training. Maternal & Neonatal Birthing Simulators (Noelle) are high fidelity manikins that can be used to deliver the complex labor and delivery scenarios in order to support training for normal deliveries, obstructed complicated labors and neonatal resuscitation. Simman 3G CSC-J storage Leardal High fidelity NOELLE Gaumard S575 High fidelity SimMan Essential HPS (Sim Man Essential) is a high fidelity manikin that can be used to develop a clinical situation to support training of Basic and Advanced Life Support and help to assess learner s skills based on a realistic clinical situation. Sim Man Essential provides same functions that are provided be Sim man 3G accept drugs recognition and Eyes respond to light. Istan Male Patient Simulator Fully mobile patient simulator with advanced physiology and functionality for unlimited training possibilities in patient care, Istan is certified for inflight use abroad major military aircraft Simman Essential Leardal High fidelity Istan CSC-J storage CAE Healthcare High fidelity 18 19

11 Clinical Affairs Human Patient Simulator MegaCode Kelly MegaCode Kid A full-body life-like simulator (MegaCode Kelly) is a med fidelity manikin that is operated via SimPad to display normal and abnormal heart, lung and bowel sounds in order to enhance practice of advanced, difficult and obstructed airway scenarios and IV therapy. MegaCode Kid is a full-body, lifelike manikin. It is specifically designed for training professionals in the practice of emergency care, patient handling and the transportation of the sick and injured, BLS,CPR. MegaCode Kelly Leardal Med fidelity MegaCode Kid Laerdal Med fidelity Nursing Anne Resusci-Anne A full-body, lifelike simulator is a med fidelity manikin that is operated via SimPad to display normal and abnormal heart, lung and bowel sounds in order to teach all skills from basic patient handling to advanced nursing skills Resusci Anne model simulates an adult of average physiology, and is designed for realistic training of basic life support. Nursing Anne Leardal Med fidelity Resusci Anne Laerdal Low fidelity 20 21

12 Clinical Affairs Resusci Junior Resusci Junior is a full Body Pediatric which is designed for realistic child CPR training. Resusci Junior Laerdal Low fidelity Nursing Anne Resusci Baby is a Realistic anatomy of infant that enable learners to obtain competence to deliver quality CPR for infants Nursing Anne Laerdal Low fidelity 22

13 CSC-J FACILITIES Clinical Skills Laboratory The Clinical skills laboratories are fully equipped physical space that provide safe and controlled environment In which learners can practice clinical skills and critical thinking before using them in real clinical settings. Clinical skills laboratories have been developed to support the acquisition, maintenance and enhancement of student s clinical skills in healthcare profession. Clinical skills that can be taught and learned include history taking, teamwork communication skills, physical examination and technical and practical procedures. Clinical skills laboratories include Basic Skills Training lab, IV Injection Training lab, Procedure training lab, OB/ Gynae/Urology Airway training lab and Harvey tee lab. We have Clinical skills laboratories that include Basic Skills Training lab IV Injection Training lab Procedure training lab OB/Gynae/Urology Airway training lab Harvey tee lab 25

14 Clinical Skills Laboratories Basic Skills Training lab Ear examination simulator The Ear examination simulator is a task trainer that simulates ear models and provided with 11 sample cases to support examination training of external acoustic meatus and tympanic membrane with a direct otoscope. Basic Skill Training lab is a learning environment that is fully equipped to enhance Training of Basic clinical Skills such as basic airway management, Ear & Eye examination, Blood Pressure training, Abdominal Palpitation, Breast and chest Examination. Basic Skill Training lab is including the fowling task trainers: 1. Ear examination simulator 2. Eye examination simulator 3. Breast Exam Task 4. Blood Pressure training arm 5. Trainer Abdominal Palpitation Task Trainer, Ear examination simulator Kyoto kagaku M88 Task trainer Eye examination simulator The Eye examination simulator is a task trainer that allows identification of common eye disease and includes 10 slides of fundus finding. Various cases can be set up for trainees using combinations of slides depth and pupil diameter. Ear examination simulator Kyoto kagaku M82 Task trainer 26 27

15 Clinical Affairs Clinical Skills Laboratories Blood Pressure Task Trainer Abdominal Palpitation Task Trainer Adult arm model with electronic trainer that is designed for training the procedure of blood Pressure measurement. Abdominal Palpitation Task Trainer is pregnant torso model which used to educate students the steps of Abdominal Palpitation for Pregnant and for fetal body parts and heartbeat monitoring. Blood Pressure Laerdal Task trainer Maternity Model Type KOKEN LM043 Task trainer Breast exam Simulator The Breast Exam Task Trainer responds to gentle palpation in an extremely lifelike way to be used for training in clinical breast examination technique. Breast exam simulator Limbs and things Task trainer 28 29

