For many years, the gap between acquiring theoretical, classroom learning and translating that knowledge into care for patients has troubled medical education.
The adaptation of technology developed for the aircraft industry, in which simulators recreate the experience of flying with stunning believability and accuracy, now makes it possible for learners at every level to develop and hone their physical, communications and teamwork skills without ever putting a patient at risk. In simulation-based learning, full-scale, standardized, electromechanical mannequins effectively stand in for patients, and actors trained to portray certain maladies serve as standardized patients.
Washington University School of Medicine employs simulation for all levels of students in a variety of settings, optimizing the technology and the techniques for the task and the learners.
Medical students in all four years learn to diagnose and treat conditions from the common to the rare and life-threatening. For example, using the programmable mannequins:
- First-year students explore human physiology
- Second-year students practice physical examination skills
- Third-year students learn airway management and cardiac resuscitation techniques
- Seniors preparing for graduate medical education are evaluated on the mannequins as they manage a set of eight scenarios that require rapid diagnosis and acute intervention.
The mannequins look, sound and behave so much like real patients, accurately recreating human physiology, that students quickly suspend their disbelief and become immersed in the experience of providing care.
The simulation centers provide:
- Pre-programmed or customized scenarios
- Digital recording of training sessions
- Immediate review and debriefing by an instructor
- Replication of many human conditions and reactions
- Training on a much wider variety of diagnoses than is possible in real life
- Immersive team training to ensure effective interaction
- A way to alleviate the apprehension that trainees feel as they make the transition from student to practicing physician
- No risk to actual patients.
The Howard and Joyce Wood Simulation Center in the Farrell Learning and Teaching Center is outfitted with the latest technology including four high-fidelity patient simulators and a task training room. Digital recording and playback capabilities make it possible to review and discuss student performance.
Surgeons-in-training benefit if they have the opportunity to rehearse a complex skill set before they ever enter an operating room. In the Surgical Skills Lab, hands-on exercises help teach a variety of surgical skills, from basic suturing to knot tying. Laparoscopic and endoscopic techniques are practiced on more advanced simulators. In the lab, residents also review common problems arising from surgical patients and learn to handle those issues while on call. The overarching aim is to ease the transition from medical school to the operating room.
Third-year medical students rotating through a surgical clerkship are trained in the lab, and it is part of a class for senior medical students headed to surgical internships. For residents, it serves as a venue to practice skills in a low-pressure, relaxed environment. As students gain experience and their confidence grows, tasks become more complex. Most of the complications seen in real life are recreated in the lab, with the advantage that when things go wrong, the trainee can simply hit the restart button.
Residents and small teams also train in the Clinical Simulation Center at Washington University School of Medicine and Barnes-Jewish Hospital. Equipped with the most advanced mannequin-based simulation, the center provides a location for groups of trainees at many levels — practicing physicians, residents, students, nurses and allied health professionals — to integrate task-training with simulation, with the ability to run a specific scenario repeatedly until the performance of all team members is error-free.
Community physicians and lifelong learners of all medical disciplines who want to learn new skills or refresh their decision-making can arrange to visit the center at their convenience for experience that would be impossible to get in any other way. They can pursue the high-fidelity simulation of a case from diagnosis through management of complications without risk, then evaluate their performance via a review of the recorded proceedings.
Pediatricians-in-training and all those who care for children confront unique challenges — tiny patients, biological systems that may still be developing and responses that are often different from those exhibited by adults. These particulars are addressed by the pediatric simulation capabilities in the Saigh Foundation Simulation Center at St. Louis Children’s Hospital.
Through simulation-based education, training and research, the center improves health care professionals’ skill in managing pediatric patients. Three pediatric mannequins with capabilities similar to those of their larger counterparts simulate all aspects of pediatric care with high-fidelity realism.
The SLCH simulation center provides health care professionals with individual and team training experiences. The simulated training environment can be tailored to novice as well as experienced professionals. providing participants with experiences in managing simple or complex events.