|The training your physician received may not be that different from a pilot’s. Today, more medical schools and continuing medical education programs are increasingly turning to simulation as a viable and patient-minded source of training.
“Simulation, as we know it today, was born out of the aviation industry,” states Dr. Brian Gillett, Director of the Maimonides Center for Clinical Simulation. “In the 1970s, the aviation industry identified that 70% of flight catastrophes were the result of a breakdown in leadership, communication and decision-making – not equipment failure.” So the aviation industry turned to psychiatrists to find a solution. From that process, a simulation-based training program, known as Crew Resource Management, emerged.
This training program was developed to teach flight crews how to function as a team, and communicate and identify potential problems in order to manage them before they turned into disasters. “Health care really parallels the aviation industry,” explains Dr. Gillett. “We’re proficiency-based, task-oriented, and reliant on a team-based approach.” However, Dr. Gillett notes that health care professionals are trained in silos. Doctors and nurses have different training philosophies and programs. “We train apart and only then come together in a crisis, so it’s not surprising that this can result in many complications,” observes Dr. Gillett.
As in aviation, medical professionals use virtual reality and other robotic simulators to train for crisis situations. Physicians and nurses can isolate a medical event, working within an interdisciplinary team to solve the situation. Without compromising patient safety, health care staff can improve their clinical reasoning, communication and teamwork skills. Staff members can observe how other disciplines would approach a patient’s diagnosis and treatment, quickly learning how the team would function in the event of an actual emergency.
The Maimonides Center for Clinical Simulation uses high-fidelity robotic mannequins to train physicians for both rare and complex medical events. These life-size robots can ‘breathe,’ blink and simulate many medical emergencies. Providers enter the Simulation Center without knowing what to expect, just as they would when first encountering any patient. Physicians and nurses can use these models to work on their resuscitative skills, clinical reasoning, and illness identification.
Like a flight simulator, minimally invasive surgery training is similar to a virtual reality video game. The software provides an interactive learning environment with real-time situations. Looking at a computer screen, as one would do in the operating room, physicians can ‘operate on a patient.’ The software is so high-tech that it provides virtual modes that use actual tissue properties (i.e. skin tissue tears, or an incision will bleed, as it would on a real person) to enhance training. Physicians will actually ‘feel’ if their surgical instrument comes into contact with ‘virtual’ tissue, giving a force feedback that mimics how real tissue and blood vessels would behave.
Clinical simulation has become a viable option for health care staff who are still in training, as well as for seasoned professionals to help them maintain or further develop their skills. “Numerous studies in medical education literature tell us – without doubt – that simulation benefits knowledge retention, communication, team work, and even applied physiology at both professional and student levels,” states Dr. Gillett. At Maimonides, we are creating a safer environment for patients by using simulation and ultrasound technology in the training, assessment and credentialing of our care providers.