16 Clinical Skills Laboratories IV/Injection Training Laboratory Advanced Venipuncture Arm Advanced Venipuncture Arm is a Task trainer that features a closed blood flow system to enhance training of Venipuncture and IV Cannulation and body back flow. IV/Injection Training laboratory is a learning environment that is fully equipped to enhance training for Injection skills and IV Lines insertions such as Central Venous Catheter Insertion, Intradermal Injection, Intramuscular Injection and Arterial Puncture. IV/Injection Training laboratory is including the fowling task training simulators: Advanced Limbs and venipuncture Task trainer things arm Arterial Puncture Task Trainer 1. Intradermal Injection task Trainer 2. Central Venous Catheter Insertion 3. Intramuscular Injection task Trainer 4. Advanced Venipuncture Arm - light (IV Arm), Task Trainer Artery puncture task trainer is model that can be used for arterial puncture procedure to help students to practices for(abg) arterial blood collection procedures AND insertion BP monitoring 5. Arterial Puncture, task Trainer Arterial Puncture Kyoto kagaku M99 Task trainer 30 31

17 Clinical Affairs Clinical Skills Laboratories Central Venous Catheter Task Trainer Intramuscular Injection Task Trainer CVC Insertion Simulator is an efficient training model in central venous catheterization procedures which helps trainees to practice and develop their skills through simulated cases of common complications. Intramuscular Injection Simulator is a task trainer that designed to provide students with the visual and tactile experience needed to learn intramuscular injection techniques. This simulator has landmarks that can be palpated so that the various injection techniques can be practiced. Central Venous Catheter Kyoto kagaku M93UB Task trainer Intramuscular Injection Simulator Nasco LF00961U Task trainer Intradermal Injection Task Trainer Intradermal Injection Training Simulator provides training of intracutaneous injection and allows for pulling of the skin and making punctures as if on a real patient. Intradermal Injection Kyoto kagaku M94 Task trainer 32 33

18 Clinical Skills Laboratories Airway Managements Lab NG Tube and Trach Care Task Trainer The NG Tube and Trach Care Trainer is a lifelike manikin torso, which is specifically designed for training professionals in the practice of basic tracheostomy care, NG tube insertion and basic airway management skills. Airway training lab is a learning environment that is fully equipped to enhance training for training of basic life support techniques and professionals in the practice of emergency care Airway training lab is including the fowling task training simulators. 1. Child ACLS Manikin 2. Adult CPR Manikin NG Tube and Trach Care Trainer Laerdal task trainer Pediatric Intubation Task Trainer 3. Junior CPR Mankin 4. Neonatal Resiscitation Manikin 5. Adult airway management trainer 6. NG Tube and Trach Care (Tracheostomy) Task Trainer It is specifically designed for training professionals in the field of pediatric airway management techniques. 7. Pediatric Intubation task Trainer Pediatric Intubation Laerdal task trainer 34 35

19 Clinical Affairs Airway Management Task Trainer Airway task trainer that allows for basic airway maneuver - bag mask BMV - advanced airway management Adult Airway Management Nasco PP00086U Task trainer 36

20 Clinical Skills Laboratories Harvey Tee Training Lab K Plus Cardio-Respiratory Patient Simulator Training System A clinical skills laboratory that is specified to support training in cardiology and respiratory such as Assessment of jugular vein pulses at 8 sites Identify different components of normal heart sounds Assessment of normal and abnormal heart sounds and murmurs Observation and palpation of apex beat at 3 sites Also, enhance respiratory examination skills Cardiology Patient Simulator K is Educational system that includes respiratory and cardiology torso model to features Cardiology and Lung normal and abnormal Sounds K-Plus Cardiology Patient Simulator Kyoto Kagaku M8481-S Med fidelity 38 39

21 Clinical Skills Laboratories OB/Gyne/ Urology lab Advanced Male Catheterisation Task Trainer Advanced Male Catheterisation Trainer has an accurate anatomy of male urethral and supra-pubic. It allows training of urethral and supra-pubic catheterization and demonstrates self-catheterisation technique to patients. OB/Gyne/Urology training lab is a learning environment that is fully equipped to enhance training of male and female Catheterisation, female pelvis examination, rectal tumors and polyp s diagnosis and Prostate Examination. 1. Advanced Male Catheterisation Trainer 2. Advanced Female Catheterisation Trainer 3. Pelvic Examination task Trainer 4. Rectal Exam Task Trainer 5. Prostate Exam Task Trainer 6. Suprapubic Exam Task Trainer Advanced Limbs and Male Task trainer things Catheterisation Advanced Female Catheterisation Task Trainer Advanced Female Catheterisation Trainer is a task trainer that has an accurate anatomy of female urethral and supra-pubic. It allows training of urethral and supra-pubic catheterization and demonstrates self-catheterisation to patients. 7. Testicular Exam Task Trainer Advanced female Catheterisation Limbs and things Task trainer 40 41

