More than 200 seniors from the University of Miami Miller School of Medicine will enter their residency programs better equipped and more confident, thanks to the expanded Transitioning to Residency course — part of the school’s new medical education curriculum.
Offered last year as an elective with 50 students, the Department of Medical Education and Miller School students saw the value of the course in residency preparedness. This year’s edition included all students in the graduating class and offered new specialty training.
“We feel this type of simulation training in acute medical emergencies is critical for every graduating student,” said Gauri Agarwal, M.D., associate dean for curriculum and associate professor of medicine. “Students are trained not only to recall critical pieces of medical knowledge, but to practice their composure, communication, decision making and teamwork skills with their patients and colleagues.”
Applying Theoretical Knowledge of Medicine in a Practical Setting
Instruction for the month-long course began in March and is a massive logistical undertaking with hundreds of faculty members, residents and simulation instructors involved. The first week focused on communication skill labs, procedural skills and review of core skills like interpreting electrocardiograms, X-rays and arterial blood gas analysis. During weeks two through four, the course shifted to hands-on simulations in which students managed acute medical emergencies.
New to the course was the addition of the specialty specific sessions. Students who matched into specific specialties were taught by faculty across all clinical departments at the medical school, including pediatrics, surgery, obstetrics-gynecology, internal medicine and emergency medicine.
“The best part of this course was having the opportunity to apply our theoretical knowledge of medicine in a practical setting,” said Steven Lang, a fourth-year student who will be entering a pediatric/medical genetics residency program at Baylor College of Medicine in Houston, Texas. “Though we learn a lot in medical school, this course gives us the practical information we will need as interns on day one.”
Testing Medical Realities Through Simulations
The course concluded with a final exam in which the students rotated through four simulations, testing their ability to handle scenarios in a timed setting. Instructors briefed the students, who were split into groups of five, on the specific simulation they would tackle.
“These scenarios are excellent since they challenge students to apply the vast information they have learned in real life,” said Stanley Starke, senior paramedic instructor at the Gordon Center for Simulation and Innovation, where some of the simulation sessions took place. “My favorite moments in leading the sessions were seeing the dynamics in how they worked together for the first time to benefit the patient — all skills they will use with their various medical colleagues.”
Immediately upon entering the room, the students delegated roles and approached either a programmed manikin or an individual recruited to play the role of a patient, obtaining a focused medical history, performing a targeted physical exam, initiating care and communicating with the patient and their colleagues. Instructors carefully monitored the simulation from another room.
“For many of us, this was our first time working as a team in an emergency scenario, and it put into perspective what our intern years will look like,” said Nicolle Rodriguez Yanes, a fourth-year student entering an OB-GYN residency program at Mount Sinai Medical Center in Miami. “As medical students, we think we are in this isolated bubble, so it's great to do this together and rely on outside resources, similar to real life.”
Upon the course’s conclusion, the instructors reviewed how the groups did, highlighting the students’ success and areas of potential improvement.
“The students gain valuable experience from practicing these scenarios in a safe environment,” Dr. Agarwal added. “Here, they can feel comfortable making mistakes and learning. I tell them that the only mistakes they can make are not asking for help or not looking up information when they have a knowledge gap."