Using simulation training in healthcare

Training healthcare providers to be able to respond to any situation they might find themselves in is crucial to their development as healthcare professionals. With recent advancement in the use of technology, simulation training provides an excellent (and safe) learning environment in the curriculum of students as well as for ongoing training for current healthcare professionals.

While hands-on learning with real patients cannot be completely replaced, simulation training provides a safe environment for learning. Making mistakes can be a valuable part of the learning process. In the simulation environment, patients at not put at risk.

According to the Society for Simulation in Healthcare, simulation training is “the imitation or representation of one act or system by another” and serves as “a bridge between classroom learning and real-life clinical experience.” No longer must students practice giving injections by using an orange or budding surgeons practice suturing by using a piece of felt.

Healthcare is catching up to other industries in using scenario based training. For instance, aviation has been a long-time user of simulation training for pilots. In fact, the first known flight ‘simulator’ was the Antoinette Trainer developed in 1909. Rudimentary by today’s standard, the simulator consisted of a “half-barrel mounted on a universal joint, with flight controls, pulleys, and stub-wings.” Over time, the setup became more advanced. Beginning in the 1950’s, technology was introduced to aviation simulation. By the 1980‘s, it was much more integrated. Today, many aviation simulators are so advanced, it would be tough to tell them apart from the real thing.

Aviation knew the importance of training pilots in situations where they could “achieve, test, and maintain proficiency in the operation of an airplane without risk to person or property and at a lower cost to training in the air” (Aviation WikiJournal).

With an explosion of technology in simulation, the opportunity to teach healthcare students has almost limitless boundaries.  At the heart of simulation in healthcare is the human patient simulator (HPS). In 1969, Abrahamson, Denson, and Wolf wrote about the ‘Effectiveness of a simulator in training anesthesiology residents’ and the use of patient simulators (Journal of Medical Education) to train physician residents. They felt that simulation held much promise and, from their findings, it would provide “a significant time saving in training” and that “anesthesiology residents might be expected to achieve this level of professional competence in a saving of 22 days over a period of 77 days.”

Today’s patient simulators are significantly more advanced. Most of them can blink, breathe, cry, sweat, and have a heartbeat and pulse. When hooked up to monitors, they can even display vital signs. With some customization by the faculty the ‘patient’ can exhibit any number of cardiac arrhythmias. The technology can even mimic virtually every major bodily function. Using different scenarios, students can experience a range of events from physical examination to major trauma. The simulator even recognizes injected medications via RFID and responds with appropriate vital signs. This is a particularly helpful (and safe) way to demonstrate a reaction to the wrong medication being given by the student.

In her article “Simulation-based learning: Just like the real thing”, Dr. Fatimah Lateef writes about the important place that simulation has in training healthcare personnel. She feels that “simulation-based medical education can be a platform which provides a valuable tool in learning to mitigate ethical tensions and resolve practical dilemmas.” Lateef follows this by saying that simulation training is “a technique (not a technology) to replace and amplify real experiences with guided ones, often “immersive” in nature.”

I agree with Dr. Lateef that the simulation (i.e., scenarios) is the key to making the training successful. However, I would add that it is the use of technology in simulation training that makes this approach that much more effective!

Stephen Burrows, DPM, is Chair & Program Director of Healthcare Information Systems at Sacred Heart University’s College of Health Professions.