Current Research and Scholarly Interests
1 Critical Care Education
One of my interests centers on the use of patient simulation as an educational and training tool in critical care. The Palo Alto VA is the Mecca of Patient Simulation; high performance simulation and a curriculum on anesthesia crisis management were invented by David Gaba and colleagues in the Department of Anesthesia. As part of the VA ICU rotation, we run monthly classes on Crisis Resource Management in Critical Care in a brand new facility that is a virtual copy of an adult ICU, complete with two computer - controlled patients. Human patient simulation offers an ever-changing laboratory for developing and testing educational methods as well as participating in our current strength - critical care team training. Research projects currently center on implementing a performance assessment tool to evaluate whether classroom instruction improves management of simulated patient emergencies, examination of team communication during simulated emergencies, and assessment of resuscitation quality following a new critical care skills course.
2 Medical Emergency Teams
Medical Emergency Teams (or METs for short) are groups that perform rapid assessment and stabilization of patients in response to signs of clinical deterioration. They have arisen in response to data demonstrating that many opportunities to reverse clinical decline are not acted upon in a time frame that would prevent further deterioration, or progression to cardiac arrest. I have implemented a MET at the VA Palo Alto and am looking at the clinical impact of this intervention; I have also developed programs for team training and technical skill development applicable to MET operation.