Biomedical Engineering Reference
In-Depth Information
examination or performance during a clinical
experience.
The students attend typically work and/or
teaching rounds, attend lectures and conferences,
and then acquire hands-on teaching at the bedside
to varying degrees. The students are expected to
acquire knowledge, judgment, leadership skills,
autonomy and interactive group working and coop-
eration skill by these relatively archaic teaching
encounters. The development and maturation of
technical skills and a keen sense of problem-
solving abilities based on the learning objectives of
the rotation are lofty but rarely mastered during the
rigors of the training period of a one-month rota-
tion. The clinical experience offered to the student,
especially in the initial stages of training has a
number of limitations, including a restricted enthu-
siasm, eagerness and motivation of the faculty (or
more senior residents) to allow students to provide
hands-on patient management. It is common that
the students are relegated to an observation role
and the ability to acquire hands-on skills will
vary broadly. Because of patient safety constraints,
students may not be given the autonomy to manage
a critically ill patient due to patient safety concerns.
Moreover, the student may be limited to certain
cases by choice of the supervising staff or resi-
dents, potentially missing the more challenging,
interesting, rare or potentially catastrophic clinical
conditions.
These are the types of cases, in particular, that
would provide considerable educational benefit for
the student under risk-free conditions. The expe-
rienced practitioner may reminisce that “trial by
fire” is a great teaching tool and should play a
major role in maturing and seasoning the less
experienced. However, taking in to consideration
teaching principles and concerns for patient safety,
learning under such conditions is not optimal for
either party. Confusion, embarrassment, loss of
self-confidence, and bewilderment on the student's
part while placing the patient in harm's way is
always a possibility, regardless of one's prepared-
ness and education. Imprinting a horrific experi-
ence in the mind of the student is one teaching
method that is long lasting but the concern for
patient safety in an emergency situation should
be paramount. This situation can now be repli-
cated by high-fidelity simulation and therefore can
be confronted in our educational process for the
adult student in a risk-free, less threatening and
appropriate teaching environment [3,10-12]. The
student's actions, behaviors and response to such
an emergency can now be assessed, corrected,
fortified and groomed by no-risk hands-on high-
fidelity mannequin training. This methodology will
fill in the gaps of the student's curriculum that
have been long regarded by some as being unable
to meet the goal of acquiring critical thinking
skills, judgment, leadership, communication, prior-
itization, and distribution of workload despite
the best efforts of educators in providing to the
student what appears to be an adequate patient
exposure [4].
The ability to practice and train without risk
is an obvious quest of any practitioner who
is immersed in today's brand of medical care.
Some may argue that the current methods of
education have served us well and the tradi-
tional pedagogic or apprenticeship style of teaching
and learning is fine. However, one should
consider that we are surrounded by “simulation
training” in many aspects of our lives and it
is accepted and embedded in many fields of
industry, safety, sports, and recreation. Even within
medicine, medical students experience mock inter-
views with actors posing as patients. We “drill”
during ACLS training. A student may prac-
tice suturing material together in the confines
of a call room to better her dexterity and
speed. Unfortunately, we have imbedded into our
education method an approach of learning new
tasks with the mentality of “see one, do one,
teach one”. This may not always be acceptable
practice.
20.4 Basic Elements of Simulation
Education
Measuring performance by the individual or the
team has been a focus of simulation-based medical
education whereas it efficacy for learning and
training has received less strenuous attention. Both
facets should be attainable goals for fortifying the
