• Treatment maintenance and generalization
• Preference
• Choice and decision making
• Stimulus control
• Efficient educational strategies
• Habits and addition

Perfusion Students Enter Crisis Management Phase of Simulation Training

Cardiopulmonary bypass is an extraordinarily invasive procedure in which the patient’s heart is stopped and the blood is pumped and oxygenated via the heart-lung machine. This enormous responsibility is placed in the hands of the perfusionists – a vital member of the open-heart surgery team.

Students in the Master of Clinical Perfusion program undergo hundreds of hours of high-fidelity perfusion simulation where they learn skills needed to operate a heart-lung machine during cardiac procedures. Dr. Bruce Searles, chair of the Cardiovascular Perfusion program is a leader in innovative perfusion education and has spent over a decade developing curriculum, techniques, and assessment tools in simulation.  He says “The 37 week immersive simulation curriculum that our departments faculty have pioneered allows our students to develop their fundamental skills in a student focused environment where mistakes and looked at as welcomed learning opportunities.  Our recent research establishes that novice perfusion students make 300% more mistakes than experienced clinicians and that through our simulation training program we can reduce mistakes and build transferable clinical skills without exposing patients to the natural learning curve.”

In the current phase of training, students spend 7 weeks understanding and preparing for low frequency crisis events. These include catastrophic pump failure, oxygenator failure, and massive air embolism. Leading the crisis management simulations is faculty Edward Darling who states, “These are rare, life-threatening events that students will probably not see during their clinical rotation training, so it is important for the students to learn how to quickly, effectively respond, communicate, and resolve these situations”. It is akin to pilots demonstrating in a simulator how to avert disaster in rare aviation events like engine failure. Students speak about the value of this training, ”It’s one thing to learn and read about the bad things that can happen while a patient is on bypass, but it’s a completely different experience to actually have to work through it in real time”, says student Matt Montesano. Another student, Christine Chow elaborates, “Simulation allows us to repetitively practice these rare events and gives us the ability to refine our technique and measure improvement. The first time I experienced a pump failure it was really rough. I felt sorry for the mannequin. However, after practicing, my ability to think and respond really improved!” 

The psychologic fidelity of simulation is especially important to the process. Darling expounds, “We treat the simlab like an operating room. We are in scrubs, hats masks and use all the exact equipment. This is important to help the students suspend their disbelief that this is not real. We want the students to have the normal physiological and cognitive stress responses one would get during an actual clinical perfusion crisis”.  In this regard student Chris Morgan added, “It’s really stressful to have to resolve a crisis event within minutes …  my heart is pounding and I’m perspiring. It can be difficult to think and see the solution when you know seconds can mean the difference between a good or a bad outcome”.

Following the crisis management training, the perfusion students will begin the clinical phase and spend five 7-week rotations at some of the leading open-heart programs in the country. Searles sharing his thoughts on the benefits of pre-clinical simulation says, “In the old model of perfusion training, students would practice learning skills on patients. We believe that pushing the learning curve back into the simulation lab is better for both student learning and patient safety. Using this this education model, we now send students to clinicals with a demonstrated skill set”. As the Silverman Hall renovation progresses, the program looks forward moving into new simulation facilities in 2023.