22 Clinical Affairs Clinical Skills Laboratories Clinical Female Pelvic Task Trainer Prostate Examination Task Trainer Clinical Female Pelvic Trainer is a task trainer that provides accurate anatomical and tactile representation of the female pelvis for hands-on examination and diagnosis of pathologies and abnormalities. Prostate Examination Simulator presents a male lower torso to enhance training of prostate examination. Clinical Female Pelvic Limbs and things Task trainer Prostate Examination Nasco LF00901U Task trainer Rectal Exam Task Trainer Suprapubic Exam Task Trainer Digital rectal examination simulator is a task trainer designed for training in differentiation of rectal tumors and polyps Suprapubic simulator is model that support training of bladder examination and Suprapubic catheter insertion. Rectal Exam Kyoto kagaku M92 Task trainer Suprapubic Adam Rouilly AR341 Task trainer 42 43

23 Clinical Affairs Clinical Female Pelvic Task Trainer Clinical Male Pelvic Trainer is a task trainer that features Genitalia including Penis and Scrotum containing testicles with epididymis and vas deferens. It is designed for training of Testicular examination Testicular Limbs and things Task trainer 44

24 Clinical Skills Laboratories Procedure Training Lab Suturing Task Trainer Basic surgical skills kit is suturing items that enable trainees to practice a range of tissue handling in basic and advanced suturing techniques. Procedure training lab is a learning environment that is fully equipped to enhance training of clinical procedure such as, Lumbar Puncture Procedure, Bone Marrow Aspiration, suturing and wound care. Procedure training lab is including the fowling task training simulators: 1. Bone Marrow Aspiration 2. Breast Cancer Task Trainer BSS Day 1 Kit Limbs and Task Trainer Task trainer Things Suture Pads Stoma Care Task Trainer 3. Lumbar Puncture 4. Wound Care 5. Suture Pads (5-Set) 6. Stoma Care Stoma Care Training is a Model that can be used to help taking care of stomach by medical students. Stoma Care B Scientific GMBH W60909 Task trainer 46 47

25 Clinical Affairs Clinical Skills Laboratories Breast Cancer Task Trainer Wound Care Model Breast Cancer model allows medical students the method of breast examination cancer Wound Care Module is a task trainer that features different type of wounds to teach different strategies of wounds bed surgical pressure ulcer care. Breast Cancer Task Trainer Koken LM-018 Task trainer Wound Care VATA VT-910 Task trainer Lumbar Puncture Task Trainer Task Trainer, Bone Marrow Aspiration The lumbar puncture simulator is a model that designed to enhance training in lumbar puncture skills. It allows students to practice the skills frequently to achieve high level of competence. Bone Marrow Aspiration task trainer is a model that support training in infant intraosseous (10) infusion techniques and bone marrow Aspiration Lumbar Puncture Kyoto Kagaku M43B Task trainer Bone Marrow Aspiration Laerdal Task trainer 48 49

26 CSC-J FACILITIES Clinics Simulation center comprise a 21 fully equipped Clinics to conduct an objective structured clinical examination (OSCE). In addition, clinics can be also used to perform session that requires use a clinical setting environment such as diagnosis, procedures history taken, clinical system examination, clinical learning skill, etc. Clinics at simulation center include Examination tables, Medication trolley, Blood pressure apparatus, Otoscope and Ophthalmoscope 51

27 CSC-J FACILITIES FACILITIES IN CSC-J CSC-J is Utilizing its capability to enhance simulation sessions as part of COM-J curriculum. CSC-J s capability is addressing the needs of each block of COM-J curriculum in a way that simulation can be effectively implemented and linked appropriately to student learning outcomes. Section II: Blocks CSC-J is Integrating Simulation throughout the sequential blocks of the curriculum that are categorized in two phases. 53

28 Clinical Affairs CSC-J FACILITIES COM - J Curriculum - Medical Program (Phase II) - Clinical Clerkship Program (Phase III) 3rd Year 4th year 5th year 6th year Foundation Studies Neurosciences Medicine I Medicine II Musculoskeletal Endocrine, Nutrition & RH Surgery I Surgery II Respiratory Hematology Urology & Renal Oncology Family & Community Medicine Obstetrics & Gynecology Cardiovascular Gastroenterology Pediatrics Special Sense and Mental Health 54 55

29 Medical Program (Phase II) 3rd Year

30 Foundation Block Venues Clinical Skill Lab Clinics Recovery room Adult In patient room Operation room Procedure lab Basic skill lab OB/GYNE, Urology lab Can be in all clinics SimMan 3G Physical Examination (Cardiovascular examination, Respiratory Examination and Abdominal Examination). BP measured manually by auscultation of Korotkoff sounds. Detect Pulses (Carotid, brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibialis pulses) synchronized with ECG. Normal and abnormal body sounds (Heart, Lung, and Bowel). Foundation Block SimMan Essential Physical Examination (Cardiovascular examination, Respiratory Examination and Abdominal Examination). Normal and abnormal body sounds (Heart, Lung, and Bowel). BP measured manually by auscultation of Korotkoff sounds. Detect pulses (Carotid, brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibialis pulses) synchronized with ECG. 59

