Simulation in healthcare : journal of the Society for Simulation in Healthcare
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Extracorporeal membrane oxygenation (ECMO) is a form of long-term cardiopulmonary bypass used to treat infants, children, and adults with respiratory and/or cardiac failure despite maximal medical therapy. Mechanical emergencies on extracorporeal membrane oxygenation (ECMO) have an associated mortality of 25%. Thus, acquiring and maintaining the technical, behavioral, and critical thinking skills necessary to manage ECMO emergencies is essential to patient survival. Traditional training in ECMO management is primarily didactic in nature and usually complemented with varying degrees of hands-on training using a water-filled ECMO circuit. These traditional training methods do not provide an opportunity for trainees to recognize and interpret real-time clinical cues generated by human patients and their monitoring equipment. Adult learners are most likely to acquire such skills in an active learning environment. To provide authentic, intensive, interactive ECMO training without risk to real patients, we used methodologies pioneered by the aerospace industry and our experience developing a simulation-based training program in neonatal resuscitation to develop a similar simulation-based training program in ECMO crisis management, ECMO Sim. ⋯ Traditional ECMO training programs have yet to incorporate simulation-based methodology. Using current technology it is possible to realistically simulate in real-time the clinical cues (visual, auditory, and tactile) generated by a patient on ECMO. ECMO Sim as a training program provides more opportunities for active learning than traditional training programs in ECMO management and is overwhelmingly preferred by the experienced healthcare professionals serving as subjects in this study. Subjects also indicated that they felt that the acquisition of key cognitive, technical, and behavioral skills and transfer of those skills to the real medical domain was better achieved during simulation-based training.
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: The objective of this study was to describe the availability and current use of high-fidelity mannequin-based simulation (HFMB) in emergency medicine (EM) training programs. ⋯ : HFMB simulation technology has not been completely adopted by EM training programs even when it is available. Most EM training programs are using HFMB simulation less often than every month and curriculum development in EM training is still in the early phases.
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Despite its relatively short track record, simulation has been successfully introduced into the surgical arena in an effort to augment training. Initially a fringe endeavor at isolated centers, simulation has now become a mainstream component of surgical education. The surgical community is now aware that the old adage, "see one, do one, and teach one" is no longer acceptable from the ethical standpoint of practicing procedures on patients. ⋯ Importantly, simulation standards are being established and there is an unprecedented national acceptance and endorsement of simulation as an invaluable educational tool; in fact, simulation is being mandated for surgical residency programs. Team training will likely expand the impact of surgical simulation considerably and help assure multidimensional competency verification. For both surgery residents and surgeons in practice, simulation holds great promise as a safe, effective, and efficient means of acquiring new skills.
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Simulators are used for training medical personnel. This report details the use of a human patient simulator for initial clinical experience of anesthesia housestaff with cardiopulmonary bypass.
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Echocardiographic images were integrated into patient simulation (PS)-based resident training with a goal of highlighting the applicability and limitations of pure pressure-based measurements in the management of different disease states. ⋯ The use of echo images to demonstrate, in real time, the hemodynamic consequences of changes in myocardial contractility, cardiac chamber volume, and valvular function is possible during PS in anesthesiology residency training. Echo imaging as a teaching tool during anesthesiology residency may yield a greater understanding of the pathophysiology of certain disease states, ultimately leading to faster diagnosis and more appropriate intervention by anesthesiologists.