Emergency Medicine residents bring dramatic flair to regional skills competition at UTSW
One of the most famous Shakespearean tableaus takes place on a balcony, where two star-crossed lovers meet in secret. Lesser-known is the version where Juliet’s 40-year-old nurse suffers a severe brain injury and a hip dislocation after falling from an open window while trying to eavesdrop. Or when Lady Montague experiences takotsubo cardiomyopathy, or “broken heart syndrome,” after her son is banished from fair Verona.
But these were some of the creative scenarios presented to a team of emergency medicine residents competing in the Romeo and Juliet-themed North Texas Regional Sono/Simwars on Thursday, May 8, at UT Southwestern. The half-day competition comprised a series of games and timed challenges testing the residents’ technical knowledge and clinical skills with sonography and emergency simulations.
UTSW Emergency Medicine residents were joined by their peers from JPS Health Network, Medical City Arlington, and Baylor University Medical Center for the event. Participants and future colleagues were assigned to mixed groups at random and had to quickly learn how to function as a team – simulating the collaborative and sometimes chaotic nature of emergency medicine.
“These simulations and techniques are very similar to what we see every day in actual practice,” said Rebecca Kernen, M.D., a third-year UTSW Chief Resident. “In the field of emergency medicine, you never know what to expect.”
The Sono/Simwars tradition started in 2016, when UTSW and JPS offered the only emergency residency programs in Dallas-Fort Worth, said Kavita Joshi, M.D., Assistant Professor of Emergency Medicine. She and Jodi Jones, M.D. FACEP, FPD-AEMUS, Associate Professor and Interim Division Chief of Emergency Ultrasound and Simulation, organized the event.
The Sono/Simwars and the number of available programs have grown significantly since then, according to Dr. Joshi.
“Our residents work so hard in training, it’s difficult to see outside the silo of our own program. This training is to remind them that a greater community of emergency medicine professionals exists,” she said. “After they graduate, they will all be working with each other. We hope that this event can strengthen the mutual trust that is needed to care for patients together in their future careers.”
The first part of the day was devoted to testing the residents’ competencies with ultrasound technology. Divided into six teams of six members each, they rotated among stations that offered unique challenges. Participants had 10 minutes to rack up the most points at each Romeo and Juliet-themed station before moving to the next one.
Instructions at one station told residents that “Romeo was stabbed in the back of the right leg by a member of the Capulet family. He is having difficulty walking now.” An unlabeled ultrasound image provided clues to the diagnosis: a ruptured Achilles tendon.
Fully embracing the theatrical nature of the day, volunteers donned period-era costumes and played the parts of patients while teams competed in emergency triage protocols. A panel of judges evaluated their skills to determine which group had the best approach to identifying and treating mystery diagnoses, such as Juliet’s pericardial tamponade and Romeo’s amitriptyline overdose. Residents had to act quickly and decisively while navigating hurdles such as unresponsive patients, interfering relatives, and well-meaning but not entirely helpful assistants.
The combination of lighthearted role-playing and competition made for the ultimate “edu-tainment,” said Dr. Joshi.
“It is a chance for residents to ‘play’ with their knowledge and to have fun with the expertise they are gaining,” she said. “As an educator, it is heartwarming to see the residents having fun and demonstrating the skills they have earned through hard work.”
Dr. Kernen’s team took first place in the final round of Simwars, impressing the judges with its effective communication, problem-solving abilities, and efficiency in treating the wounds of Romeo and Juliet.
Dr. Kernen, who also participated in last year’s Olympics-themed event, said the Sono/Simwars exercise cultivates camaraderie and allows residents to practice critical medical skills in an engaging and unique way.
“I’ve really gained a lot from these experiences,” she said. “Patients come to us in various states, but our training and amazing faculty prepare us well. And when I’m working in the actual hospital, I draw from these experiences a lot. We become well versed in using ultrasound technology and going through vital procedures. With emergency medicine, you just never know what to expect, so we do our best to prepare for everything.”
Sono/Simwars highlights
