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Simulation is a growing model of education in many medical disciplines. Withdrawal of mechanical ventilation is an important skillset for palliative medicine practitioners who must be facile with a variety of end-of-life scenarios and is well suited to the simulation laboratory. We describe a novel approach using high fidelity simulation to design a curriculum to teach Hospice & Palliative Medicine (HPM) fellows the practical aspects of managing a compassionate terminal extubation. This simulation session aims to equip palliative fellows with a knowledge base of respiratory physiology and mechanical ventilation as well as the practical experience of performing a terminal extubation. We designed a 3 hour simulation session which includes a one hour didactic followed by 2 hours of simulation, with 4 cases that focus on different teaching points regarding symptom management and practical aspects of removing the endotracheal tube . The session was designed as an annual session for HPM fellows in our region during a collaborative educational conference. Based on feedback, the session is scheduled for the beginning of the academic year and each fellow is given the opportunity to physically remove the endotracheal tube. Simulation can be effectively used to teach practical and complex bedside skills such as withdrawal of mechanical ventilation to palliative medicine trainees. This method of teaching could be expanded to teach other advanced hospice and palliative care skills.
This article was published in the following journal.
Name: Journal of pain and symptom management
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Physiological and psychological symptoms associated with withdrawal from the use of a drug after prolonged administration or habituation. The concept includes withdrawal from smoking or drinking, as well as withdrawal from an administered drug.
A computer simulation technique that is used to model the interaction between two molecules. Typically the docking simulation measures the interactions of a small molecule or ligand with a part of a larger molecule such as a protein.
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A computer simulation developed to study the motion of molecules over a period of time.
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