Dental Staff Take Bite Out of Medical Emergency Simulation
By Mary Sturgeon, DMD, RDH
Interprofessional Advanced Clinical Simulation Fellow
Shelley Miyasaki, DDS, Ph.D
Assistant Chief of Dentistry, Oral Maxillofacial Surgeon
and Richard Fidler, CRNA, NP, Ph.D
Director of Simulation and the Interprofessional Advanced Fellowship in Clinical Simulation
SAN FRANCISCO – Thirteen years ago, San Francisco VA Health Care System (SFVA) Oral and Maxillofacial Surgeon, Shelley Miyasaki, DDS, Ph.D, met the SFVA Director of Simulation and the Interprofessional Advanced Fellowship in Clinical Simulation Richard Fidler, CRNA, NP, Ph.D, when he was administering anesthesia across the drape in the operating room. Fidler was describing a simulation scenario for an airway fire to which Shelley replied, “Why aren’t you working with the dentists? We work in the airway all the time.”
Since that day, Fidler and Miyasaki have worked together providing medical emergency response training to dental services in VISN 21 and across the country. They understand that dental providers should have access to this training as vital members of the VA health care team.
Fidler, Miyasaki and the SFVA simulation team provide once monthly training session to the dental General Practice Residents (GPRs) from the SFVA; Palo Alto, California VA Health Care System and the University of California San Francisco. The program helps residents practically apply principles of medicine, pharmacology and physiology in order to help them participate more fully in their medicine, emergency and anesthesia rotations.
Miyasaki’s former resident Susie Chung, DDS, is currently the GPR program director at the Jesse Brown VA Medical Center (VAMC) in Chicago, Illinois. Four years ago, Miyasaki offered to train the GPR residents and staff from VISN 12. They began offering a full-day course for the dental service and enlisted the help of the Jesse Brown simulation team of Valerie Reid, RN, and Craig Addison, RN. Reid and Addison organize all the logistics that make these trainings a success.
In 2017, Mary Sturgeon, DMD, RDH, participated in this training as a GPR at the Jesse Brown VAMC. Fidler then recruited her to join the Fellowship in Advanced Clinical Simulation at the SFVA. In 2019, four VA dental clinics participated from Illinois and Wisconsin. The two-day curriculum included skills sessions, in-situ or in place medical emergency simulations, as well as a hospital mega code. The scenarios focused on medical emergencies that can occur in the dental setting or while dental staff are treating their patients throughout the hospital, including the operating room for restorative and surgical procedures, emergency department and in-patient units. The program gives dental teams a systematic framework to evaluate and manage medical emergencies. It helps medical and dental providers improve interprofessional communication. Fidler and Miyasaki’s department heads have always allowed them to provide this valuable training to other dental services, including staff dentists, Richard Kaplan, DMD, and Kristine Schedler, DDS, and their residents from Green Bay and Milwaukee, Wisconsin, who traveled there to participate.
From Feb. 25-27, representatives from VAMCs in Chicago, Green Bay, Miami, Milwaukee, Tampa and San Francisco took the SimLEARN Introduction to Clinical Simulation (ICS) course. The twelve participants included dentists, RNs and CRNAs who are committed to working together to train more dental and outpatient medical teams in medical emergency management. For the first time, American Dental Association continuing education (CE) credit was granted for the course. This was due to the efforts of Dr. Elizabeth Nuñez, DMD, VHA Office of Dentistry director of education, and Dr. Scott Wiltz, MD, SimLEARN associate medical director. This paves the way for dental teams to obtain CE credit for simulation training programs like other medical professionals do.
The ICS course and the teambuilding by the group, both inside and outside the course, solidified this partnership. All those involved believe we need to incorporate this type of training into all dental and outpatient medical settings where our Veterans are treated.
Also in attendance was Dr. Ankur Patel, DDS, VISN 12 Dental Education director and chief of the Milwaukee/Green Bay dental service. With his support, this collaboration is continuing to grow, with a train the trainer course planned for 2020 which is aimed at training the remaining dental providers and staff in VISN 12. Dental teams want to be better prepared to serve our Veterans and they want to improve interprofessional collaboration within our VA health care system.
For more information about training VA dental teams please contact Mary Sturgeon.
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