Simulation in healthcare : journal of the Society for Simulation in Healthcare
-
Increasing time and resource constraints, and the potential for patient complications, has led to an emphasis on finding innovative ways to teach catheter-based procedures outside of the laboratory. Virtual reality (VR) simulator training has been proposed as a potential training solution. We report on the initial validation of a full procedural VR simulator for carotid angiography (CA) using the Vascular Interventional System Trainer (VIST). ⋯ VIST represents one of the most sophisticated VR simulators in medicine. Physicians reported that it looked, felt, and behaved similar to working on an actual patient. Future work is required to validate whether this simulator will improve catheter performance on actual patients.
-
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.
-
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.
-
The Effective Management of Anesthetic Crises (EMAC) course is a joint initiative between the Australian and New Zealand College of Anesthetists (ANZCA) and simulation centers. This standardized 2.5-day course has become an integral component of training for Fellowship of ANZCA and as such is an innovative development on the global anesthesia scene. ⋯ The course is perceived by participants as changing their practice and improving their management of anesthetic crises. Exposure to the concepts of effective crisis management is now widespread in the anesthetic community in the region and should contribute to improved patient safety.
-
Today's movement towards the democratization of knowledge and dissemination of technology creates an opportunity for health care providers to reform medical education, bridge disciplines, and contribute to the correction of social inequalities. The question is whether this generation of physicians will have the courage to bring down the barriers that have deprived the majority of humanity from the medical knowledge, technology, and healthcare that rightfully belongs to all.