Biomedical Engineering Reference
In-Depth Information
student trainee. The mannequin, itself, does not
teach without a dedicated and well-trained staff of
educators who are willing to expend a considerable
amount of time, effort, and money toward better
preparedness of the student trainee, regardless of
their current level of education.
sion of time and substantial financial resources to
ensure that the future care providers are adequately
prepared.
High-fidelity patient simulation, with a full-
size computer-linked mannequin, offers an ideal
venue for presentation of critical events that can
be managed by medical personnel without risk
or harm to a patient. These simulated events can
be presented following a lecture series to rein-
force and clinically apply the concepts or they
may be presented without any background intro-
duction so as to assess the student's response
to other previously “old” review topics or brand
new material. This may provide valuable feed-
back on the students' adaptation, response and
stress management during exposure to unknown
clinical problems. Clinical cases or scenarios can
be based on pre-programmed clinical situations
that serve as a foundation of a curriculum. The
exact scenarios can be repeated in a variety of
ways: to a variety of students to allow gauging
the skills of the students amongst or against their
peers or expose the student to a repeated scenario
at various time periods (i.e., baseline, three months,
six months, twelve months) to assess their skills
and retention of clinical material, judgment and
critical thinking [10-12]. Likewise, videotaping
the scenarios in realistic re-creations of clinical
settings will provide a hard copy for future refer-
ence and review by both the student and the
instructor. This technology, as compared to the
present pedagogic-apprentice methods of learning
and teaching offers an advanced ability to provide
feedback to the educators who then have the
opportunity to assess students' performances using
standardized cases and to determine whether the
educational objectives set out in the curriculum
are being matched by performance in a clinical
setting. This methodology compares favorably to
the current method in which the mentor must grade
the student based on her observing the student
on rounds or a brief interaction in the hospital
hallway or at the patient's bedside [3]. The ability
of the instructor to properly and accurately evaluate
the effectiveness of non-simulator based educa-
tion is currently limited to a grade on a written
20.3 Adaptation of Simulation
to Medicine
The medical profession has recently seen a
marked interest in simulation as an educational
adjunct to the standard methods of teaching
and training students, i.e., lectures, reading,
journal club, mock interviews, case presentations,
and bedside/operating suite/clinic apprenticeship.
Work hour limitations, financial restrictions,
paradigm shifts in the delivery of medical care
to fewer highly trained individuals supervising
many less highly trained medical care providers
and generational alterations have and will continue
to revamp our methods of teaching and learning
[4-6]. Simulation is increasingly being utilized
for training medical personnel. In addition to the
ability to remediate, certify, validate or evaluate
the student's clinical acumen, it can assess crit-
ical thinking and leadership skills, one's commu-
nication capabilities, the ability to prioritize in
problem solving, the effective use of monitoring
and laboratory/radiographic data, the efficient use
of resources, organization of care, distribution
of workload and stress management. Simula-
tion is not the panacea nor a replacement for
lecture-based learning, reading a journal, viewing
a educational CD, attending a conference, or
pursing bedside teaching rounds. It provides a
powerful adjunct to the apprentice model of
medical education [7-9]. As evidence accumu-
lates in support of simulation methodologies and
better defines its advantages, benefits and limita-
tions, we will experience a paradigm shift from
the “old” to the “new”. However, the purchase
of a “high-fidelity human simulator” will not,
alone, guarantee success. The clear advantage
of individual and team training using a simula-
tion model cannot be realized without dedicated
faculty, a well-developed curriculum, the provi-
