Medical Tech Education - lyndadanielunderwood.weebly.com€¦ · TECHNOLOGY AND MEDICAL EDUCATION: Medical Simulation Lynda Daniel-Underwood, MD Andrews University: Lead690 September,

TECHNOLOGY AND MEDICAL EDUCATION:

Medical Simulation

Lynda Daniel-Underwood, MDAndrews University: Lead690September, 2007Advisor: Courtney Pindling, PhD

Images on this page taken from:http://www.medsim.org/

What is Simulation?

“Simulation is a training and feedback technique in which learners practice tasks and processes under realistic settings and circumstances using tools and models, such as virtual reality, and utilizing feedback from observers, such as professors, peers, actor-patients, and video cameras.”

(AIMS, 2005, p. 1)

Medical Simulation

“Medical simulation allows students and experienced clinicians to learn or improve a skill or demonstrate competency [using technology] without harming the patient.”

(AIMS, 2005, p. 1)

Medical Simulation In Action

Mannequin Prep for Medical Simulation at Loma Linda Medical School

Simulator

Medical Simulation

Simulation is a training and feedback method in which learners practice tasks and processes in lifelike circumstances using models or virtual reality, with feedback from observers, peers, actor-patients, and video cameras to assist improvement in skills. Simulation is a training and feedback method in which learners practice tasks and processes in lifelike circumstances using models or virtual reality, with feedback from observers, peers, actor-patients, and video cameras to assist improvement in skills.

(AIMS, 2005)

Loma Linda Example

Dr. Daniels Prepared to Setup Educational Simulation

Rationale for Medical Simulation

Medical errors kill as many as 98,000 people annually (cost: $37 to $50 billion)The need to how quickly trained medical professionals to react to a health crisisMedical residents are operating under rules that limit the direct interactions between students and instructorsNursing shortages expected to reach 20% by the year 2020 - , are forcing some health care facilities to implement mandatory overtime for nurses and increased patient care loads: contributing to an already high number of stress related errors.

(AIMS, 2004)

Medical Simulation Setup

Physician/Medical Educator Create Complex Models of Heath-care Patients’ Behaviors Under Real Heath Care Crisis ConditionsPatients’ Vital Signs, Crisis Behaviors, Interventions, and Treatment Outcomes are DocumentedData from Real Patients are Programmed into Simulator’s Portfolio: Computers, Mannequins, and Clinician’s Educational Resources

Virtual Patient (Mannequins) Setup

Mannequin Prep as Real Human and Hookup to Simulator

Simulator Setup

Dr. Daniels Transferred Real/Hypothetical Patient’s Information and Operating Conditions to Simulator From Real Patient’s Stats.

Approaches to Simulation

A full environment simulator is similar to flight simulators used to train pilots. The pilot is immersed in a complete replica of the cockpit environment. In medicine, sophisticated mannequins, known as patient simulators provides health care professionals with a computer-based patient that breathes, responds to drugs, talks, and drives all the clinical monitors in the operating room, e.g., blood pressure and pulse rate. Task trainers provide a simulated subset of functionality, such as how to give a smallpox inoculation or how to insert a chest tube.

Approaches to Simulation, cont.

Computer-based training provides software programs that train and assess clinical knowledge and decision-making skills.

Simulated/standardized patients allow students to interact with actors trained to act as patients providing students with valuable feedback on, among other things, bedside manner.

(AIMS, 2005). What is Medical Simulation?

Simulation Training Environment

Trainees Work with Clinical Instructor as if with real patientsTrainees provides interventions to simulated real-health crisis conditionsClinical-Instructor acts as guide to trainee’s acquisition and demonstrations of health treatment competencies: skills and knowledgeMannequins respond and behavior as real-humans to treatment: physical care and medication

Trainees with Medical Mannequins

Trainees with Clinical Instructor

Simulator Monitor of Proceedings

Simulator Monitors Mannequin’s Vital SignsSimulator Monitors Physiology of MannequinSimulator Monitors and Record Trainee’s Actions and Effects of Intervention to Crisis ConditionsSimulator Controls/Impose Sub-routines to Mannequins: Drugs, Physiological Changes, Doctor’s Suggestions, etc.

Simulator in Action

Simulator Interactions with Medical Proceedings with Mannequin

Simulator in Action, cont.

Simulator Monitoring Medical Proceedings with Mannequin

Simulator Media Outputs

Trainees Observed Simulator’s Media Outputs during Proceedings

Debriefing

Trainees Review Actions and Interactions of Actual Proceedings: Simulator PlaybackInstructor-Trainees Q&A SessionTrainees Opportunity to Reflect and Obtain Feedback of the Actions and Reactions to Promote Learning and Improvement of Next SimulationApproaches: Uninterrupted and Interrupted Upon Error

Debriefing Playback

Trainees and Instructor: Reflect and Q&A during Playback

Pre- and Debriefing Conference

Trainees with Instructor: Pre-briefing/ Debriefing Conference

Future of Simulation in Medical Education

“In medical education, simulation will play a larger roll. The future is open especially with new procedures (laparoscopy) and new equipment (intubation), the learner can “see one, try many, do one successfully.“

Lynda Underwood-Daniels, MD, 2007

Reference, part 1

AIMS. (2004). Health care: A model for improving patient safety and ensuring quality. Retrieved August, 23, 2007 from http://www.medsim.org/press/reports.asp

AIMS. (2005). Building a national agenda for simulation-based medical education. Retrieved August, 23, 2007 from http://www.medsim.org/press/reports.asp

Reference, part 2

Bond, W. F., Lammers, R. L., Spillane, L. I., Smith-Coggins, R., Fernandez, R., Resnek, M. A., et. al. (2007). The use of simulation in emergency medicine: A research agenda. Academic Emergency Medicine, 14, 353-364.

Roblyer, M. D. (2006). Integrating educational technology into teaching (4th ed.). Upper Saddle River, New Jersey: Pearson Education, Inc.

Reference, part 3

Schwartz, L. R., Fernandez, R. Kouyoumijian, S. R., (2006). A randomized comparison trial of case-based learning versus human patient simulation in medical student education. Academic Emergency Medicine. 14, 130-137.

Shivkumar, S. (2006, September) Strategies for improving eLearning effectiveness. Internal Workshop on e-Learning for Adult Continuing Education. Cochin University of Science and Technology, Cochin, India.