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Simulation training has long been used in the military and in the automotive and airline industries. Einstein is now making simulations an integral part of student education, particularly in obstetrics/gynecology.
Practice scenarios are supervised by faculty members and feature lifelike mannequins and computers to replicate doctor-patient encounters. Trainees can hone their communication and technical skills in a safe, supportive environment before setting foot in an actual examination or delivery room.
Most training takes place at the Montefiore Einstein Center for Innovation in Simulation (MECIS), housed in newly renovated quarters in Einstein’s Van Etten Building. The 2,460-square-foot center occupies a suite of spaces appointed to look like real clinical settings.
Dena Goffman, M.D. ’01, spearheads ob/gyn “simu” training at Einstein-Montefiore. An associate professor of clinical obstetrics & gynecology and women’s health (maternal and fetal medicine), she directs the Montefiore Einstein Quality, Patient Safety and Simulation Program (QPSSP).
Dr. Goffman launched Einstein-Montefiore’s first simulation training for ob/gyn team members in 2010. QPSSP has since expanded to include monthly team training for attendings, residents, nurses, midwives, physician assistants, fellows, anesthesiologists and neonatal unit staff, and a two-day summer “boot camp” for interns.
Encouraged by the success of Dr. Goffman’s “simu” training, Staci Pollack, M.D., M.S., director of undergraduate ob/gyn medical education, created a training program to prepare third-year medical students for their ob/gyn rotation. The program was launched in 2015 with members of the Class of 2017 as its first users.
“Thanks to support from staff at the MECIS and clinical skills center, and the involvement of many ob/gyn faculty members, we were able to mobilize the resources to provide our students with a baseline of practical experience that allows them to approach their clinical learning on the wards with confidence,” says Dr. Pollack, who is an associate professor of clinical ob/gyn at Einstein and an attending physician in reproductive endocrinology at Montefiore.
“The ob/gyn team must be ready to spring into action at the first sign of maternal or fetal distress,” notes Dr. Goffman.
She is assessing the simulation program’s impact. Her study of 71 obstetrical attendings and residents found that simulation training helped them better manage shoulder dystocia (when the baby’s shoulders get stuck behind the mother’s pubic bone).
In a randomized study of 30 third-years, those receiving simulation training took part in more deliveries during their clerkship rotations than members of a control group whose only pre-rotation training was a PowerPoint presentation.
“Our program prepares clinicians to manage medical emergencies with consummate skill and seamless collaboration,” she says.
Left: A pair of mannequins, components of a maternal and neonatal birthing simulator, provide lifelike substitutes for mother and newborn as Dena Goffman, M.D. ’01 (left), walks students through the steps for a safe vaginal delivery.
Right: With a laparoscopic box trainer, Justin To, M.D. (far right), an assistant professor of obstetrics & gynecology and women’s health at Einstein and an obstetrician/gynecologist at Montefiore, introduces students to the basic techniques of minimally invasive surgery, which can make a lifesaving difference in a gynecological emergency.
Top Image: Using an anatomically correct model, Staci Pollack, M.D., M.S. (left), guides third-year students as they practice the proper way to insert a speculum and perform a Pap smear.
