Simulation Resources for your Anesthesia Interest Groups

Why We Created This Guide

Typically, anesthesiology is a specialty that medical students discover late in their education. Countless anesthesiologists would say that they fell in love with the specialty serendipitously during their clinical rotations in medical school. Anesthesiology is a specialty of “doing”, from pushing medications to alter real-time physiology to gratifyingly complex procedures to on-the-spot innovation. For that reason, anesthesiology needs to be seen and experienced to truly appreciate it; however, opportunities to do so are rare, particularly in the preclinical years of undergraduate medical education. 

Consequently, Anesthesia Interest Groups (AIG’s) can play an influential role for first- and second-year medical students by introducing them to anesthesiology early in their educational journeys. While journal clubs, faculty lectures, and resident panels play valuable roles in propagating a preexisting interest in perioperative medicine, nothing can spark newfound passion quite like hands-on work.

We sent a survey to AIG’s across the country to learn about their experience with simulation. We received responses from 41 schools, of which 63% of the AIG’s had hosted some sort of simulation event in the past. Of the AIG’s that had previously hosted a simulation event, all but one reported having a simulation center at their school. Of the AIG’s that had not hosted a simulation event in the past, 93% reported that they would be interested in hosting a simulation event in the future if the ASA shared a simulation guide.

In reflecting on our experience organizing our own simulation event, as well as the apparent enthusiasm for simulation events among other AIG’s, we set out to create this page as a resource for other AIG’s hoping to host their own simulation event. We know that some schools have more resources than others, so we did our best to create an inclusive guide that’s applicable to schools with small and large budgets alike.

1. Simulation Activities

• With a sim center (PDF)
  • High Fidelity Scenarios
    • Beginner Scenario - Atrial Fibrillation (PDF)
      • Supplemental material: Atrial Fibrillation EKG (JPEG), ACLS Tachycardia with a Pulse Algorithm (PDF)
    • Advanced Scenario - Autonomic Instability (PDF)
• Without a sim center (PDF)
• Online activities (PDF)

2. Learning from One AIG's Simulation Experience

Our Simulation Experience:

Aiming to encourage the growing interest in anesthesiology at our medical school, we decided in early 2020 to host a simulation event later that year. The looming worldwide pandemic that would soon follow delayed that goal significantly, but we ultimately held our event in September 2022. Outside of overcoming the problems posed by COVID-19, we also encountered a slew of obstacles in organizing our own simulation event from scratch, all the way from big-picture event structure to smaller logistical concerns of material acquisition and funding. 

Our event took place at our school’s simulation center, with the event structured around four different stations. Attendees rotated through all four stations, spending 25 minutes at each one, with 5 minutes budgeted for transition. Each station was staffed by a faculty member volunteer, with additional help provided by senior residents and AIG board members. Registration was opened to first-year medical students 2 weeks prior to the event on a first come, first served basis. We capped registration at 24 students in order to split up into four groups of 6. We had a short waiting list of students, which we ultimately utilized to account for dropouts leading up to the event. Following the event, we provided pizza to attendees.

Station	Description	Image
High Fidelity Simulation	This was a basic high-fidelity simulation run by a faculty member and resident that took place in our school’s simulation lab. Beginner and advanced scenarios are available for download below based on your target audience.  If you don’t have access to high-fidelity simulation equipment, these scenarios can be run with a monitor app and basic task trainer.
Ultrasound-Guided IV	After a brief demonstration, participants practiced using ultrasound to start an IV. We used budget-friendly yam cake ultrasound phantoms that we assembled prior to the event, as well as IV catheters that we received from anesthesia technicians. See database for more information on the yam cake model.
Airway	Participants learned about different methods of establishing an airway in patients and practiced them on training mannequins provided by the anesthesiology department. Approaches included oral and nasal airways, LMA, direct laryngoscopy, video laryngoscopy (McGrath), and fiberoptic intubation. Select which approaches to teach based on instructor level (senior medical student vs. faculty) and target audience.
POCUS	This station utilized a POCUS ultrasound simulator that we borrowed from the sim center. A faculty member helped students work through important point-of-care ultrasound views, as well as some basic pathologies. For many schools that don’t have access to this machine, standardized patients and student volunteers are great alternatives.

What We Learned:

Timing

An event requiring use of the simulation center often needs to be planned at least several months in advance. This is also necessary when it comes to finding a date with multiple busy faculty and student schedules, even if you aren’t using a simulation center. If you are ordering supplies online, be sure to account for shipping delays.

Budget

Simulation models can be expensive! Borrow expired IV catheters/needles from your affiliated hospital’s anesthesia technicians. If you don’t have an affiliated anesthesiology department, do some research online to find cheap, basic supplies. Create affordable DIY setups, using inspiration from the database examples below. If your school has a simulation center, talk to the staff about what supplies can be borrowed for free. If you don’t have a simulation center, reach out to your school’s education team to see if they have any equipment that you can use (ultrasound machine, basic task trainer, etc.). Ask about policies regarding student volunteers for non-invasive activities like ultrasound practice.

Audience

Medical students vary widely year-to-year in their knowledge, so it can be difficult to host simulation events with students of multiple years. Pick a target group and tailor your event to that audience. Simulation events can be used to introduce preclinical students to anesthesiology, to prepare 3rd year students for clerkships, or as a refresher for 4th year students before their sub-internships. Require registration ahead of time in order to maintain an adequate student:faculty/resident ratio, as well as student:supplies ratio.

Staffing

If your school has an affiliated anesthesiology department, reach out to faculty members and residents early to secure their participation. If your school doesn’t have an affiliated department, many basic activities can be run with the leadership of senior medical students (US-guided IV, basic airway task trainer, etc.). You can also reach out to your school leadership to check if any faculty members are able to assist with activities. Obviously an anesthesiologist is ideal, but the basic skill set is shared by other physicians such as emergency medicine doctors.