University of Rochester Experts Bring Real-World Insights to Critical Care Training

What if I told you that there is a hospital in Mesa, Arizona, filled with patients who have no heart?

Strange as it sounds, that’s an accurate description of the Banner Simulation Medical Center, a 55,000 square foot facility that has long been home to the Critical Care in Obstetrics Course, which concluded its latest session on November 9th.

This year’s Course drew 247 participants from around the world, including Maternal-Fetal Medicine (MFM) specialists, full-spectrum Ob/Gyns, critical care specialists, obstetrical hospitalists, midwives, nurses, nurse practitioners, physician assistants, and trainees.

Critical Care in Obstetrics Course: An Abbreviated History

Dr. Loralei Thornburg, Professor of Obstetrics and Gynecology at the University of Rochester, was there when it all began, 10 years ago.

The project was spearheaded by Dr. Mike Foley (pictured on right) and Dr. Mary D’Alton, with support from the leadership team at the Society for Maternal-Fetal Medicine, to achieve a specific goal, says Dr. Thornburg:

To put the ‘M’ (maternal) back in MFM. To bring people together and give them skills for these critical events

Dr. Thornburg began her involvement as part of the Content and Debriefing Committees, and now serves in a leadership role.

Comprehensive Review of OB Emergencies

Though the specific scenarios change every year, the Course always covers the most common and life-threatening complications in obstetrics, including:

• Stroke
• Trauma
• Seizures
• Cardiac Arrest
• Resuscitative Cesarean
• Hypertensive Emergency
• Amniotic Fluid Embolism (AFE)
• Disseminated Intravascular Coagulation (DIC)

As Dr. Kendra Gray, one of the faculty members for the Course says:

“[I]t’s not about preparing for ‘if’ – it’s about being ready for when the worst happens.”

High-Fidelity Simulation

While the Course is unique in its subject matter, the true highlight is its teaching modality. The Course combines traditional classroom-based learning with hyper-realistic simulated scenarios.

Participants practice critical scenarios such as emergency cesarean sections and maternal codes in an actual hospital setting, creating an immersive experience that feels like the real thing. That’s all thanks to the Banner Simulation Medical Center, where computerized mannequins are the only artificial component.

University of Rochester Participation

Many members of the University of Rochester Department of Obstetrics and Gynecology have participated in and taught in the Course.

The ongoing commitment to sending faculty, staff, and trainees has created an environment in which team members are prepared for critical events and can fall back on a shared training experience.

I have been able to manage hypertensive diseases and hemorrhages with confidence while bringing that knowledge back to residents, students, and colleagues.

The Maternal-Fetal Medicine Fellowship Program ensures that all fellows attend at least once, in their first year, and offers the opportunity to return in their second and third years to teach and facilitate debriefs.

As a result, there are former fellows from our program now practicing around the country who have received this excellent training and continue to participate as instructors.

This year’s contingent included first year fellows Dr. Sid Hariharan and Dr. Mary Gallo, along with third year fellow Dr. Shaun Wesley, and Dr. Logan Todhunter, who is pursuing dual board certification in Maternal-Fetal Medicine and Critical Care Medicine.

Continuing Medical Education Done Right

Despite being a leader in the Course and the Maternal-Fetal Medicine Division Director here at the University of Rochester, Dr. Thornburg insists that she learns something every year: “Every single time I learn something. Something we could be doing differently or could be doing better”.

Asked for an example, she took no time at all to identify a key insight from this year’s Course: giving Zofran at the time of spinal or epidural anesthesia can reduce the risk of hypotension. That, in turn, helps to reduce the need for IV fluids, a practical benefit during a national IV fluid shortage.

In fact, Dr. Thornburg says that the best aspect of the Course is the open exchange of ideas between participants who are practicing in various settings around the country.

It’s not about saying ‘this is the only way’ to do something. It’s about learning from one another, generating ideas for improvement. We’re all committed to reducing maternal mortality by being prepared for worst-case scenarios. There’s no room for ego.”