Use of High Fidelity Simulation in Cardiac-specific Anesthesia Scenarios for Resident Education and Assessment

High fidelity simulations provide a unique opportunity for teaching and evaluation of knowledge, clinical reasoning, decision making and teamwork. We have developed a series of novel cardiac based simulations that review difficult learning objectives of cardiac anesthesiology rotation. We hypothesized that residents who have completed a rotation in cardiac anesthesiology will perceive these simulations to be both mentally challenging and a useful tool in preparing them for their subsequent clinical experience and for their anesthesiology board. For the first time, we have used the NASA Task Load Index Scale in evaluating Neuro Cognitive Workload during Cardiac Anesthesia Based simulation scenarios .Residents who have completed the cardiac rotation at least once would be assigned the task in small groups either a group of 2 or group of 3.The module consists of 3 different scenarios. The scenarios include, weaning the patient off of cardio pulmonary bypass, management of severe protamine drug reaction and acute hypotension from malfunction of the coronary graft in a simulated operating room in real time. 1. Setting up a Simulation Lab,almost similar to real cardiac operating rooms would have cardio-pulmonary bypass machine,transesophageal echocardiography images upon request,all emergency medications with various infusions pumps,defibrillator,real time monitors include EKG,SpO2,invasive arterial line,CVP,PAP,ETCO2,operating room surgical equipment,anesthesia machine with ventilator. 2. Tasks Assigned to the residents 3. Feed-back and Teaching Session 4. At the end of each session residents are encouraged to reflect upon how they performed and learning gaps that they perceived and areas that they felt needed to improve upon. 5. Feedback session would be followed by interactive teaching to reinforce the knowledge. 6. Evaluation of Hypothesis using NASA TLX Scale. Immediately following the Simulation based training, residents would be given the paper based NASA TLX scal