How patient simulation is shaping the next generation of healthcare providers
“If there’s anything I’ve learned about simulation, it’s actually about people at the end of the day"
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Medical students must undergo rigorous and often time-consuming learning processes. From studying everything in their textbooks to working with real patients in a residency, the path from program acceptance to practising professionally is a long one. One specific learning tool stands out as particularly important: patient simulation.
Patient simulation, also known as simulation-based learning, enables students to practice essential skills in a hands-on manner without requiring direct contact with a real person. It can take on many forms and is a valuable asset in the learning process for the healthcare professionals of tomorrow.
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“Classically, people see these very complicated mannequins. They look essentially like crash test dummies that we can operate on, and we can do very complex things, procedures like intubations, we can put IVs in and what not,” said Dr. James Leung, who wears many hats, one being Assistant Dean of the Centre for Simulation-Based Learning (CSBL) at McMaster University. “The idea is that it’s a nice, safe way to do things so that patients aren’t exposed to any harm.”
Simulators, however, go far beyond the scope of just practicing physical skills, such as inserting an IV.
The history of patient simulation
The use of patient simulation isn’t a new technology. It stems as far back as the early 1900s when nursing schools would use dummies as part of their curriculum, as well as other role-playing simulations to improve bedside care.
Until the 1960s, however, these tools were quite limited. The first computer-based version was introduced in an operating room setup to help students with anesthesia throughout that decade, and by the 1980s, the technique had been refined.
“From there, it really just exploded,” said Dr. Leung. “Other sorts of programmers realized that this could be very useful for us.”
From its humble beginnings to the present day, patient simulation has undergone significant growth, making learning in the classroom more aligned with on-the-job training in a controlled and safe environment.
Now, there are several technologies available that can be used to create patient scenarios and environments, including:
- High-tech mannequins with realistic vital signs and mimicry of human physiology
- Task trainers that mimic body parts to help insertion of IVs, catheters, or to learn how to properly treat wounds
- Standardized patient simulation that utilizes people as actors to portray different medical conditions and situations
- Virtual reality for creative, interactive, and immersive surgical procedures or emergency situations
- Hybrid simulation, which combines more than one type of simulation to create a more realistic learning environment
- Virtual patients that offer digital interactive assessment tools.
According to Dr. Leung, these tools are wide-scoping.
“I like to call it a multi-tool. It’s an educational tool at its core, but really, it has branching things in terms of education for a sort of quality improvement. It also has things for systems improvement … research as well,” he said.
Using patient simulation to serve patients better
Serving patients is the number one priority for medical professionals, and to do so correctly, patient simulation must be an integral part of their overall learning experience. But it’s not just because of what they learn when they’re performing routine surgeries on a mannequin. It’s also how the simulation learning allows them to communicate with one another.
Why? Because when students in a classroom are working on something, they can bounce ideas off one another, learn different techniques and approaches from their facilitator or teacher, and expand their skill set through the art of sharing perspectives and knowledge.
“If there’s anything I’ve learned about simulation, it’s actually about people at the end of the day,” said Dr. Leung. “There’s the mannequin that’s there, but it’s the people and the person-to-person interaction. So, the mannequin becomes a sort of vessel in between that we share in this experience.”
Dr. Leung notes that there are many instances in which these types of communication can be highly beneficial beyond the simple scope of learning how to perform a task, such as operations or CPR. It can help teachers understand their students better, as well.
“It’s also a nice opportunity, just to understand the frames of mind of our learners to see what’s going on in their head to get a really deep dive,” he said.
While the objective in patient simulation is to ensure that medical students are ready to enter the workforce and perform the necessary tasks, it ultimately comes down to the same end result: providing both quality care and safety.
While mistakes can happen in healthcare, going back to the drawing board to figure out “why did it happen?” can also be achieved through patient simulation, as well as determining the best possible layout for specific hospital or clinic settings to provide adequate care to patients.
“When COVID hit, it was really an effective tool that helped us really upscale, prepare ourselves,” said Dr. Leung. “These are the ways that we can stay safe. This is the way we can make things safer for our patients in terms of separating environments, and we’ve also used it as a way to actually test new equipment as well, especially with things such as personal protective equipment.”
At the end of the day, it’s all about the patients and creating scenarios that will one day help medical professionals provide the best possible care in any situation.
“It can seem like a very daunting field, but there’s always support, and I think there’s a community of people that are interested in this as well,” said Dr. Leung. “It’s a lot of work behind the scenes of people who are dedicated and believe that this will really help people improve the care we provide.”
Building confidence while feeding curiosity
Confidence can go a long way when working directly with patients. When a medical professional is sure of their capabilities, it’s easier to build trust with their patients and make sound decisions regarding patients’ care, leading to better outcomes.
Patient simulation programs can help with that, too.
Dr. Leung notes that when they’re able to work on situations in the lab, coming across a similar situation in the real world becomes much less daunting or challenging to deal with as a new healthcare provider.
“In some situations, they may only encounter this really big emergency once or twice in a career, and you may never even encounter it in your training at all,” he said. “But if you were to put it in a sim scenario like I could, we could offer it every week. We could recreate this environment so that even in this once or twice event in your career, you’ll never encounter this by chance. You’ll have that ability to do that (in a lab).”
Curiosity is also a crucial aspect of medical training and often leads to medical advancements. In simulation-based learning, students can play around with experimental forms of therapy, treatments or procedures in a way that helps them to “develop themselves in terms of experimenting a little bit on things you never want to experiment on a real patient.”
“I really like that word curiosity because in simulation training, that’s one of the big anchors,” said Dr. Leung. “The best feedback I ever got is just to always stay genuinely curious. That’s what really makes or breaks successful stimulation educators. Being curious about does this work? Does this not work? It gives you that opportunity to understand how did this work? Why did this work, or why didn’t this work? … It’s a really curiosity-driven field.”
