By Wendy Sarubbi | May 16, 2016 2:24 pm

Going from the classroom to the hospital can be nerve wracking for rising third- year medical students entering their clerkships. And with a recent report stating that one-in- three hospital deaths can be attributed to medical errors, the importance of proper training and patient safety are critical. So, to better prepare students for the transition to patient care, the College of Medicine did an intensive day of simulated training May 12 that included sessions on proper scrubbing, suturing and how to carry newborn babies.

“It introduces the hospitalized patient, the hospital environment and the process of how doctors take care of patients.  We used standardized cases that stress to the students the need to be a keen observer and to act on their observations,” said Dr. Colleen Moran-Bano, assistant professor of pediatrics, who oversaw the training.

Clinical nurse educator Kristin Yager from Orlando Health is an 18-year veteran as an operating room nurse. She has helped train medical students going into surgery clerkships for the past five years. During the simulated rounds, she showed students how to decontaminate themselves in preparation for surgery by meticulously washing and scrubbing their hands and nails. The process can take up to 10 minutes. She also showed the physicians-in-training how to keep the hands sterile after washing. “Students are surprised how much goes into a surgical scrub,” she said.

Nearby, fourth-year M.D. students taught their younger classmates suturing skills, such as knot tying and instrumentation. “I’m really enjoying it”, said third-year student Madeline Goldberg, “It’s given me more confidence and getting to work with fourth-year students is less intimidating.” Her teacher was graduating senior Michael Metzner, who will begin his surgical residency at the University in Texas next month.

“I think it’s important to volunteer for these kind of opportunities,” said Metzner. “It reminds me of how far we have come in just four years.”

Overseeing the suturing session Dr. Aileen Caceres, who directs the obstetrics/gynecology clerkship. “The students are nervous at first and I see this all the time, but it gets them prepared for their clerkships in the operating room,” she said of the simulation training. All third-year students go through required clerkships in specialties including internal medicine, surgery and OB-GYN.

The training also included 18 standardized patients (trained actors), who were gowned and waiting in exam rooms pretending to be newly hospitalized patients. Some were attached to mock IV fluids and nasal cannulas. Others carried “sick” baby mannequins. The patients’ complaints ranged from allergic reaction to medication to heart problems. One patient had red makeup on her body to simulate an allergic rash. Another coughed repeatedly and said he had not slept all night.

“The Sim Rounds prepare students to focus on the patients’ current status from the night before when they were admitted to the hospital, to the present time,” said Standardized Patient Educator Rebecca Beiler, who oversees the actors in the medical school’s Clinical Skills and Simulation Center. “After seeing their patient, each student provides an oral presentation to a faculty member in a small group setting, where the medical students must triage who has the most severe patient and present their patient, much like what the students might encounter when they are in the clinical setting.”

By the end of the sessions students are more confident as they transition from, “not just taking down patient data and coming up with a diagnosis but also coming up with a therapeutic plan to take care of the patient,” said Dr. Moran-Bano. “The Sim Rounds more concretely defined their role and what is expected of them when they are on their clerkships.”


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