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Updated: Dec 25, 2025

Emergency Undocking in Robotic Surgery: A Simulation Curriculum
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Intraoperative Sepsis: A Simulation Case for Anesthesiology Residents.

Timothy T Webb1, Tanna J Boyer1,2, Sally A Mitchell1,3,4

  • 1Assistant Professor of Clinical Anesthesia, Department of Anesthesia, Indiana University School of Medicine.

Mededportal : the Journal of Teaching and Learning Resources
|March 25, 2020
PubMed
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Anesthesiology residents improved septic shock management through a simulation focusing on critical actions like fluid resuscitation and invasive line use. This training is vital for intraoperative patient care during sepsis events.

Area of Science:

  • Medical Education
  • Critical Care Medicine
  • Anesthesiology

Background:

  • Sepsis and septic shock are leading causes of mortality, necessitating expert management in intensive care units (ICUs).
  • Anesthesiology residency training must equip residents with skills for critical care, particularly managing intraoperative septic shock.
  • Understanding sepsis presentation and treatment is fundamental for safe patient care during surgery.

Purpose of the Study:

  • To evaluate the effectiveness of a simulation-based training program for anesthesiology residents in managing intraoperative septic shock.
  • To identify common critical actions missed by residents during septic shock management scenarios.
  • To enhance resident preparedness for rare but life-threatening events like acute septic shock in the operating room.

Main Methods:

Keywords:
AnesthesiologyCritical Care MedicineHigh FidelitySepsisSeptic ShockSimulation

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  • A simulation scenario involving a patient with peripancreatic cyst debridement, hemodynamic instability, and septic shock was developed.
  • Year 2 anesthesiology residents (n=26) participated in yearly 1-hour simulation sessions.
  • The simulation covered key Anesthesiology Milestones related to sepsis and septic shock.

Main Results:

  • 155 residents completed the simulation, with common errors including delays in recognizing the need for invasive lines and appropriate fluid resuscitation.
  • Participants often missed critical steps such as inquiring about blood cultures and antibiotics.
  • Most residents could diagnose and treat intraoperative septic shock, but all benefited from debriefing and identifying areas for improvement.

Conclusions:

  • Simulation provides an optimal platform for practicing rare and critical clinical events like intraoperative septic shock.
  • This simulation effectively reinforced current sepsis definitions and evidence-based treatment guidelines for residents.
  • The training scenario proved valuable for identifying and addressing specific deficits in residents' management of septic shock.