International influence

What began as a discussion between colleagues about how to fill a training gap for residents, has now grown into a nationally and internationally known annual boot camp, that puts trainees through their paces.

It was in 2010, when Drs. Kathryn Roth, Resident Alumna ('08) and Kevin Fung, Resident Alumnus ('02) first met to discuss what changes they could make to how to enrich resident training – especially as it related to managing high-risk patient scenarios that occur less frequently.

With that, the beginning stages of the Emergencies in Otolaryngology-Head and Neck Surgery Bootcamp began.

Using the airline industry as a comparison, Dr. Roth explained that every pilot spends a set number of hours in simulation practising scenarios that can be low frequency yet high-risk. She and Dr. Fung felt the residents needed something similar to explore cases where the stakes are high. 

“As a resident you may not have the opportunity to see every type of emergency case right away, which leaves it to more of a ‘hit-or-miss’ approach depending on what patients come in,” Dr. Roth explained. “We wanted to give residents the opportunity to practise their skills in a safe, hands-on teaching environment where questions are encouraged — a more relaxed environment than a patient care emergency room.”

During the Bootcamp, residents have the opportunity to participate in six skill stations in the morning that deal with models involving epistaxis, post-surgery bleeds, and tracheostomies. Building on these experiences, residents move to more complex scenarios, such as a post-thyroidectomy hematoma or severe airway obstructions.

“Residents work in teams to try to save their mannequin patients,” Dr. Roth said. “We can manipulate the patient vital signs and the situation, and we have nurses and other staff member embedded in the scenario to ensure the training feels like a realistic, high-pressure situation that requires effective communication and problem solving.”

Now in its seventh year, the Bootcamp has grown significantly and become a nationally- and internationally-recognized program. Each year they welcome resident representatives from every province in Canada including Quebec, as the program is bilingual.

Dr. Roth also noted that when the University of California, Davis wanted to start its own Bootcamp, they sent representatives to see how the Bootcamp was run. The Bootcamp’s success has helped to establish the Department of Otolaryngology-Head and Neck Surgery as a leader in this area.

This year, the course will be expanded to two days instead of one to make room for additional training. Dr. Roth said they will also be welcoming their Emergency Medicine colleagues into the training, as residents in that area often deal with the same scenarios before specialty residents are called in. “In real life they would be working together, so it makes sense to train the same way,” she said.

While Dr. Roth is proud of the growth the Bootcamp has had, she explained what really excites her is knowing that residents can leave the course feeling confident in the skills they have.

“The whole point of the Bootcamp is to give residents the building blocks they need, and the opportunity to practice their skills and make mistakes in a safe setting, as opposed to the real world,” she said. “Maybe they will be able to draw upon these skills to save a life at 2:00 a.m. in the future when they are on their own. That’s what this is about.”