OWH: What are the challenges of simulation-driven medical training?
DS: We’ve have had success in training medical students, residents, fellows, and even practicing physicians, over 20 years. But we’ve never had an integrated campus-wide simulation program.
Our new center integrates our efforts across all departments, different schools, and diverse levels of learners – from the novice, first-year medical student to the sophisticated training modalities for practicing physicians. But, we are about two and a half years into planning the opening of our new center in September.
It’s quite a challenge to get everybody on the same page, standardize the processes, streamline our evaluation expectations, and create a supportive infrastructure. These new concepts have been a challenge for us.
But, results are evident, like that team training and practicing resuscitation drills are lowering the mortality rate in hospital systems related to rapid response conditions, or central line training is making a significant difference on patient outcomes and length of stay in the ICU.
OWH: As a modern-day mechanism, how does simulation ensure physicians – both the novices and the experts – are kept up-to-date? How will technology continue to impact care?
DS: Simulation gives you a safe environment to measure performance and remediate as needed to teach additional skills to folks that need to brush up on various things.
Our simulation is not just part training for medicine or training for residents, but part of our fabric as a whole educational infrastructure. It can be, and probably should be, used to verify the levels of performance that patients expect.
If, for example, you look at the aviation paradigm, where a pilot has to get checked out on any specific aircraft they’re going to fly, they arguably have about a half a century head start on medical simulation because flight simulation really started around World War II, with a simulator called the “Link Trainer”. And very quickly they diminished crashes on landings. But aviation also has an incredible amount of resources. Their simulators routinely cost several million dollars.
Medicine is not quite there yet, but if I had my crystal ball, I’d say in the future every physician who graduates medical school, and every physician matriculating through the more advanced training levels will also likely have verification that they have requisite competency to do what’s required in their practice.