Simulation Lab

Simulated learning for the Medical profession

“Failure is not an option” in the Medical & / or Surgical management of a patient. Advances in technology & pharmaco-therapeutic agents have made it possible to treat many diseases which were at one time considered ‘hopeless’. This has benefitted a large patient population & has added to a sizable geriatric population. The flip side of this is that there is an increased risk of morbidity & mortality, thereby giving doubts as to the efficacy of the treatment & also the competency of the physician concerned. This major patient safety issue can be addressed to a certain extent by training the physician adequately to handle most emergency situations. Poor outcomes of treatment continue to occur due to patient & disease related factors.

Learning for a medical student typically begins in the Anatomy department where the anatomy is taught on the human cadaver. Clinical medicine is actually learnt on the live patient under the supervision of appropriately qualified faculty. This has an inherent lacuna in the availability of the right kind of patient & the co-operation of the patient with the student. Increasing number of hospitals has also added to the reduction of the student /patient ratio leading to inadequate exposure of the student to various clinical conditions. This discrepancy is more so in the western world which is compounded by the fear of malpractice litigation & patient’s not giving consent to be examined by students. Surgical training occurs also on the live patient but under the close supervision of experienced faculty who literally hand hold, the students for the duration of their course. Does this have a risk of compromising patient safety?

The need for Simulated learning

Simulation is the creation of an artificial environment for education, assessment, and research & health system integration with the purpose of improving patient safety, effectiveness & efficiency of delivery of health care. This will also add to the understanding of the stress response of medical professional in the simulated environment. Health care workers are at risk constantly acquiring infectious diseases like HIV & Hepatitis due to accidental injury in the process of patient care. Honing their motor skills in a simulated environment viz. learn to give injections, perform invasive procedures will help reduce or avoid these work related injuries.

Simulated training has its origin in the aircraft flying where the safety of many passengers is at stake. Each pilot is said to have a minimum number of flying hours on the simulators before he can fly an actual aircraft & also needs to put in a few hours of simulated flying each year. This is akin to the mandatory Continuing Medical Education (CME) credits which are in place in some countries but yet to see the light of day in India.

Today simulated learning can be done with

  1. Mannikins made to look & function in part like a human body
  2. Surgical training with mannikins to simulate human organs
  3. Computerised mannikins that respond to all forms of medication & other treatment
  4. Surgical training on human cadaver specially prepared for this purpose
  5. Simulated learning with digital simulators

The first two are essentially meant to train the undergraduate in addition to his /her regular curricular studies. The first three can be used to train the Emergency medicine & critical care management very effectively & periodic courses can help update their knowledge.

Surgical training in specially prepared cadaver is a boon to the aspiring surgeon where he/she can perform the surgery on the human cadaver which looks & feels like the live human body barring the bleeding.

Digital simulators are a good tool for the practice of certain types of invasive procedures like Gastrointestinal Endoscopy & laparoscopy where the technology has not only simulated the internal appearance but also as appropriate haptic feedback making it actually feel & look like normal tissue.

Simulated training for the medical professional is a boon & the regulatory authorities controlling medical colleges & medical practioneers should make an effort to include this vital training aspect into the curriculum.

The M S Ramaiah Advanced Learning center has been designed & implemented with state of the art facilities to meet these training needs of the medical professional.

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