Simulation Fellowship in OBGYN

This is a one-year non-ACGME accredited fellowship program, which began as a collaborative effort between the New York Simulation Center for the Health Sciences (NYSIM) and the NYU Department of Obstetrics and Gynecology in July of 2014. Our first fellow, Dr. Kristen Uquillas, has completed her one-year of training in June of 2015. She is now continuing her training as MFM (Maternal Fetal Medicine) fellow. As far as we know, our fellowship is the first in the world to provide simulation training in OBGYN.

During the following academic year (2015-2016), we re-structured the fellowship in order to make it sustainable long-term and to provide clinical exposure to the fellow at the sites were s/he is running simulation sessions. Below is the description of the fellowship in its current state, for 2016-2017 academic year. It is the model we are hoping to continue going forward.

For 2017/18, the fellowship is based at the Department of OBGYN at NYU, which covers a wide array of simulation activities (examples of some of the simulations are outlined below) at NYSIM (simulation center at NYU/Bellevue), NYU Tisch, Bellevue and Lutheran hospitals. It is led by Dr. Veronica Lerner of the Department of Obstetrics and Gynecology, who serves as the Fellowship Director, and Director of Simulation within the department of OBGYN.

This unique opportunity allows the fellow to divide his/her time between designing, implementing, and running simulations specific to the OB-GYN department both at the simulation center and “in-situ” (or unit-based), and to be involved in designing and implementing inter-professional simulation in situ at NYU Tisch, Bellevue and Lutheran Hospitals. Programs are designed for UME (medical students), GME (residents), and CME (attending-level). Curriculum also includes inter-departmental and inter-professional simulation work.

In order to maintain clinical skills and to be engaged in QA and patient safety work, fellow works “on the ground” as a part-time Laborist at Lutheran Hospital, covering 7-8 12 hour shifts per month). The rest of the time is spent on simulation work.

1. Examples of Simulation Education Activities for 2016-2017

  • Procedural Skills Training Programs: Designing and implementing courses using partial task trainers. Participating in the set-up, breakdown and trouble-shooting of partial task trainers. For example:
    • OBGYN Residency Bootcamp- 2 week course for forth year medical students who matched into Ob-Gyn residency to help facilitate the transition. Includes multiple stations using task trainers to teach cesarean section, perineal laceration repair, suturing/knot tying, circumcision, ultrasound (fetal biometry and transvaginal ultrasound), vaginal delivery and placement of fetal scalp electrode and intrauterine pressure catheter, and sterile technique, obstetrical emergencies, contraception, gynecologic surgical skills, electrosurgery, hysteroscopy, IUD workshop, and contraception.
  • OB/GYN residency surgical skills curriculum: colposcopy/LEEP, hysteroscopy and perineal repair trainings, abdominal and vaginal hysterectomy, laparoscopic skills curriculum, and open surgery skills.
  • Standardized Patient Programs: Writing OSCE and simulation encounters, training standardized patients on roles, creating checklist items to use simulation for learner assessment. For example:
    • OB/GYN resident Test of Integrated Professional Skills (TIPS) exam- an objective structured clinical exam-simulation hybrid exam that assesses Ob-Gyn resident integration of technical, cognitive and affective skills.
    • OB/GYN clerkship simulation sessions- 2-hour sessions during the Ob-Gyn clerkship with a small group of 4 medical students covering key Ob-Gyn topics such as abnormal uterine bleeding, contraception, labor management and gestational diabetes. 
  • Center Based Immersive Simulation: Designing simulation scenarios and implementing debriefings to achieve learning objectives. Operating simulators from the control room and audiovisual equipment independently. Collaborating with OB/GYN residency leadership to design impactful curricula. Collaborating with other departments in designing and implementing interdisciplinary and inter-professional simulations.
  •  OB/GYN resident simulations: (i.e. operative delivery, TOLAC, periviability, maternal sepsis and maternal code)
  •  Pulmonary and Critical Care Fellow OB emergency simulations
  •  Teamwork and skills courses including postpartum hemorrhage, shoulder dystocia, and eclampsia
  •  In-situ Immersive Simulation: Designing simulation scenarios and implementing debriefings to achieve learning objectives. Collaborating with QA to design impactful curricula. Collaborating with other departments (anesthesia, nursing) to implement inter-professional simulations.
  •  In-situ team-based interdisciplinary simulation of obstetrical emergencies at Bellevue, NYU, and Lutheran.