31 Clinical Affairs Foundation Block MegaCode Kelly Physical Examination (Cardiovascular examination, Respiratory Examination and Abdominal Examination). Bilateral carotid pulse. Measurement of Noninvasive Blood Pressure. Normal and abnormal Heart, Lung and Bowel sounds. Cardiology patient simulator Comprehensive clinical cardiovascular examination. Normal and abnormal Heart sound (Auscultation at four primary cardiac areas: mitral, tricuspid, pulmonary and aortic). Demonstrate respiratory sound. Nursing Anne Basic patient handling. Measurement of Noninvasive Blood Pressure. Physical Examination (Cardiovascular examination, Respiratory Examination and Abdominal Examination). Auscultation and recognition of normal and abnormal (Heart, Breath and Bowel sounds). Lung sound auscultation trainer Comprehensive Respiratory Examination. Perform many different lung sounds with and without heart sound anteriorly and posteriorly (Lung sounds can be specific per lobe). Blood Pressure Training Arm Allow blood pressure training. Systolic, diastolic, heart rate and auscultator gap programmable. Representation of both systolic and diastolic pressures. Ear examination simulator Allow training in the examination of the external acoustic meatus and tympanic membrane. Learn how to use otoscope. Learn how to differentiate different ear problem. Training in Ear wax and foreign body removal

32 Clinical Affairs Equipment Sphygmomanometer BP measured manually Equipment Vital Signs machine Can measure Vital Signs & blood pressure automatically Equipment Scrub Zink For detail scrub technique, gloving & sterility Equipment Scrub Zink For detail scrub technique, gloving & sterility 62

33 Musculoskeletal Venues Clinical Skill Lab Clinics Can be in all Venues Can be in all Labs Can be in all clinics Musculoskeletal Cae Istan Male Patient Simulator circulation : femoral,popliteal, carotid and brachial pulse cyanosis on fingers and toes central iv line insertion airway management: mechanical ventilation support simple and advanced airway (Surgical and needle cricothyrotomy) Bilateral chest tube insertion CPR Defibrillation and cardio version using live defibrillators Can be used for joint examination( fully articulated movement in the wrists, elbows, knees and ankles) Wound Care Model Proper management of different stages of pressure ulcers. 65

34 Respiratory Venues Clinical Skill Lab Clinics Adult In patient room Adult ICU room Operation room Recovery room Procedure lab Basic skill lab CPR/ACL/Airway lab Can be in all clinics Respiratory SimMan 3G The airways can be manipulated by a learner: Head tilt/chin lift Jaw thrust w/articulated jaw Cricoid pressure and manipulation Suctioning (oral & nasopharyngeal) Ventilation method: Bag-mask ventilation Laryngeal mask air way Orotracheal intubation Nasotracheal intubation Transtracheal intubation Endotracheal intubation Breathing: Normal and abnormal breath sounds Patient Monitor Features Breathing SpO2 Airway respiration rate (awrr) End-tidal CO2 (etco2) End-tidal O2 (eto2) ino2 ph 67

35 Clinical Affairs Respiratory SimMan Essential The airways can be manipulated by a learner: Head tilt/chin lift Jaw thrust w/articulated jaw Cricoid pressure and manipulation Suctioning (oral & nasopharyngeal Ventilation method: Bag-mask ventilation Laryngeal mask air way Orotracheal intubation Nasotracheal intubation Transtracheal intubation Breathing: Normal and abnormal breath sounds Patient Monitor Features Breathing SpO2 Airway respiration rate (awrr) End-tidal CO2 (etco2) End-tidal O2 (eto2) ino2 ph MegaCode Kelly Airway Management Skills: Obstructed airway Endotracheal intubation Nasotracheal intubation Oropharyngeal airway insertion Nasopharyngeal airway insertion Bag Valve Mask Light wand intubation Laryngeal Mask Airway insertion Laryngeal Tube Insertion Combitube insertion Trans-Tracheal Jet Ventilation Suctioning techniques Stomach auscultation to verify proper airway positioning Auscultate normal and abnormal Lung sounds 68 69

36 Clinical Affairs Respiratory Nursing Anne Oral nasal intubation Eye and ear irrigation Tracheostomy care and suctioning Oxygen delivery procedures Auscultation and recognition of normal and abnormal breath sounds. Cardiology patient simulator Respiratory clinical examination training. Demonstrate respiratory sound with and without cardiac sounds Equipment Spirometer NG Tube and Trach Care Trainer Tracheostomy care Tracheal suctioning Oropharyngeal and nasopharyngeal airway insertion and suctioning Endotracheal tube insertion securing and care Equipment Airway Management Task Dinamap Basic airway management Advanced airway management 70 71

37 Clinical Affairs Ear examination simulator Allow training in the examination of the external acoustic meatus and tympanic membrane Learn how to use otoscope Learn how to Differentiate different ear problem Training in Ear wax and foreign body removal Lung sound auscultation trainer Comprehensive Respiratory Examination Perform many different lung sounds with and without heart sound anteriorly and posteriorly (Lung sounds can be specific per lobe) 72

