Sinai Health System
The simulation program at Sinai Health System (SHS) has evolved over the years and focuses on non-technical skill acquisition and crisis resource management teaching for trainees. The program has both a research and a teaching component with 2-3 research fellows participating in simulation scenarios and education research. We have recently purchased simulation hardware which allows us to perform in-situ simulations in the operating room at short notice with very little preparation, allowing us to utilize existing space and equipment and minimize trainee time away from their clinical responsibilities. This setup allows for significant flexibility in adjusting scenarios and simulations to different training levels. The program also works with the University of Toronto Surgical Skill Centre for some larger research projects. The goal is to have all residents rotating through SHS exposed to at least one simulation session that includes teaching and debriefing
Toronto General Hospital
The TGH Anesthesia Resident Simulation Program occurs within our Royal College of Physicians and Surgeons-accredited simulation center at Toronto General Hospital, conveniently situated in the Surgical Admission Unit at the Peter Munk Cardiac Centre. These weekly sessions are dedicated to the mastery of critical scenarios and the effective management of crisis situations. Each session is meticulously structured, incorporating a blend of teaching, learning, and debriefing. The scenarios are rooted in real-life situations and are designed to incorporate the CanMeds competencies.
The program comprises 15 scenarios, tailored specifically to the TGH patient population. These encompass four resuscitation scenarios, four vascular cases, two cardiac incidents, three thoracic situations, and two transplant-related scenarios. These scenarios span both intra-operative and post-operative contexts.
The Simulation Center is impressively equipped, boasting a range of resources, including a SimMan Mannequin, an anesthesia gas machine, standalone vital sign monitors, an oral suction setup, an oxygen flow meter, a Glidescope®, Fiberoptic bronchoscopy equipment, infusion pumps, blood products, a crash cart with a defibrillator, and various drug vials and syringes.
The feedback received for this curriculum has been overwhelmingly positive. It has been instrumental in boosting residents' confidence and honing their skills in managing critical scenarios pertinent to their TGH rotation. Furthermore, it has proven invaluable in enhancing their crisis resource management abilities.
Toronto Western Hospital
The advanced training suite at Toronto Western Hospital (TWH) is a resource for the entire hospital, inclusive to all departments to carry out high fidelity and part task training simulation for both education and research purposes. Specifically for the anesthesiology residency program, a curriculum has been developed, allowing residents to participate in high fidelity crisis resource scenarios on a weekly basis. Additionally, anesthesiology residents and fellows can come to the suite to refine bronchoscopy skills using a sophisticated virtual bronchoscopy simulator. A neuroanesthesiology high fidelity simulation curriculum is being developed for TWH fellows to get exposure to perioperative neurosurgical emergencies.
We also run multidisciplinary scenarios with operating room and recovery room nurses to practice effective handover of patients postoperatively. Many other initiatives are in the pipeline to give all of our anesthesiology trainees greater access to educational simulation opportunities.
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Toronto Western Hospital
Department of Anesthesiology
399 Bathurst St., McL 2-405
Toronto, ON M5T 2S8
phone: 416-603-5118
fax: 416-603-6494