Illinois Medicine

running through the College of Medicine experience, the culmination of that approach is the use of skills simulators to teach students clinical skills prior to their third-year rotations. This training is a core part of the Essentials of Clinical Practice and Professionalism course, which was added to the curriculum in the summer of 2004 to ensure all students are prepared to perform common medical procedures prior to being called on to do them on patients during their rotations. The students spend three days in June before their rotations in the Graham Clinical Performance Center, where they learn 14 clinical procedures they might be called on to perform, then practice them on plastic anatomical models. ment for graduation. At the end of their third year, students take an exam in which they must perform each of the procedures, which an instructor evaluates using a checklist of the required steps. Each student must score 100 percent on the exam or go through remedial review of the skills until they achieve a perfect score. "It's good to practice on the models and have instructors there who can help you when you have questions," says Erin Perkey, a fourth-year medical student and president of the Chicago Medical Student Council. "Overall, it made me more confident to do these procedures when I was at the hospital." "There's no better way to learn than practicing hands- The course also includes three skills review sessions (in which some new skills are also taught) during the third year. In addition, sessions focusing on risk management and ethical and professional issues are presented. During these sessions, the students are divided into groups of about five students each and rotate through rooms in the Dr. Alan L. and Mary L. Graham Clinical Performance Center at 15-20 minute intervals. In each room, an instructor demonstrates one of the skills using the simulators and then guides the students as they practice the skill themselves. The simulators range from the very basic, such as a plastic, flesh-colored pad on which students practice suturing, to models of a human head and throat on which students practice airway intubation, to an arterial blood model that allows students to draw simulated blood through a syringe inserted into it. Even more high tech is a computerized mannequin that allows students to practice team-based management of critical events. "Our main goal is to make sure that each of our students has the opportunity for enough hands-on practice in a safe environment to gain real mastery of clinical skills, so when they work with patients they can perform these procedures safely and with confidence, and we can make sure they're coming out of medical school with a really good foundation of clinical skills," notes Rachel Yudkowsky, MD, MHPE, director of the Graham Center and associate professor in the department of medical education. In fact, mastery of these skills has become a require- on," concurs new medical graduate Richard Keyme, MD '13, who is spending an intern year at MacNeal Hospital in Berwyn, Ill., prior to a physical medicine and rehabilitation residency at Stanford Hospital. "When you work with the model and you go through the checklist to make sure you're doing everything, it's a constant reminder about patient safety, when to wash your hands, when to glove. It allows us to come prepared to learn in a real setting and to not put any patient in danger." Carr, who interrupted her medical school studies midway to spend four years doing her doctoral research, was a bit nervous about beginning her third-year clinical rotations, so she was grateful for the skills review. "It was good to have feedback in terms of whether or not you did the skill correctly," says Carr. "The College of Medicine is always trying to give you a hands-on approach." While the specifics of team-based learning, peerto-peer education and skills simulation differ, all of these curriculum innovations are part of a larger trend within 21st century medical education. "The emphasis is moving away from how we teach things to students to how we help students learn," Hyderi says. "Beyond that, it's engaging students to think critically about the material, how to problem solve and identify their learning gaps and fill them." Carr says the college prepared her well in that regard. "I have a thought process that I've learned here," she says. "If I have a question, I feel prepared to find the answers. The patients will be different and the responsibilities will be different, but the thought process will be the same." Simulated patient encounters develop clinical skills that prepare students for rotations and their residency placement upon graduation from the College of Medicine. illinois medicine | 15

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