Biomedical Engineering Reference
In-Depth Information
20 Chapter for Simulation for
Bioterrorism
THOMAS C MORT AND STEPHEN DONAHUE
20.1 Introduction to Simulation
High-fidelity mannequin simulation: Is it a new
modality of education or is it simply a technology
advancement of what is already embedded in each
us from childhood? Learning to ride a bike, ice
skate, hit a baseball, or a downhill ski takes practice
over an extended period of time for most children
coupled with plenty of time and instruction from a
mentor. As a child, we engage in sporting events
and play games to develop and mature our phys-
ical, emotional, social, and intellectual skills. This
technique of learning by doing and experiencing
mistakes, receiving correction and then starting all
over again is steadfast in our growth as a child but
is often neglected in adulthood.
Adults in the medical community are expected
to perform with accuracy and efficiency in the
delivery of patient care, even in emergency crises.
However, our current methods of instruction and
education may underestimate the complexity of
today's technology and our ability to quickly
absorb new information such that we can then
perform a task, operate a piece of equipment or
follow a protocol/algorithm even under normal
working conditions. This perilous assumption is
not only unsafe, but it is doubtful that can personnel
educated in this manner can perform confidently,
efficiently and correctly when faced with a clinical
situation that can only be described as “on demand”
during an acute crisis. Our current method of in-
servicing personnel on newly written protocols and
new equipment may benefit from an update to
reflect the degree of time and effort that must be
expended to truly master new skills. To illustrate
this point, if the hospital introduces a new brand of
defibrillator with biphasic technology and deploys
them throughout the institution following a manda-
tory in-service, should we expect personnel to be
well-versed in the use the new defibrillator? Will
a brief 10 minutes in-service or lecture provide the
basis for personnel to respond with ease, convic-
tion, confidence, and efficiency, plus understand
the new technology following a brief discussion?
Envision the havoc and potential misapplication of
the technology when the staff are being asked to
incorporate the new equipment in a patient care
crisis about 4 months later. It is quite obvious
that the crucial steps of “drilling” personnel on the
intricacies of proper and efficient equipment use
is missing from this type of educational endeavor.
Ill-prepared personnel may be likely to falter in
their performance of acute care skills potentially
leading to patient injury. While it may be diffi-
cult to find many in the medical field willing to
pronounce that there are significant problems with
the system and the way medical care is deliv-
ered, claims by the Institute of Medicine esti-
mates nearly 100,000 lives lost each year due to
medical errors [1]. Though not all “medical errors”
are related to crisis management, simulation-based
education may allow an inroad for improving
competency, team work, and individual perfor-
mance that may lead to a reduced number of
medical errors.
20.2 History of Simulation
Though introduced to medicine as early as the
late 1960s, mannequin-based simulation training
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