Full programmatic description of our programs is available here:

2. Faculty Development

  • “Train the trainer courses” Simulation Instructor Courses: Teaching debriefing with good judgment, observing faculty and providing feedback on debriefing.
  •  NYSIM Instructor Course: Debriefing and Simulation Education
  •  OB/GYN faculty development for teaching medical students with simulation
  •  Collaborating with OB/GYN clerkship leadership to facilitate training faculty to teach with simulation

3.  Quality Improvement Activities “improving your workplace via simulation”

  • Working with QA liaison to address and correct latent safety threats identified during in-situ simulations
  • Co-authoring a proposal for expansion of the Obstetric Safety and Simulation Program at Lutheran Hospital, including a patient safety nurse to support the program with teaching, curriculum design, research and act as a QA liaison.

4.  Research and Scholarly Activities

  • Understanding and applying relevant education theories to all aspects of work in simulation.
  • Participation and presentation at monthly fellowship meeting/journal club
  • Conducting scholarly projects and research endeavors in healthcare simulation (i.e. preparing and presenting abstracts at state and national conferences, writing manuscripts for publication)

 
5. Personal and Professional Development

  • Attending regional, national and international conferences (i.e. NYSIM Annual Hot Topics in Simulation Education Symposium, International Meeting for Simulation in Healthcare)
  • Collaborating with obstetricians at other institutions to implement simulation programs at national conferences (i.e. Annual Meeting of the Society for Maternal Fetal Medicine)
  • Participating at NYSIM Annual Symposium for Fellows in Healthcare Simulation
  • Participating in monthly Grand Rounds on Simulation at NYSIM
  • Participating in Hot Topics, annual regional simulation conference at NYSIM

6. Administration and Operations of Simulation Division

  • Contributing to the operations of simulation activities
  • Attending administrative meetings throughout the year

Schedule

The fellowship offers PGY5 salary support of $69,000 annually. 
 
Clinical: 7-8 12 hour Laborist shifts per month. These are evenly distributed over days/nights and weekdays/weekends. 
 
Optional L+D call coverage may be available in addition to clinical duties for moonlighting purposes.

We are currently accepting applications for the simulation fellowship for the academic year 2017-2018. Please contact Dr. Veronica Lerner to apply via email: veronica.lerner@nyumc.org, or phone: (646) 331-0401.

 

Board of Directors

 

Veronica LernerDr. Veronica Lerner, Fellowship Director
Associate Clinical Professor, Department of Obstetrics and Gynecology
Director, OBGYN Simulation Program

Dr. Veronica Lerner, Fellowship Director
Dr. Veronica Lerner is an Associate Professor in the Department of OBGYN, and holds her BA from the University of Colorado at Boulder and her medical degree from the University of Colorado Health Sciences Center. She completed her residency in OBGYN at Mount Sinai Hospital in NYC, and a Fellowship in pelvic surgery in Virginia Mason Hospital in Seattle, WA. After joining NYU/Bellevue as faculty in 2007, she became involved in simulation and is now Director of Simulation in the Department of OBGYN.
 
Dr. Kristen Uquillas, 2014-2015 Fellow

Dr. Uquillas holds degrees from Dartmouth College (BA) and Stanford University School of Medicine (MD). She completed the residency in Obstetrics and Gynecology at New York University Langone Medical Center and served as the Education Chief, assisting with the didactic and simulation curriculum for residents. She completed her NYSIM OBGYN Simulation and Education Fellowship in June of 2015 and she is currently doing her MFM fellowship at USC. She plans to incorporate simulation into her future career as an MFM.
 
Dr. Lorraine Toner, 2016-2017 Fellow

Dr. Toner holds degrees from Plattsburgh State University (BS), New York University (MS), and St. George’s University School of Medicine (MD). Prior to medical school, she worked as an academic researcher at Rockefeller University in Nobel Laureate Ralph Steinman’s laboratory studying HIV transmission, and Memorial Sloan Kettering Cancer Center, developing novel chemotherapies for lymphoma. She completed her Obstetrics and Gynecology residency at Danbury Hospital in CT, where her interest in research resulted in numerous abstracts, oral and poster presentations. She also worked to develop a simulation curriculum in residency education. As an OB/GYN simulation fellow, Dr. Toner hopes to develop a simulation curriculum that could be infused into all OB/GYN residencies nationwide. She aspires to be an MFM and use simulation to improve patient safety and outcomes.