38 Hematology Venues Clinical Skill Lab Clinics Adult In patient room Procedure lab Basic skill lab Can be in all clinics Advanced Venepuncture Arm Hematology Intravenous Cannulation and Venipuncture Venepuncture IV Cannulation Anatomically veins location Vacuum blood collection 75

39 Cardiovascular Venues Clinical Skill Lab Clinics Adult In patient room Adult ICU room Procedure lab Basic skill lab Can be in all clinics SimMan 3G Cardiovascular Extensive ECG library, pulses from Heart sounds - for every anterior location. ECG rhythm monitoring (4-connector, 3-lead ECG). 12-lead ECG display. Pacing. Defibrillation and cardio version using live defibrillators. BP measured manually by auscultation of Korotkoff sounds. Pulses: (Carotid, brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibialis pulses synchronized with ECG). CPR. 77

40 Clinical Affairs Cardiovascular SimMan Essential MegaCode Kelly Extensive ECG library, pulses from Heart sounds - for every anterior location. ECG rhythm monitoring (4-connector, 3-lead ECG). 12-lead ECG display. Pacing. Defibrillation and cardio version using live defibrillators. BP measured manually by auscultation of Korotkoff sounds. Pulses: (Carotid, brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibialis pulses synchronized with ECG). CPR. 3 4 lead ECG. Pacing with variable threshold, with or without capture capabilities ( joules). Pulses: Bilateral carotid pulse. Brachial and radial pulses. Measurement of Noninvasive Blood Pressure. Heart sounds synchronized with ECG. Nursing Anne Cardiology patient simulator Measurement of Noninvasive Blood Pressure. Auscultation and recognition of normal and abnormal heart sound. Comprehensive Cardiovascular clinical examination training. Normal and abnormal Heart sound (Auscultation at four primary cardiac area mitral, tricuspid, pulmonary,aortic). S1 and s2 auscultation in relation to synchronized ECG, arterial pulsation, JVP. Palpation of cardiac impulses (RT ventricle, LT ventricle, dilated left ventricle). Palpation of arterial pulsation (At carotid, radial, femoral arteries). Arrhythmia can be simulated by palpation. Monitoring screen: (ECG, JVP, CAROTID ARTERIAL PULSE, and APEX CARDIOGRAM)

41 Clinical Affairs Cardiovascular Equipment Lung sound auscultation trainer erform many different heart sounds with and without lung sounds. ECG monitoring Resusci Anne Used in training of CPR skills using AED. Blood Pressure Training Arm Allow blood pressure training. Systolic, diastolic, heart rate and auscultator gap are programmable. Representation of both systolic and diastolic pressures

42 Medical Program (Phase II) 4th Year

43 Venues Clinical Skill Lab Clinics Adult In patient room Operation room Adult ICU room Recovery room Procedure lab Can be in all clinics Neurosciences SimMan 3G Immobilization Techniques for Traumatic Spinal Cord Injury Perform physical assessment to judge the state of cord injury through advance configurations. Perform proper techniques in immobilizing the patients with cord injury. Perform proper way of transferring patient (e.g ground to spine board). Proper application of supportive equipment (e.g splints, neck collar). Epilepsy and Seizure Management Perform initial intervention of patients under epilepsy or seizure to prevent injury or fall Perform necessary medical management such as: - Administration of medication (e.g Diazepam). - Perform re-assessment that s prompts further medical interventions in scenarios such as; Recurrence of epilepsy or seizure attack. Management to prevent aspiration of secretion. Stabilization of patient after the attack. Providing prompt safety to the patient. Assessment of Level of Consciousness Glasgow Coma Scale Glasgow Coma Scale score for the Patient Case is calculated though automatic or manual mode LLEAP configurations. Sources of information help the learner to judge the state of disability such as: Eyes Blinking eyelids. Eyelids: open, closed or partially open. Eyelids can be opened for examination by the learner. Pupil dilation: constricted, dilated or in between. Pupillary accommodation. Synchrony / asynchrony. Normal and sluggish speed of response. Neurological Mental State Examination Perform MSE through by observing the manikin current state of mind (configurations), under the domains of appearance, attitude, behavior, mood, 85

44 Clinical Affairs Neurosciences SimMan Essential Immobilization Techniques for Traumatic Spinal Cord Injury Perform physical assessment to judge the state of cord injury through advance configurations. Perform proper techniques in immobilizing the patients with cord injury. Perform proper way of transferring patient (e.g ground to spine board). Proper application of supportive equipment (e.g splints, neck collar). Lumber puncture simulator Palpation of lumbar anatomy landmarks Lumbar Puncture and CSF Collection Nursing Anne Immobilization Techniques for Traumatic Spinal Cord Injury Perform physical assessment to judge the state of cord injury through advance configurations. Perform proper techniques in immobilizing the patients with cord injury. Perform proper way of transferring patient (e.g ground to spine board). Proper application of supportive equipment (e.g splints, neck collar). Eye examination simulator Direct Ophthalmoscopy, Visual Fields and Acuity Examination Direct eye examination Identify different cases of eye abnormality

