When it comes to simulating a large scale crisis, USF College of Public Health students in the master of science in public health (MSPH) occupational medicine residency program are getting as close to the real deal as possible.
Through a partnership with the James A. Haley Veterans’ Hospital and Clinics in Tampa, students have the opportunity to take part in emergency management preparedness and training. It prepares them for handling a large scale disaster and triage of multiple patients with varying degrees of injuries and illness.
The VA’s “SIM BUS” contains mannequins dressed with mock injuries to fit six different scenarios.
Dr. Ronald Figueredo, COPH occupational medicine resident, examines a patient exposed to a rail car oil shipment explosion. (Photo by Anna Mayor)
The most recent simulation included patients with an array of chemical exposures from chlorine gas to ammonia.
Upon entering the bus, residents are provided information cards noting the status of the patient’s injuries. They utilize critical thinking skills and make decisions on how they would triage the patients, categorizing who needs care first, according to Dr. Eve Hanna, occupational medicine faculty in the Department of Environmental and Occupational Health.
Trainees in the program are resident physicians from the USF Health Morsani College of Medicine. Residents complete clinical rotations at locations in Tampa including the VA, Tampa General Hospital, local private occupational medicine clinics and OSHA.
Occupational medicine is a board certified medical specialty with a focus on worker populations, diagnosis and treatment of work-related injuries, illnesses and exposures.
The simulation training happens twice a year for students in the MSPH occupational medicine residency program.
Residents of the COPH’s occupational medical residency program and instructor Dr. Eve Hanna (third from left) take a moment to show some USF school spirit following the simulation training.
“It’s a higher form of learning,” Dr. Hanna said. “In order for all parts of your mind to be engaged you have to be doing something. In a lecture you’re just sitting there and taking the information in, so once you become an active participant you learn and retain the information better.”
Dr. Theodore Aquino, chief resident of occupational medicine at USF Health Morsani College of Medicine, said that coming from a military background, he’s had experience in dealing with mass casualty scenarios and that in emergency scenarios providers must triage patients to do good for the greater number of people.
“There is no replacement for real world training, but a close runner up would definitely be a simulation,” he said. “We’re taught see one, do one, teach one, so if you can’t necessarily see one or do one in a live scenario, live emergency, or live patient, a simulation is the next best thing,” he said.
Chief resident of occupational medicine at USF, Dr. Theodore Aquino, works to triage patients during the simulation. Trauma categories were defined as immediate care (red), delayed (yellow), minor (green) or expectant (black).
Dr. Janet Sprehe, program director of simulations at the VA, manages all simulation education.
She said the VA obtained the simulation bus in August of 2015 and it has been used to train USF College of Public Health medical doctors and residents and USF College of Nursing students, as well as University of Tampa nursing students. The bus has been used for trainings across the Tampa Bay area, including at MacDill Air Force Base and the Hillsborough Emergency Management Command Center.
VA nurses, including emergency room and ICU nurses, provide clinical coaching as students make decisions regarding each patient.
“We have had over 700 people utilize the bus in training,” she said. “It’s great to see everyone liking what we’re training them on. Our goal is to keep simulating different types of emergencies to help people be prepared in what they need to do.”
The bus is equipped to provide medical services in the event of a disaster and, according to Sprehe, could be ready for operation within an hour.
Dr. Brandon Dawkins, a senior occupational medicine resident, said the simulation helped him become more familiar with how it feels to make a critical decision that will help to minimize harmful effects.
“It was difficult at first to understand how to balance the varying levels of triage during the simulation,” Dawkins said. “As a clinician one is trained that everyone who presents to the health care system will get the full complement of resources available. This is very different from an emergency or disaster situation as there are more constraints on time and resources. This creates a situation where attempting to give the full complement of resources to a patient without proper triage may result in injury or death that could have been prevented.”
For resident Dr. Dwayne Wilson, the simulation training was a new and helpful experience.
“Basically, preparation is the key to responding to an event, the more you plan, the more you prepare, the more reflexive memory to assess a patient or disaster event, so that’s why I feel this really helps,” he said.
COPH occupational medicine resident, Dr. Dwayne Wilson, checks the pulse of a patient who was exposed to a mixture of bleach and ammonia.
The occupational medicine residency program at the COPH is a two-year concurrent academic and practicum training program, accredited by the Accreditation Council for Graduate Medical Education.
For more information about the program visit the program’s website or contact Kelly Freedman, program coordinator, at kfreedm1@health.usf.edu.
Photos by Anna Mayor, USF College of Public Health
