1 what is simulation in healthcare? jeffrey b. cooper, ph.d. professor of anaesthesia, harvard...
TRANSCRIPT
1
What is Simulation in Healthcare?
Jeffrey B. Cooper, Ph.D.Professor of Anaesthesia, Harvard Medical School
Department of Anesthesia and Critical CareMassachusetts General Hospital
Executive Director, Center for Medical Simulation, Cambridge, MA
Disclosures
• No commercial interests related to simulation
• Leader of a non-profit education and research organization that promotes simulation
2
3
Objectives
• Introduce simulation and the breadth of its uses in healthcare
4
Patient Safety and Medical Education Challenges Addressed by Simulation
l Training clinicians in risky procedures on real patients is no longer acceptable
l Apprenticeship-based learning depends on chance events
l There are limited opportunities to experience rare events and crises
l The 80-hr week has reduced contact hours for physician trainees
l Training for teamwork is atypical
5
Using Simulation for Patient Safety and Culture Change
What is “simulation”?
What are the ways simulation is used?
What is the role of debriefing?
6
What is Simulation in General?
A “technique” not a “technology” for interactive and often “immersive” activities that re-create experiences of a real-world environment, to amplify or replace actual experiences
7
8
Spectra of Simulation & Immersive Learning in Health Care
Simulation and immersive learning can apply to health care in many different ways
There is a spectrum of applications across each of ten (or more) aspects of simulation
From Gaba DM: The future vision of simulation in healthcare, Qual Saf Health Care. 2004; 13 (Suppl 1):i2-10.
9
Spectra of Simulation
1: Purpose of simulation
Education(Knowledge)
Training(Skills, Tasks,
Behaviors)
Testing Formative Summative High-stakes Recurrent
Research Pedagogy Hum Factors Physiology / Pharmacology
PatientCare Surgical case planning Protocol design Equipment procurement
Gaba: Q&SHC, 2004
10
Spectra of Simulation
6: Knowledge, skills, behaviors
Conceptual Understanding
Knows
TechnicalSkill
Knows howShows how
DoesMasters
Attitudes & Behaviors
TeamworkPatient-centric
EthicsProfessionalism
DecisionMaking
CognitionMeta-cognition
-Static-Dynamic
Gaba: Q&SHC, 2004
11
Spectra of Simulation
8: Technology applicable to simulation
Verbal “what if”
Role-playingMultimedia
Standardized patient(Actor)
ElectronicPatient
SimulationReplica
Clinical Site; Physical
(mannequin); Full VR
Patient Simulation
Computer- screen
Screen-based virtual world
Part-task Trainer
Physical VR
Gaba: Q&SHC, 2004
12
Hybrid Patients
Standardized Patients
Computer Simulation
13
Procedural Simulators/Part Task Trainers
Central Line Placement
Intubation
14
Simulators /Part Task Trainers
Ultrasound
Laparoscopic skills
Colonoscopy
New cardiac surgery training devices
Chamberlain Heart U North Carolina
15
16
Trauma Sim
Mannequin Simulators
17
Control Room
18
Full Team Training with Simulation
19
Debriefing: The key to learning from simulation
20
More Information at These Web Sites
WWW.bris.ac.uk/depts/bmsc(Good link to other simulation facilities)
WWW.SSIH.ORG (Society for Simulation in Healthcare)
www.harvardmedsim.org (Center for Medical Simulation)