Advancements in the Medical Simulator Industry
Providing medical learners with an opportunity for deliberate practice goes towards increased practitioner confidence, competence and improved patient safety through fewer errors.
Whilst some medical professionals are skeptical of the full benefits of simulation in education, with the opinion that medical procedures are often too complex to simulate accurately, the general view is that if there is the option to practice in advance of a real situation then both practitioner and patient will benefit.
The American Anaesthetist, David M. Gaba, M.D., said:
‘No industry in which human lives depend on the skilled performance of responsible operators has waited for unequivocal proof of the benefit of simulation before embracing it.’ (1992)
Simulation is the “dress rehearsal” to a real event where a student or learner can make countless mistakes without anyone coming to harm. Also, by understanding the benefits of simulation, it’s range of uses as well as where it’s limitations lie, teachers can improve the learning experience for their students.
Where Medical Simulation began
The first recorded use of a medical simulator for educational purposes was in the 17th century by Dr Gregoire of Paris. He used a pelvis with skin stretched over it to simulate an abdomen whilst explaining complicated deliveries to midwives.
Quite extraordinary at the time, yet for reasons mainly linked to cost, this concept didn’t gain traction in the following centuries. There was also a reluctance to adopt new methods of teaching and an underlying resistance that using simulation was ineffective for learning.
It wasn’t really until the 1960’s and 70’s that significant developments were made. Researchers in Miami developed “Harvey” a cardiology simulator based partly on computer enhancement.
In the 1980’s Gaba introduced computerized manikins for anaesthesiology training and around the same time, UCSD School of Medicine developed the aortic aneurysm simulation with their very accurate software “Surgeon 1986”.
The Wide Range of Uses for Medical Simulation Now
Over the past two decades the medical simulator industry has seen more rapid advancements. These range from simulating regular visits to the GP to complex heart surgeries.
Technology has paid a big part in expanding the use of simulation and making it more effective. And it isn’t just the medical industry that is making use of technology – pilots and the trained forces also have a key focus on safety so regularly use simulation as part of their training.
Are High Fidelity Simulators More Effective?
Today, there are many “off the shelf” manikins that breathe, dilate their pupils and more. Modern manikins are more sophisticated and practical and many make use of wireless technology.
There are synthetic based models for procedural tasks, referred to as low-fidelity simulators compared to virtual reality simulators, which can be considered as high fidelity, due to their added complexity.
It has been proven though that low fidelity synthetic models and manikins are in fact just as effective as the more advanced high fidelity systems that cost significantly more and often need a specialist teacher.
Grober, carried out a study and concluded that the fidelity of the simulator should reflect that of the learner and the overall goals of the learning activity.
“In situ” Simulations
Simulation is routine to medical and health professionals in education. In some centers they now operate “in situ” simulations where the real team are brought together, in the real location using the simulator as the patient.
It is heavy on resources but encourages teams to work on communication, decision-making, judgment and leadership – all vital to patient safety, especially in a pressured environment such as an operating theatre.
The SMI Eye Tracking Glasses
One of the latest developments in medical simulation is the release of the SMI Tracking Glasses, effectively an eye and gaze tracking system. Its high-speed processing and pinpoint accuracy allows learners to see exactly where the teacher is looking whilst demonstrating procedures and also in reverse, the teacher can see the actions of students for assessment and review.
This technology is expected to be a huge step for medical simulation. The UCLA School of Nursing is already using this for training.
The Importance of Patient Based Training
Experts in the field communicate that whilst simulation is essential and most junior doctors are assessed on simulation, it must not completely replace patient based operative activities.
The Objective Structured Clinical Exam (OSCE) has been operating over 30 years and shows reliable results in terms of assessment.
Medical simulation is set to continue advancing rapidly as new technology becomes available. The pressure on educators to achieve results is part of the instigator however, it mainly comes back to patient expectation – nobody expects or wants a major, or minor for that matter, procedure with risk involved carried out on them for the first time.