New Online Learning Approach Prepares Doctors for Stanford Residencies
Jul 19, 2010 - 12:22:41 PM
(HealthNewsDigest.com) - STANFORD, Calif. — At first you just see the medical resident’s hands on the video screen and hear him muttering to himself.
“Syringe…,” he says under his breath, as he nervously opens and closes the medical supply drawers searching around for what he might need. He fills a syringe with some milky liquid, tentatively preparing an IV for his patient, looking around for help.
“Are you ready to go?” booms out the voice of the attending physician whose face suddenly fills the screen of this educational video. “The patient is a 24-year-old with a penetrating trauma to the belly. OK, stop! You’re going to use propofol on this patient?!!!”
The setting is clearly a simulated operating room, with a robotic mannequin as the patient, but the resident’s anxiety feels all too real. And the scary soundtrack — imagine the ominous music played when the shark approaches in Jaws — only adds to the tension. This is not just entertainment, it’s also educational.
This video is part of START (http://start.stanford.edu), a new 10-month online course from the Stanford University School of Medicine, filled with lectures, video-podcasts, interactive group projects, virtual classrooms and virtual mentoring. The name stands for Successful Transition to Anesthesia Residency Training, and is the brainchild of Larry Chu, MD, assistant professor of anesthesia, and Kyle Harrison, MD, clinical assistant professor of anesthesia. The course was designed to help relieve some of the anxiety that often accompanies the start of the residency.
The latest class of anesthesiology residents, 26 of them, arrived at Stanford at the beginning of July. They had just completed an internship year spent in hospitals across the country, during which they received general medical training — but without focusing specifically on anesthesiology. In the past, this has left the trainees on edge as they had to jump right in to anesthesia on day one of their residencies.
The new program aims to impart critical information to make for an easier transition. The residents learn, for instance, from the episode with propofol — the milky liquid — that they shouldn’t use it for anesthesia induction when a patient is in shock. As the instructor advises later in the episode, it could kill the patient.
The online course is also meant to help keep a connection between the residents and Stanford during the internship year that follows their graduation from medical school. (The residents are accepted into the program just as they graduate from medical school, right before starting the internship year.)
“We wanted them to feel like they were still part of our department despite being scattered all over the country,” said Chu, co-director of the program. “But they’re very busy in their internship year. The challenge was, how do we make it so they actually want to do it. So it’s useful and fun.”
The solution was to make the course virtual, available for viewing when the interns themselves had some spare time, and to make it a bit theatrical and dynamic.
“In each video episode, for example, we used a dramatic situation to motivate their learning,” Chu said. “We wanted them to see firsthand what we see as doctors, so we used the point-of-view camera.”
That meant Chu had the camera strapped to his forehead when he acted out the role as nervous new resident in the above-described video. Harrison, who dabbled in community theater and teaches in the Palo Alto Veterans Affairs Simulation Center, played the role of “authoritative attending” in the video who shows up just in time to save the patient. The videos were produced by the two doctors themselves at the Palo Alto-VA and also at the Stanford Center for Immersive and Simulation-based Learning located in the Li Ka Shing Center for Learning and Knowledge, the new high-tech educational building on the medical school campus designed to encourage innovative projects like this one.
For new resident, Megan Oelijnzak, MD, 33, from Minnesota, the course achieved its goals.
“That first week (of residency) was really hard,” said Oelijnzak. “It can be anxiety-provoking. You start wondering, ‘Do I know enough?’ It was nice to have that connection that the online course provided. They showed us pictures of the campus, they talked about what they wanted us to know.”
To prepare for the course, Chu and Harrison conducted a survey of previous residents to determine what would be helpful. And they did a bit of research on how best to educate their incoming class, which is part of so-called “millennial” generation, defined as those born between 1979 and 1995.
Their brains are wired to learn differently, Chu said. They’ve grown up in front of devices with screens. They socialize via cell phones, computers and video games.
“We’re using these techniques because we want to engage the millennial learners who are now beginning to enter our residency program,” Chu said. “Using technology in education isn’t as daunting today as it used to be. We created the START program with online tools that are now available to any faculty member.”
For Boris Heifets, MD, one of the new residents recently arrived from New York, the training course was “pretty awesome.”
“It was so much better than just straight-up PowerPoint presentations. It was a good way to pass the time during my night shifts. When I got to Stanford, I felt like I already knew Dr. Chu and Dr. Harrison.”
More information about Stanford’s Department of Anesthesia is available at http://med.stanford.edu/anesthesia/.
The Stanford University School of Medicine consistently ranks among the nation’s top medical schools, integrating research, medical education, patient care and community service. For more news about the school, please visit http://mednews.stanford.edu. The medical school is part of Stanford Medicine, which includes Stanford Hospital & Clinics and Lucile Packard Children’s Hospital. For information about all three, please visit http://stanfordmedicine.org/about/news.html.
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