45 Endocrine, Nutrition & RH Venues Clinical Skill Lab Clinics Adult In patient room Recovery room Adult In patient room Adult ICU room Procedure lab Basic skill lab OB/GYNE, Urology lab Can be in all clinics Eye examination simulator Review of Ophthalmological Clinical Skills Direct eye examination Identify different cases of eye abnormality. Endocrine, Nutrition & RH Clinical Female Pelvic Traine Vaginal Examination & Pap Smear Recognition of perineal and pelvic anatomy including bony landmarks. Digital vaginal examination Cervical smear procedure (including use of speculum) 89

46 Clinical Affairs Intramuscular Injection Simulator Intramuscular & Subcutaneous Injections Intramuscular injections for Gluteus, Ventrogluteal, Vastus Lateralis muscles. Assessment of landmarks for proper techniques in intramuscular injections 90

47 Urology and Renal Venues Clinical Skill Lab Clinics Adult In patient room Procedure lab Basic skill lab OB/GYNE, Urology lab Can be in all clinics Clinical Female Pelvic Traine Genital examination procedure Testicular examination Rectal examination of the prostate Urology and Renal Digital rectal examination simulator Techniques in rectal examination. Differentiation of rectal diseases of palpation Palpation of normal prostate or endo cervix. Rectal palpation (i.e 7 cm depth) 93

48 Clinical Affairs Advanced male catheterization trainer Advanced Catheterisation Trainer Correct handling of male and female anatomy Aseptic catheterisation technique Catheter placement for male and female. Fluid management. Withdrawal of catheter. Intermittent self-catheterisation (ISC) (used with the optional Self-Catheterisation Stand) Suprapubic catheter insertion and catheter management (using Suprapubic Bung) Advanced Female Catheterisation Trainer Advanced Catheterisation Trainer Correct handling of male and female anatomy Aseptic catheterisation technique Catheter placement for male and female. Fluid management. Withdrawal of catheter. Intermittent self-catheterisation (ISC) (used with the optional Self-Catheterisation Stand) Suprapubic catheter insertion and catheter management (using Suprapubic Bung) 94

49 Oncology Venues Clinical Skill Lab Clinics Recovery room Adult In patient room Operation room Adult ICU room Procedure lab Basic skill lab OB/GYNE, Urology lab Can be in all clinics SimMan 3G Managing Cancer Pain Simulate patients who are in pain. Performed Therapeutic Communications Administration of Pain and Anti-Cancer Medications Oncology Nursing Anne Clinical Assessment in Women with Breast Cancer / Breast Examination / Introduction to Mammograms Recognition of breast disorders, their sizes and relative locations With breast exam module, with unchangeable abnormalities. 97

50 Clinical Affairs Clinical Female Pelvic Traine Managing Cancer Pain Examination and diagnosis of pathologies and abnormalities Task Trainer, Breast Exam Clinical Assessment in Women with Breast Cancer / Breast Examination / Introduction to Mammograms Inspection and Palpation of Breast cancer. 98

51 Gastroenterology Venues Clinical Skill Lab Clinics Adult In patient room Procedure lab IV lab Can be in all clinics SimMan 3G Perform abdominal Examination IV infusion into peripheral veins (Right Arm ) Bowel sounds Manegment UGb Gastroenterology SimMan Essential Perform abdominal Examination IV infusion into peripheral veins (Right Arm ) Bowel sounds 101

52 Clinical Affairs MegaCode Kelly Perform abdominal Examination IV infusion into peripheral veins (forearm, antecubital fossa and dorsum of the hand) Bowel sounds Nursing Anne NG Tube insertion, care medication administration and removal,lavage/ Gavage IV care and management Ostomy irrigation and care 102

53 Clinical Clerkship Program (Phase III) 5th Year

54 Medicine I Venues Clinical Skill Lab Clinics Inpatient adult room OR room Can be in all labs Can be in all clinics SimMan 3G Medicine I AIRWAY MANAGEMENT: Basic airway maneuvers (Head tilt/chin lift Jaw thrust). Suctioning (oral & nasopharyngeal). Ventilation method: Basic ventilation (Bag-mask ventilation). Advance ventilation (Laryngeal mask air way, Orotracheal,Nasotracheal intubation). Endotracheal intubation. Surgical airway management (tracheostomy,cricothyrotomy) Chest tube insertion Management of tension pneumothorax by needle decompression and chest tube insertion CPR. 107

