The Value Of Simulation Training For Healthcare Professionals

Alex Rawlings

Introduction

• Why Simulation ?• Benefits of Simulation• Value in other Industries• Simulation in Healthcare• Driving Forces• The Value of Basic and Advanced Simulation• Nurturing The Professional• Into the Future

The Value Of Simulation

Why Simulation ?

• Experiential Learning Theory • Intellectual comprehension requires experiential

foundation. Kinaesthetic learning. Kolb 1984• Mezirow, Freire stressed that the heart of all learning lies

in the way we process experience, in particular, our critical reflection of experience

• “I hear I forget, I see I remember, I do I learn” • Simulations allow the user to observe the impact of their

choices without the outcomes having any impact on the real operation. Smith 1999

The Value Of Simulation In Other Fields

• Minimizing Training and Performance Risks

• Limited Access to Real-Life Conditions

• Need For Effective Training

• Individual and Team- based training and assessment

• Multiple forms of simulation used side by side

• Good Investment

Medical Simulation In The Military

MSTC Military Simulation Training Centre

The Department Of Defence is one of the largest fund producers in the USA

• Simulation is recognised as an effective training tool

Medical Simulation Training includes: • Casualty Assessment• War Trauma Response• Emergency Evacuations • Team Communication Training • After Action Assessment• Scenario Recreation from recorded data

Simulation TrainingIn Healthcare

• Simulation is not new

• Wang Weiyi 1027AD

• Recognised the needs of students and patients

Used for the training of midwives. A tool for visualisation.

Driving Forces• To Err Is Human: Building A Safer Health System IOM

2000 Kohn, Corrigan and Donaldson

Deaths due to preventable medical error estimated at 1.8 – 4%

• Safety First DOH 2002

Patient Safety to be core focus of healthcare agenda

• Design For Patient Safety DOH 2003

Attempted solutions based on paucity of knowledge of working system and needs of staff. NHS does not appear to see itself as a high risk industry

Basic Simulation

• Safe Learning Environment

• Familiarisation

• Foundations

• Competence and Confidence

Advanced Simulation

Evolution of Simulation Training• Advance in Technology and Funding • Controlled Environments• The Willing Suspension Of Disbelief• Focussed training• Personal Skills and Mixed-Team Skills• Debriefing• Multi-disciplinary teaching teams• Raising Awareness• Human Factors

Advantages

• Routine procedures and events can be practised and improved

• Complex, unusual or rare situations can be practised

• Unifying knowledge into synergistic whole

• Making Passive knowledge into Active knowledge

• Errors can be allowed to happen without intervention from a supervisor – gaining awareness of cause and effect

• A learning environment which is immersive and engrossing

Associated Benefits

• Learning what cannot be taught

• Holistic awareness

• Risk-free not stress-free

• Mental and emotional preparation

• Reflection as a tool for life

• Communication and Decision Making

• Analysis of Risk

Nurturing The Professional

Core Values Of Professionals:

• Safe• Accurate• Effective• Affective – Sensitive to the Psychological Dimension

• Developing capabilities beyond competence

Dr Ian Curran, Barts and London Medical Simulation Centre

Into The Future

• Evolving Safety Culture

• Human Factors

• Raising Standards

• Accreditation and Revalidation

“In the future, however, medical simulators must move beyond representing individual procedures to include environmental conditions, alternative equipment/instrument designs, team dynamics, organizational factors, and cultural issues”

“Training systems must be merged with imaging, medical information, telemedicine, the internet and robotic systems to allow physicians to consider alternative diagnoses and treatments and to experiment with different therapies or rehearse procedures before committing to a course of action.”

Scerbo “The Future of Medical Simulation And The Need For Human Factors”

Question

“What kind of industry would ask people to perform complex, emergency tasks very well, NOT give them state of the art training, and punish them for failure?”

Paul Preston MD

Conclusion

• Not just valuable but vital

• What medical staff deserve (they also enjoy it !)

• It’s all about the patients