Pearls From Your Peers: Attending the Worst Case Scenarios (WCS) Course
Amy S. Whigham, MD, MS-HPEd, interviews Dale Amanda Tylor, MD, MPH, about the WCS: Managing OTO Emergencies in Practice simulation course and why it is crucial for practicing clinicians to experience modern simulation.
Worst Case Scenarios is an education course that allows learners to participate in simulated clinical scenarios with a group of peers. The included cases are scenarios that may be considered “worst case” as low-frequency but high-acuity events. In this installment of “Pearls from Your Peers,” Amy S. Whigham, MD, MS-HPEd, interviews attendee Dale Amanda Tylor, MD, MPH, about her first time attending this course. The 2024 Worst Case Scenarios: Managing OTO Emergencies in Practice course was held at the University of Miami – Simulation Hospital Advancing Research & Education (S.H.A.R.E) as a 4.5-hour preconference workshop to the AAO-HNSF 2024 Annual Meeting & OTO EXPOSM.
Have you had much experience with simulation in the past?
Having completed medical school in 2002, residency in 2007, and pediatric fellowship in 2009, I have not had significant exposure to modern simulation as a part of my formative education. I was fortunate enough to have access to a cadaveric lab in medical school for dissection purposes, cadaveric heads, and temporal bones in residency, and to experience pediatric airway foreign body simulation with anesthetized piglets. These were incredibly helpful as learning tools. Yet, I admit I could not comprehend how a simulation lab could recreate the "real thing" before taking this course.
Why did you sign up for the WCS course?
Having started my career as an academic complex pediatric otolaryngologist, I was lucky to have had access to weekly grand rounds and regular quality improvement sessions to stay current. I had numerous partners, fellows, and residents who could provide near-immediate input and assistance in scary clinical scenarios. I had worked in a facility with every piece of equipment I could fathom. Transitioning to private practice in a smaller community, without any access to CME opportunities locally, few colleagues, and lacking equipment I previously took for granted as standard, all led me to seek out ways to continue to grow and practice medicine at the current standard of care. Reading articles gets you only so far. This workshop piqued my interest, as I have been in several situations on call where I wished I had a bigger "bag of tricks" or more recent clinical experience.
What was your impression of the course?
Honestly, I was shocked at how real every scenario felt and how tense the situations were. It felt great to get the treatment plan correct. In areas where I could have done better, it was learning without shame and without putting a patient's life at risk. The debriefing after each scenario was extremely helpful for my cohort to share insights and anecdotes in addition to clarifying best practices. I came out of the day invigorated for having experienced six different nightmare scenarios, any of which could be something I would encounter in my practice—though I hope never to!
Were you surprised by anything?
I was surprised at the variety of the learners. There were many residents, newer attendings, and more senior attendings in my cohort, which seemed similar to other groups. It was great to have learners with different experiences in my group. We all learned from each other. In addition, I was surprised that there were not more mid-career otolaryngologists in attendance. In my opinion, this is an ideal educational opportunity for mid-career private practice otolaryngologists. To me, this is the exact demographic that would benefit most- being far enough out from training, often not practicing in a place where there is regular CME locally, taking calls in facilities with less robust protocols for emergencies, and the reality of running your own practice away from a hospital without staff that may not have the optimal level of training for serious emergencies.
What do you want other members to know about WCS?
I would encourage anyone, especially a mid-career otolaryngologist, to attend this session in the future. This is an amazing opportunity to work through emergency clinical situations, practice your skills, and learn from your colleagues. It was truly the most beneficial training I have attended since completing my fellowship.