55 Clinical Affairs Medicine I SimMan Essential Circulation: Extensive ECG library, pulses from ECG rhythm monitoring (4-connector, 3-lead ECG). 12-lead ECG display. Nursing Anne IV care and management. Catheterization skills. Vascular Access: IV access (right arm). Eyes: Blinking eyelids. Eyelids: open, closed or partially open. Eyelids can be opened for examination by the learner. Set of interchangeable pupils available. Advanced male catheterization trainer Aseptic Urethral catheterization technique. Suprapubic catheter insertion and catheter management. MegaCode Kelly Heart sounds synchronized with ECG. Urinary Catheterization. Advanced Female catheterizations Trainer Aseptic Urethral catheterization technique. Suprapubic catheter insertion and catheter management

56 Clinical Affairs Medicine I Advanced Venepuncture Arm Venepuncture: (Collect venous blood sample by needle and syringe, Collect venous blood sample by an evacuated closed-tube system). IV Cannulation. Eye Examination Simulator Allow examination of the fundus using ophthalmoscope. Training in identification of common eye disease. Arterial Puncture Wrist Lumber Puncture Simulator Artery puncture practices for arterial blood collection procedures. Training of Lumber puncture procedure (CSF collection, measurement of CSF pressure). Cardiology Patient Simulator S1 and s2 auscultation in relation to synchronized ECG. ECG Monitoring screen. SUPRAPUBIC TRAINING MODEl The supropubic catheterizations model allows the practitioner to feel the normal pressures exerted by the abdominal wall on catheterizations. Allows the practitioner to understand the average length of catheter required to be inserted in order to drain the bladder

57 Clinical Affairs Equipment Spirometer Equipment Dinamap 112

58 Surgery I Venues Clinical Skill Lab Clinics Inpatient adult room OR room Can be in all labs Can be in all clinics SimMan 3G & Essential Surgery I AIRWAY MANAGEMENT: Basic airway maneuvers (Head tilt/chin lift Jaw thrust). Suctioning (oral & nasopharyngeal). Ventilation method: Basic ventilation (Bag-mask ventilation). Advance ventilation (Laryngeal mask air way, Orotracheal,Nasotracheal intubation). Endotracheal intubation. Surgical airway management (tracheostomy,cricothyrotomy) Chest tube insertion Management of tension pneumothorax by needle decompression and chest tube insertion CPR. 115

59 Clinical Affairs Surgery I MegaCode Kelly Airway Management Skills: Basic airway management( Bag Valve Mask) Advanced airway management (Endotracheal intubation Nasotracheal intubation). Surgical airway management (cricothyrotomy). Suctioning techniques. Chest Tube Insertion (Advanced version only): Management of pneumothorax. NG Tube and Trach Care Trainer Tracheostomy care Tracheal suctioning. NG tube insertion and removal NG tube. NG tube irrigation and monitoring. Feeding tube insertion and removal. Gastric lavage and gavage. Oropharyngeal and nasopharyngeal airway insertion and suctioning. Endotracheal tube insertion securing and care. MegaCode Kid Airway Management Skills: pediatrics size Advanced airway management (l intubation). Basic airway management (Bag/Valve Mask Ventilation). Resusci Anne Used in training of CPR skills using AE. Nursing Anne Tracheostomy care and suctioning. Oral nasal intubation Advanced Venepuncture Arm Venepuncture. IV Cannulation. Iv effusion (blood transfusion

60 Clinical Affairs Surgery I Arterial Puncture Wrist Artery puncture practices for arterial blood collection procedures. Arterial catheterization for IABP measurement Advanced Female Catheterisation Trainer proper physical examination of female genital tract Aseptic catheterization technique. Catheter placement Catheter insertion for measuring fluid output Withdrawal of catheter. Suprapubic catheter insertion and catheter management. Interm ittent self-catheterization (ISC) when using the optional Self Catheterization. Advanced male catheterization trainer proper physical examination of male genital tract Aseptic catheterization technique. Catheter placement. Catheter insertion for measuring fluid output Withdrawal of catheter. Suprapubic catheter insertion and catheter management. Intermittent self-catheterization (ISC) when using the optional Self Catheterization. Suturing Task Trainer Digital rectal examination simulator Techniques: Making an incision. Application of skin adhesives(glue, staples) Basic suturing techniques (continuous,interrupted) Advanced suturing techniques (sub cuticle, multiple layer suturing,intra-abdominal anastomosis) Per rectal examination Differentiate rectal tumor and polyp by palpation Palpation of normal prostate and endocervix

61 Clinical Affairs PROSTATE EXAMINATION SIMULATOR Training of prostate examination. learn to distinguish clinically between the benign and malignant condition. Lumber puncture simulator Training of Lumber puncture procedure (CSF collection, measurement of CSF pressure). Epidural block. Wound Care Model Proper management of different stages of pressure ulcers. 120

