Table 1 Brief narrative description of the Simulation/Standardized Patient Application Cases

Case1: Systematic Analysis of a Medical Error (requires high fidelity simulation mannequin)

Overall Goal: Understand the impact of a medical error, conduct a root cause analysis and generate an action plan to prevent future errors.

Scenario: A 45-year-old male who was admitted for shortness of breath. He was found to have a right main stem pulmonary artery embolism. He has been on intravenous unfractionated heparin for the past 48 h without proper dose adjustment. His aPTT has been < 20 s since admission. The heparin dose was incorrectly calculated when initially ordered by the intern. In addition, nursing staff and pharmacy subsequently failed to adjust the dose of heparin for 48 h. He is now in Pulseless Electrical Activity (PEA) arrest. Your team is being called into a code blue/cardiac arrest. Your task is to follow ACLS protocol with your team. Following this, you will conduct a root cause analysis of the event. Your main task is to identify possible contributing causes of the error and create a root cause analysis (RCA) using the fishbone diagram provided. Following discussion of the RCA, the group will suggest an action plan to prevent this error from occurring in the future.

Case 2: Interprofessional Hand-off (requires high fidelity simulation mannequin with voice control)

Overall Goal: Provide written and verbal hand-off using a standardized format.

Scenario: A 76-year-old male with past medical history of severe COPD, CAD s/p CABG, Diabetes type 2, peripheral artery disease, and hypertension, who was admitted early this morning for acute on chronic respiratory failure due to progression of his underlying severe COPD. Patient was placed on supplemental oxygen via venti-mask, albuterol/ipratropium nebulizers every 4 h and given IV solumedrol (methylprednisolone). He appears to be stable for now, but is very sleepy and has been deferring all questions to his wife. Your task is to review the list of interval events throughout the day and generate an IPASS hand-off for the incoming team using the IPASS format.(12)

Case 3: Safe Discharge (requires a standardized patient actor)

Overall Goal: Demonstrate patient teach back and safe discharge planning

Scenario: A 56-year-old white male is newly diagnosed with type 2 diabetes. At 200 lbs., he has a history of hypertension and hyperlipidemia. He was admitted 2 days ago for uncontrolled blood glucose levels requiring IV insulin. His AIC is 11% and has not responded to PO diabetic medications in the past. He is now ready to be discharged. The nurse provided teaching on how to manage diabetes at home. She has given him instructional materials, including the brochures “Facts about Diabetes” and “How to manage diabetes at home.” The patient has also watched videos that cover basic information about diabetes management, such as how to use the blood glucose meter. Patient is ready to be discharged but he feels very overwhelmed by the information provided to him. You are the day team on the general medicine floor. Your task is to make sure he is all set to go home and answer any questions he may have.