For 5 credits in MOCA Part 4, simulation course participants can identify practice improvements prompted by their course participation.  They then complete a brief follow-up report to the ASA within 90 days of the course.

Here are examples of practice improvements by MOCA simulation course participants:

"I printed, laminated, and spiral bound a series of 12 critical event checklists for use in the ORs in my hospital.  Health system leadership distributed the cognitive aid to all the hospitals in our system."
"I created a handoff template that included key information such as relevant and abbreviated medical history, difficulty of intubation, IV access, and plans for extubation. I carry these cards with me and placed several in the top drawer of the anesthesia cart so that other providers have access to them. Not only has this made my handoff to other providers easier but they also now know what information to expect me to request of them, so communication is more efficient."
"Until my MOCA simulation training, I did not know that the Ambulatory Surgery Center where we do many regional anesthetics did not have lipid emulsion available in case of LAST. I met with the OR manager and the members of my department to discuss the use of lipid emulsion in LAST and to identify a plan to acquire and stock lipid emulsion. We have acquired the medication and have a plan to make sure it is in the block carts."
"Much to our surprise, we discovered at our MOCA course that we are not familiar with the way our resuscitation equipment (such as our defibrillator) works, and we know very little about its function. We now run mock drills so we learn how to use this equipment, and should we need it in an emergency."

Steadman, RH, et al. Practice improvements based on participation in simulation for the MOCA Program. Anesthesiology 2015