62 Pediatrics Venues Clinical Skill Lab Clinics NICU room Pediatric Adult In patient room Can be in all labs Can be in all clinics NOELLE RAIN FOR NEONATAL RESUSCITATION & NEONATAL CARE SIMULATION APGAR score, neonatal examination Handle the neonate confidently and competently Pediatrics MegaCode Kid Advanced ECG Kid Closed chest compressions CPR Airway Management Skills: Oral intubation Nasal intubation Digital intubation Bag/Valve Mask Ventilation IV Drug Administration: IV insertion into the peripheral veins of forearm, hand and antecubital area (Accessible veins include: median, basilic and cephalic) Intraosseous infusion at both Tibial Tuberosity and Medial Malleolus sites Multi-Sounds Auscultation and Recognition Skills: Seven auscultation sites for auscultation and recognition of heart, breath and bowel sounds 123

63 Clinical Affairs Pediatrics Resusci Junior Used in training of CPR skills Advanced Venepuncture Arm Venepuncture IV Cannulation Iv effusion (blood transfusion) Resusci Baby Lumber puncture simulator Used in training of infant CPR skills Training of Lumber puncture procedure (CSF collection, measurement of CSF pressure) Pediatric Intubation Trainer Oral intubation Nasal intubation Digital intubation Bag/Valve Mask Oropharyngeal airway insertion Naso pharyngeal airway insertion Ear examination simulator Allow training in the examination of the external acoustic meatus and tympanic membrane Learn how to use otoscope Learn how to Differentiate different ear problem Training in Ear wax and foreign body removal

64 Clinical Affairs Pediatrics Bone Marrow Aspiration For training in infant intraosseous techniques Bone marrow aspiration Equipment Sphygmomanometer: Measure blood pressure (including use of nonelectronic sphygmomanometer) and plot on chart for infant and older child Equipment Peak Flow Meter A peak flow meter is a portable device that measures airflow, or peak expiratory flow rate (PEFR). It can be used to: Determine the severity of your asthma attack Check your response to treatment during an acute asthma episode Monitor progress in treatment of chronic asthma and provide information for any changes in your therapy Detect worsening lung function and avoid a possible serious asthma flare-up Equipment Equipment Tape,weighing scale,charts Measure and plot on chart head circumference, weight and height for an infant, older child Dinamap Measure pulse oximetry and thermometer

65 Clinical Clerkship Program (Phase III) 6th Year

66 Obstetrics & Gynecology Venues Clinical Skill Lab Clinics Labor & delivery room OB/GYNE, Urology lab Can be in all clinics Obstetrics & Gynecology NOELLE EPIDURAL PROCEDURES Simulate different scenarios of normal and abnormal virginal delivery C section using real surgical instrument Simulate an obstructed labor, shoulder dystocia and allow Practice management techniques and maneuvers such as McRoberts, Woods screw, hands and knees, EPISIOTOMY REPAIR Post-partum hemorrhage management Perinatal monitor: Baseline fetal heart rate Fetal heart rate variability Accelerations Decelerations EFM and FSE heart tones Uterine contractions frequency and intensity Trace history w/ print out capability All fetal vital signs are fully programmable 131

67 Clinical Affairs Obstetrics & Gynecology Maturnaty model type 2 Allow practicing and teaching the four Leopold s Maneuvers and fetal heartbeat monitoring NG Tube and Trach Care Trainer NG tube insertion and removal NG tube NG tube irrigation and monitoring Feeding tube insertion and removal Gastric lavage and gavage Clinical Female Pelvic Traine Recognition of perineal and pelvic anatomy including bony landmarks Digital vaginal examination and speculum examination Bi-manual examination Cervical smear procedure (including use of speculum) Pap smear Digital rectal examination Also can demonstrate different pathologies and abnormalities like Ultrasound Examination Training Model ECHOZY Instrumentation and probe manipulation Basics of abdominal sonography: Cross sections and sonographic anatomy Sonographic demonstration of each indivisual organ Localization of hepatic Couinaud s segments Large Fibroid - Nulliparous Ectropion Cervix Small Fibroid - Nulliparous Polyp Cervix Ovarian Cyst - Multiparous Cervix Advanced Venepuncture Arm Stoma care IV effusion Practice stoma care and self-care training

68 Special Sense and Mental Health Venues Clinical Skill Lab Clinics Adult In patient room Adult ICU room Recovery room Basic skill lab Can be in all clinics SimMan 3G Blinking eyelids. Eyelids: open, closed or partially open. Eyelids can be opened for examination by the learner. Pupil dilation: constricted, dilated or in between. Pupillary accommodation. Synchrony / asynchrony. Normal and sluggish speed of response. Special Sense and Mental Health SimMan Essential Blinking eyelids. Eyelids: open, closed or partially open. Eyelids can be opened for examination by the learner. Set of interchangeable pupils available. 135

69 Clinical Affairs Special Sense and Mental Health Ear examination simulator Allow training in the examination of the external acoustic meatus and tympanic membrane. Learn how to use otoscope. Learn how to Differentiate different ear problem. Training in Ear wax and foreign body removal. Equipment Otoscope Eye examination simulator Allow examination of the fundus-using ophthalmoscope. Training in identification of common eye disease. Equipment Ophthalmoscope

70

71