Where can we go?

What can you do in a medical school curriculum with simulation?

To get some idea of just where it is currently possible to go, one can look at Harvard Medical School. They have an integrated use of simulation into the curriculum. The following is a list of how simulation is used in their first two years of medical school:

AAA rupture

Peptic ulcer perforation

Perforated colon cancer

Pancreatitis

Chloelithiasis, Cholecystitis

Kidney stone

DKA

Toxidromes/overdoses—cholinergic, anticholinergic, sympathomimetic, tyylenol, opioids

Beta blockers

Alcohol withdrawal

Seizures

Hypoglycemia

Brain tumor

Small bowel obstruction

Diverticulitis

Ectopic pregnancy

Adnexal torsion

Pulmonary embolism

Acute coronary syndrome—unstable anginia, STEMI and nonSTEMI

Cardiogenic shock

Hypotensive bradycardia

MI—RV infact as well

Demand ischemia in the setting of GI bleed

Carbon monoxide inhalation

GI bleed—upper: esophageal varices, esophageal cancer

GI bleed—lower: diverticulosis

Spontaneous and traumatic subarchnoid hemorrhages

Traumatic head bleeds: epidural, subdural, parenchymal

Traumaic spleenic rupture,

Pneumothorax—including tension pneumothorax

Pulmonary contusions

Orthopedic injuries

Pericardial tamponade

Pericarditis

Myocarditis

Cellulitis

Hypertension crisis/pulmonary edema

Congestive heart failure ascerbation

Meningitis, headache

Urinary tract infection—sepsis

Aortic dissection

Epidural abscess, cauda equine

Sickle cell pain crisis, acute chest syndrome

Bells palsy

Anaphylaxis

Neurogenic shock / trauma

Hemorrhagic shock

Mesenteric ischemia

Complete heart block

Vasovagal syncope, prolonged QT, brugada

Advanced Cardiac Life Support Program

Rhabdo hyperkalemia

Esophageal rupture

Volvulus, cecal, sigmoid

Aortoenteric fistula

Vertigo, peripheral versus central

When looking at this list one should bear in mind that simulation as a field is in its infancy. This extensive list is but a starting point.