Internal Medicine Resident Inpatient Case Simulations

Objectives and Guidelines

Power point intro to SIMS

Purpose:  To ensure Internal Medicine residents can competently and safely manage basic and common inpatient diagnoses.

The continual restriction of resident work hours has prompted the creation of a supplementary educational forum wherein we test resident’s knowledge and ability to manage basic ward diagnoses.  This format will involve the completion a brief simulated History and Physical and the writing of admission orders based on information gathered during the simulated case. 

This exercise currently involves new second year senior residents.  It will occur monthly and include residents on elective rotations.  This will occur approximately 4 to 6 times per year for each resident. Physicians will spend approximately 1.5 hours in the SIMET Center performing the exam, writing orders, and meeting with an attending counsellor after completing required preparatory work.

Prior to the test day, residents will be required to read assigned article pertaining to the case and to complete an online test.  ACP Medicine articles are used as required reading followed by the accompanying ACP article questions.  Supplementary material may be provided to the resident based on current guidelines.  The answers to the quizzes will be discussed during the attending counseling session.

The selected residents will gather in the SIMET Center to perform a one-on-one mock History and Physical.  The History portion will be guided by a staff Hospitalist.   SIMET Center Mannequins will be used to guide the Physical portion of the exam.  The resident will need to gather this information within 30 minutes.  They will then be given another 30 minutes to write out a short Primary and Secondary Diagnosis as well as a concise order set for the diagnosis they assessed.   Residents’ orders will be graded based upon inclusion of Hospital Core Measure Requirements, if applicable, as well as basic Guideline elements for the core diagnosis.  Following the completion of the orders, residents will receive one-on-one feedback from the Hospitalist that conducted the exam.  They will be graded based on pass/fail method using objective guidelines.