For Josh Cheema, ’15 MD, a resident in Medicine-General Internal Medicine and Geriatrics, leading an end-of-life discussion with a patient seemed simple when he heard about it during lecture; faced with this task with a standardized patient during Feinberg’s recent intern ‘bootcamp,’ however, he found it challenging.
“You fumble your words, you misunderstand your patient or they misunderstand you, and your communication falters,” Dr. Cheema said. “This session forced us to practice having these difficult conversations with standardized patients while our colleagues and faculty members are observing to give us feedback. It was challenging and nerve wrecking, but incredibly useful.”
Dr. Cheema, one of 58 interns to complete the two-day training program, practiced the procedural and communication skills he will use in his residency, including practice encounters with actors portraying patients, known as standardized patients. Trainees in internal medicine, dermatology, preliminary medicine, neurology and anesthesia participated in sessions including mechanical ventilation management and electrocardiogram (EKG) and radiology interpretation.
Blair Golden, MD, resident in Internal Medicine, found the procedural skill sessions useful including the session on paracentesis, a procedure to remove fluid from the abdomen.
“We practiced needle technique in the paracentesis session and getting feedback from the instructors and mistakes out of the way was a huge help,” she said. “This experience was a chance to get our feet wet before we get on the wards.”
The bootcamp began in 2011 as collaboration between Feinberg and Northwestern Memorial Hospital to address the so-called “July effect,” where the combination of experienced residents leaving and new trainees beginning at the same time was thought to have a potential effect on patient outcomes.
“Incoming interns here have all achieved a lot of success in their young careers, but still have a great deal of variability in their clinical experiences,” said Aashish K. Didwania, MD, ’05 GME, associate professor in Medicine-General Internal Medicine and Geriatrics and director of the Internal Medicine Residency Program. “The ‘bootcamp’ helps train everyone to a competent or mastery level in these core skills.”
Quentin Youmans, ’15 MD, resident in Internal Medicine, and his peers walked into a simulated intensive care unit with a simulated patient – a computerized mannequin – and worked through different scenarios using a mechanical ventilator such as treating septic shock, and how to recognize if a patient is being over-ventilated or receiving too much oxygen.
“Learning the ins and outs of the mechanical ventilator was particularly challenging,” he said. “There are a number of parameters that need to be monitored to successfully provide ventilator support. The bootcamp gave me the opportunity to troubleshoot problems and ask questions before dealing with real patients.”
“My goal is to provide the absolute best care for all of my patients and I know that the training provided here will help me meet that goal,” Dr. Youmans said.
Amanda Fuchs, ’15 MD, resident in Internal Medicine, said she enjoyed having time to refine her skills before she starts caring for patients on the wards.
“It’s nice to have time to be formally walked through a skill,” Dr. Fuchs said. “Now is the time to fine-tune what we’ve learned and put the skills we’ve practiced to work, as our participation in the care of patients increases.”