Did you know that the University of Virginia School of Medicine is one of the 20 charter sites for physicians to receive their Maintenance of Certification in Anesthesiology (MOCA)? Doctors travel to sites across the country for recertification, and here at UVA, they spend a day in the Claude Moore Medical Education Building’s Medical Simulation Center, learning and demonstrating their proficiencies for patient care.
In the 10-year MOCA re-credentialing cycle, anesthesiologists must earn 50 points in their knowledge and skills assessments. By coming to our Simulation Center every five years, doctors can earn 25 points on each single-day visit. It is, by far, the most efficient way of getting those points. We take this seriously and, points aside, strive to provide an enriching learning environment for attendees.
We push them, and we push them hard. The entire day is almost entirely simulation-based. Participants break up into teams and experience simulated patients in crisis situations: cardiovascular instability, hypoxemia, malignant hyperthermia, anesthesia toxicity. The works. Then we add a twist: How do these situations resolve with, say, pregnant patients?
Not every test is an emergency. We also present participants with situations that are common or from which they would benefit from practice, like sepsis. From rare to common to close-calls to abnormal … our Simulation Center provides a variety of learning experiences.
SOM’s MOCA Is More than Recertification
Because no patient is cared for by a single person, the healthcare team’s performance is also evaluated. After each exercise, the team gathers to debrief. I believe this is a crucial part of the experience. The team candidly talks about what happened during in the simulation. They answer the question, “What were you thinking?” in an educational, non-judgmental way. There is a tacit assumption that our participants are smart and provide good care to patients — but, what trap did the team fall into? What were they doing (or not doing) together? We not only care about what occurred to result in the simulated patient receiving a bad outcome, but also what can be done to ensure this does not happen again. It is an opportunity to raise the bar for all attendees.
MOCA is administered through the American Society of Anesthesiology, and they invite participants to take a “customer satisfaction” survey. Feedback on our Sim Center experience has been wonderfully positive. Many physicians are happy to come to our School and receive their recertification in this manner. For us, it’s not just a matter of making sure anesthesiologists have their points and that they can check an item off their to-do list. We take pride that, when participants leave UVA, they feel it was a worthwhile experience. Many leave Grounds feeling that the day spent in our Simulation Center changed the way they think about their practice. That is incredibly rewarding.
Our Simulation Center is excellent and there are many talented people who have contributed mightily to its success, from the moment it was conceived to today. This includes Dr. Marcus Martin, Dr. Mark Kirk, Dr. Vaia Abatzis, Dr. Keith Littlewood, the Claude Moore Foundation, and the faculty and staff who envisioned the NxGen curricula and support the center itself. They have my gratitude and my thanks.
R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education