Biomedical Engineering Reference
In-Depth Information
gentle guides to the flow of the scenario, are
fully aware of the plot, and fill a supporting cast
role to the production. Their character is always
subservient to those played by the students (other-
wise, students surrender initiative). People playing
the actors are either not known to the students, or
if known, are not in the students' evaluative chain
of command (otherwise, students surrender focus).
However, the roles that the actors play should
be well known, easily conveyed with a simple
introduction, (e.g., “I'm just the EMT-trainee that
brought in your patient”) and they help move the
story along when the students fail to pick up on an
important clue (e.g., “Do you want me to answer
that phone for you?”).
Professional Human Patient
actors [as in objec-
tive structured clinical examinations (OSCEs)]
can provide their expertise in portraying specific
illnesses and evaluating student performance. In
addition, “walk-on” amateurs make for good non-
clinical actors, especially as the voices of robotic
patients, (e.g., the woman in the office down the
hall with three children may realistically vocalize
for the female robotic simulator's delivery). In all
cases, live actors should be employed as patients
when the patients' primary mode of communi-
cating clinical information is through movement,
touch, and verbal conversation. They may also be
used when students are expected to perform non-
invasive procedures.
cases, these complex simulation devices should be
employed as patients when the patients' primary
mode of communicating clinical information is
through clinical monitors and when the students
are expected to perform invasive procedures.
21.4.3 Rooms and Environments
The
stage
is wherever the action is expected to
take place. Most clinical simulations will take
place in a recreation of a specific clinical envi-
ronment and will be located far away from real
patient care to minimize the possibility of contam-
inating real treatment objects with dysfunctional
fake ones. Emergency-management simulations
can take place in real emergency management
centers, provided that the faked training signals and
altered communication links used during the exer-
cise are restored to their original “real” configura-
tion (e.g. the ICBM missile attack training tape that
was left in place and almost started WW III). Like
the robotic patients, the fidelity of the stage envi-
ronment needs to be no more elaborate than what
is essential to convey the desired story, but realistic
enough to introduce undesirable distractions.
Regardless of the stage and of the type of
scenario, both audio and video
recordings
are
made of students' words and actions. It is essential
for students to review these recordings immedi-
ately after their session, so that they themselves
can assess their performance and determine where
they
need to improve their competencies. Partic-
ipating in a simulation is like eating a meal;
assessing one's own performance is like digesting
that meal. Likewise, this feedback is extremely
valuable for simulation professionals and instruc-
tors in assessing how well their scenario design
and execution fulfilled their goal of helping the
students expand their competencies.
The
simulation control area
is usually adjacent
to the stage, and houses all the remote control
devices that the simulation professionals use to
manipulate the sights and sounds experienced by
the students. The control area should be sight- and
sound-isolated from the stage to decrease distrac-
tions and increase realism. Students can partici-
pate successfully in simulation exercises without
21.4.2 Device Simulators
Patient simulation devices
offering a wide range
of features and presentation capabilities are now
available for a wide range of acquisition and
use/upkeep costs. They can be as simple as rubber
fore-arms for intravenous (IV) placement (good
for making the students carry out all the time and
gear consuming tasks in gaining IV access without
damaging real human arms) or as complex as
the high-fidelity, full-body, real-clinical monitor-
driving, drug- and ventilation-responsive, operator-
intensive, fixed-site machines. The best device is
the one that allows students to take clear, decisive
actions that lead to success or failure in achieving
the teaching objectives of their instructors. In all
