Learning with Medical Simulations

Deirdre BonnycastleClinical Teaching

College of MedicineUniversity of Saskatchewan

Objectives

Upon completion of this module,

participants will be able to:

Describe four types of simulations

Identify how simulations can improve learning

Task of Medical Students

1. Learning to think like a physician

2. Learning to act like a physician

Theoretical Underpinning

Experts deliberately practice the art and science of medicine by having opportunities to :

Reflect on their practice

Create new patterns of information by connecting old and new material

Correct mistakes in thinking and action

Practice to the point of automaticity

UnconsciousIncompetence

ConsciousIncompetence

UnconsciousCompetence

ConsciousCompetence

Theoretical Underpinning

Awareness

TeachingPractice

New Challenges

FeedbackFeedback

Four Types of Simulations

1. Simple

3. Standardized Patient

2. Mechanical

4. Virtual Scenario

Simple Simulation Examples

Simple

What is the advantage of

using simple simulation?

allows practice of basic skills

patient safety/comfort allows practice with

minimal supervision available 24 hrs relatively inexpensive

What disadvantage

is there?

lack of direct feedback lacks patient interactivity only useful for simple skill

building

Simple

Key teaching points

1. Provide students with step by step written or image instructions initially

2. Encourage peer learning/practice

3. Use with 5 step method of teaching skills/procedures http://medicaleducation.wetpaint.com/page/5+Step+Approach+to+Teaching+Skills%2FProcedures

4. Practice to point of automaticity for simple skill

Simple Mechanical

Multi-task Simulated Person

Complex Mechanical

Scenario Control Room 3D Internal Image + Simulated Person

BMJ Simulation Module http://learning.bmj.com/learning/search-result.html?moduleId=6080077&searchTerm=“Simulation”&page=0

Mechanical Simulation

What is the advantage of

using mechanical

simulation?

allows practice of more complex skills and teamwork

patient safety/comfort allows for varied levels of

risk student has basic skills

when they enter OR/clinic

What disadvantage is

there?

high cost lacks patient interactivity requires supervision time consuming requires dedicated space

and personnel

CLINICAL/HOSPITAL ENVIRONMENT

SIMULATOR LAB

Identify learning objective

Simulator-based practice

Patient Feedback

Further practice as needed

Competent

Process of Using Simulator Labs

Feedback

Problem:What is Medical Competence?

MEDICAL KNOWLEDGE

CLINICAL REASONING

PATIENT COMMUNICATION

DEXTERITY/SKILL

Learned through Simpleand Mechanical Simulation

?

Answer:Hybrid Standardized Patient

©Thanks to Dr. Roger Kneebone

Attach a manufactured body part to an actor

Hybrid Standardized Patient

What is the advantage of

using a hybrid standardized patient?

program patient reaction patient safety/comfort learn to explain

procedure to patient/parents

practice draping and other physical patient preparation

What disadvantage is

there?

moderate cost time consuming requires dedicated space

and personnel not appropriate for OR

Answer:Virtual Scenarios

Second Life

Virtual Scenario (Information)

Health Information Island

Virtual Scenario (Disaster)

Play 2 Train

Virtual Scenario (Clinical Reasoning)

Imperial College Londonhttp://www.elearningimperial.com/index.php?option=com_content&task=view&id=37&Itemid=58

©Pictures thanks to Dr. Bertalan Meskó http://scienceroll.com/2008/08/17/unique-medical-simulation-in-

second-life/

Virtual Scenario

Learn more about Second Life at

http://medicaleducation.wetpaint.com

Click on The Networked Student and scroll down.

Thank youRead more about simulations here

http://www.medicine.usask.ca/faculty/cbf/medical-simulations