Cardiovascular Physiology Workshop for Harvard Medical Students
Mona Hedayat, MD, Aidan Sharkey, MD, Maria Borelli, MD
Published October 1, 2024 | Clinics in Medical Education
Issue 3 | Volume 1 | September 2024
A systemic framework for teaching cardiovascular physiology and pathophysiology is most powerful when integrating inextricably linked cardiovascular anatomy and physiology with hemodynamics. The gap in teaching cardiovascular physiology to medical students often lies in (1) integrating theoretical knowledge with its clinical application in clinical settings; (2) incorporating the latest technological advancements, such as cardiac ultrasound and simulation models, into the curriculum; (3) developing practical skills, such as performing cardiac ultrasound and interpreting data obtained from invasive hemodynamic monitoring; and (4) providing varied teaching methods to accommodate the diverse learning styles of medical students, such as incorporating hands-on experiences, visual aids, and interactive technologies, amongst others.
We hold quarterly three-part cardiovascular physiology workshops for second and third-year medical students rotating in their surgical clerkships. The main goal of these workshops is to help medical students develop the pattern recognition skills necessary to formulate the diagnosis, suggest therapeutic interventions, and monitor the patient’s response more confidently. During these three-part workshops, we have integrated three modalities (Harvi, Cardiac US, invasive hemodynamic monitoring systems) to review normal cardiovascular physiology and high-yield cardiovascular pathologies in a case-based learning approach. The complex cardiovascular physiology concepts are reviewed using Harvi (an interactive, dynamic, simulation-based platform) to help trainees conceptualize the connection between the changes in the various fundamental parameters (preload, afterload, and contractility) and the effect on measurable clinical parameters (including pressures, flow, and end-organ perfusion) through the window of the ventricular-pressure volume diagrams. The students are introduced to a step-wise approach to goal-directed cardiac ultrasound to evaluate anatomical structures and hemodynamics, including machine preparation, patient preparation, and recommended sequences. Additionally, the trainees become familiarized with commonly used invasive hemodynamic monitoring systems, including pulmonary artery catheters, addressing the knowledge gap in understanding the fundamental principles of hemodynamic data acquisition and quantitative and qualitative analyses of hemodynamic
waveforms in normal individuals and various cardiovascular disorders.
Hypotension / Shock Differential Diagnosis
Hands-on simulations were a central feature of the day, allowing participants to engage with temporary pacemakers in real-time scenarios. This practical experience was complemented by interactive digital quizzes to test the fellows’ knowledge in real-time, ensuring that core concepts were understood. One such quiz focused specifically on the management of temporary pacemakers, providing immediate feedback and learning opportunities.
The focus on real-time assessments, with interactive tools such as quizzes, tutorials, and practical simulations, created a dynamic and immersive learning environment. The faculty members fostered not only technical skill development but also critical thinking, encouraging attendees to reflect on the complex challenges they face in the operating room when managing patients with advanced cardiac devices. This Grand Rounds workshop offered a valuable learning experience, building confidence in the perioperative management of patients with temporary pacemakers, ensuring that BIDMC anesthesia fellows are well-prepared to handle these complex cases in their clinical practice. This workshop was a vital part of the Grand Rounds program, ensuring the ongoing professional development of physicians who handle the complexities of cardiac device management in high-stakes surgical settings.
Determinants of Cardiac Output
Since its launch in March 2024, our educational initiative has been a resounding success. We have completed three sets of workshops (totaling nine sessions) for approximately 30 medical students, all of whom have benefited from our unique approach to teaching cardiovascular physiology.