The Department of Anesthesiology recently held its 50th in-person Maintenance of Certification in Anesthesiology (MOCA) session, continuing a series of high-quality in-person simulations that began in 2014.
Nikolaus Gravenstein, M.D., the Jerome H. Modell, M.D., Professor of Anesthesiology, lead clinical advisor at CSSALT, and director for the MOCA courses, said the program was first created to serve the large faculty here at the University of Florida Department of Anesthesiology.
“There weren’t many places that offered programs like this. So we went through the approval process and now we’re able to hold sessions on Saturdays to minimize the amount of work that our faculty miss.”
The MOCA sessions are set up as a series of brief clinical simulations, each with two participants.
“In each of these simulations, something inevitably goes imperfectly,” said Gravenstein. “Everybody takes part in two simulations and is always in the ‘hot seat’ once, and everyone else observes via monitors in an adjacent room. After the simulation, we have a discussion and debriefing session to talk about what happened and what could have been done differently. It’s really all about building the discussions.”
Kathy Parrish, MBA, manager of administrative services for the Department of Anesthesiology, said the courses have been very popular.
“Physicians leave the courses with a lot of information, or with things they need to talk to their staff or hospital about,” said Parrish. “Afterwards, we get a lot of great comments about the scenarios, handouts, and debriefs, and we regularly share evaluation and feedback with our MOCA faculty.”
Parrish said physicians attend the courses from all over the United States, and many come back when it’s time for them to renew their 10-year certification. “We know it’s working and we know it’s helping because we have people coming back.”
“It’s really all about building the discussions.”
Nikolaus Gravenstein, M.D.
Lauren Berkow, M.D., FASA, professor of anesthesiology and chief of the division of neuroanesthesiology, is one of several faculty members who helps run the MOCA program.
“We have an extremely successful MOCA course,” Berkow said, “as evidenced by the stellar evaluations and returning attendees over the years. Our course is continuously updated to include new trends in technology as well as practice guidelines, and I think our ability to highlight innovations in simulation developed here at UF sets us apart from other MOCA courses.”
Gravenstein credits much of the course’s success to the engineers and scientists at CSSALT, headed up by Samsun Lampotang, Ph.D., the Joachim S. Gravenstein Professor of Anesthesiology and director of CSSALT.
Dave Lizdas, M.S., is an engineer with CSSALT and plays a key role in ensuring that each simulation runs smoothly for its participants. Simulation support goes beyond the day of the course and includes holding workshops for trainers and the embedded simulation personnel who portray patients, nurses, and other roles.
“My favorite simulations are the ones that have interesting interactions with the embedded simulation personnel,” said Lizdas. “Some of our scenarios, for example, might have more communication between the surgeon and the scrub technician, or involve an attending who has to leave a procedure on short notice and do a quick handoff. These might be a little stressful, but the discussions afterwards are always lively and fun.”
"I think our ability to highlight innovations in simulation developed here at UF sets us apart from other MOCA courses.”
Lauren Berkow, M.D., FASA
Gravenstein and Lizdas are both looking forward to continuing to grow the program by continuously integrating feedback, adding new simulations, and refining the existing ones. Gravenstein said more than 20 simulations have been developed for the course, up from an initial half-dozen.
“There’s always process improvement,” said Lizdas. “We always take notes and have debriefs to identify ways we can improve the simulations on the back end. We’re regularly writing new scenarios, improving the manikins, and improving the simulation scripts, all in collaboration with our clinicians.”
Gravenstein also commends the support of the department’s administrative staff in facilitating the course.
“We’ve been fortunate to have fabulous support from the administrative side of the department,” said Gravenstein. “There’s so much work involved with organizing and setup. None of this would work without that piece of the puzzle and without all the people who volunteer their time on the weekends to help make these courses happen.”
