2016 has been a year of product development and greater understanding of the simulation world on a global scale... I have started to write a new theoretical outline for immersive education since my personal belief is that the traditional educational pedagogies are being left behind by the technologies now available to us.
I propose to try and write an article each week during 2017 explaining the key theories of medical simulation in the hope that those of you who follow these ramblings can apply these to your own practise. I will explain how we can use new technology and why and how these technologies add to the saving of lives in healthcare education. Simulation is a fast growing global healthcare business and within healthcare we are just starting to understand the benefits of using our new found educational techniques and technologies to enhance patient care. Integrating the virtual, holographic and augmented worlds into immersive experiences we will have to design new ways of thinking and ensuring engagement is linked to patient benefit. The basic pretexts of a medical simulation haven't changed but the technologies available to educators goes way beyond those found in most "high fidelity" simulation facilities. Many people use a simulator to try and establish deficiencies in student performance... To identify training needs... To test systems and find fault... The simulator has become " the canary in the mineshaft" a phrase used by Gallagher and Isenberg in their book Simulation in Anaesthesia ( 2007) Back in the nineteenth century, when coal mining was a very dangerous profession (even more dangerous than it is today), miners took a caged canary down into mines, and watched them with anxious eyes. If the canary suddenly dropped dead, that meant that the deadly gas, carbon monoxide, was slowly seeping into the shaft, and it was time to run like hell. Medical Simulators are often used in a similar manner to the Canary - to warn us of skills deficits in our students, or just as commonly - our Teaching! But Why do people use simulators ?
This is where we will begin our 2017 journey... With a simple Question... What is a simulator? Is it a manikin? Is it a room? Is it a strategy? Is it a technique?So many tools can now be used - that go way beyond the traditional manikin and defibrillator strategies. Many techniques use low technology to achieve incredibly high reality! And it is this fundamental question that I would ask you to explore... At my teaching institution ( the academy of professional development) we use a number of tools to encourage the student to go beyond the traditional simulation strategy... #Simbodies - medical manikins that look and feel like real people... Designed in the UK and now being sold worldwide Using tools such as the #simbody we see better and more immediate suspension of belief within our students, we can see true emotion and caring that we would not have seen with more traditional ( plastic) manikins. These tools are used by military and HEMS teams and have a multitude of features that enable clinicians to experience " new things". We have reduced the relaince upon cadevers and animal models... At the Academy we use iSimulate - an iPad based clinical monitor - used on real people or manikins to recreate vital signs which require human interaction and clinical assessment / decision making. These vital signs are manipulated to force decision making in the mind of the clinician, and the vital signs and subsequent information is presented to the clinician in a manner that matches the reality of the "real" world. But at the academy of professional development our over riding belief is that Simulation goes way beyond the Manikin or actor - It also requires the interaction with the clinical environment as well... since we know that the environment shapes our behaviours We specialise in the use of Interactive environments - using 360 degree Video and Projection technology combined with lasers which map human interaction We use Smell machines, to recreate Vomit and Faeces - Up to 300 smells available We are in the process of redesigning many "traditional" academic programmes to cater for the learning preferences, styles and expectations of our learners. And we have written a research strategy to look at the effect of immersive education directly on patient outcomes. I hope that you will encourage others involved in medical simulation to follow these posts and that in a 12 months time we will have developed a greater understanding of the whole new "science of simulation." SO - Back to the Question - What is a Simulator? Dave Halliwell is a researcher and educator who delights in asking the bigger questions. His clinical work includes supporting Middle East agencies to test their healthcare systems, and supporting military medical developments worldwide. He is a fan of new technologies and can be found lecturing on his passions of simulation and resuscitation in a number of international conferences in 2017. ( USA, Australia and Europe)
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