AN INTRODUCTION TO:
HUMAN PATIENT SIMULATION
LEADERSHIP AND LEARNING LEADERSHIP AND LEARNING
ARE INDISPENSIBLE TO EACH OTHERARE INDISPENSIBLE TO EACH OTHER
JOHN FITZGERALD KENNEDYJOHN FITZGERALD KENNEDY
Prepared and Presented By:Prepared and Presented By:David Hiltz, NREMT-PDavid Hiltz, NREMT-Pand Rod Kimble, EMT-Pand Rod Kimble, EMT-P
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WHAT IS HUMAN PATIENT SIMULATION?
The use of manikins to reproduce clinical scenarios for the purpose of education, evaluation, or research.
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SIMULATION TECHNOLOGY HISTORY AND PRECEDENTS
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http://www.youtube.com/watch?v=ICqPGkto3Yo
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Medical schools and residencies are currently facing a shift in their teaching paradigm. The increasing amount of medical information and research makes it difficult for medical education to stay current in its curriculum. As patients become increasingly concerned that students and residents are ‘‘practicing’’ on them, clinical medicine is becoming focused more on patient safety and quality than on bed-side teaching and education. Educators have faced these challenges by restructuring curricula, developing small-group sessions, and increasing self-directed learning and independent research. Nevertheless, a disconnect still exists between the classroom and the clinical environment. Many students feel that they are inadequately trained in history taking, physical examination, diagnosis, and management. Medical simulation has been proposed as a technique to bridge this educational gap.
The utility of simulation in medical education: what is the evidence?
Mt Sinai J Med. 2009 Aug;76(4):330-43. doi: 10.1002/msj.20127.
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LOTS OF OPTIONS WHAT ARE THEY?
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COMPLIANCE AND COMPETENCY:WHAT IS THE DIFFERENCE?
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SKILL / TASK TRAINERS
Useful for introducing or practicing psychomotor skills.
Lack situational context.
Varied levels of sophistication.
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MICRO-SIMULATION
Use of software to simulate a subject or situation on a computer screen.
Varied levels of sophistication.Evidence-based. Includes a debriefing analysis and a review of their
actions. Universal access.
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MANIKIN-BASED SIMULATION
Manikin Task Trainers Resusci-Anne / VitalSim
High-fidelity, computerized manikins with human functions.
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HIGH FIDELITY HUMAN PATIENT SIMULATORS
Outward appearance of reality. May be enhanced by simulation specialists with props and make-up.
Cosmetic fidelity
Respond realistically to interventions. Controlled by computer software programs individualized by
simulation specialists. Response fidelity
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HIGH FIDELITY HUMAN PATIENT SIMULATORS
RESPONSE FIDELITYPatient speaks to the participant. Able to perform interventions with realistic response. IV insertion with blood return. Chest tube insertion. Endotracheal Intubation.
Physiologic responses. Patient’s chest rises. Patient has pulses, breath sounds, bowel sounds. Hemodynamic parameters display on typical monitor screens.
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FULL-SCALE HUMAN PATIENT SIMULATION
Manikin functions and hemodynamic monitor displays are controlled by the manikin’s
computer software.
Requires electrical power.
Requires compressed air to initiate manikin responses. e.g. pulses, chest rise, breath sounds.
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COMPUTER CONTROL AREA
Control area should be hidden from participants. Sight
Soundproof
Can be accomplished from the bathroom of a typical hospital room.
Formal simulation suites have a control room with a one way mirror.
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USES OFFULL-SCALE SIMULATION?
Crisis Management -Team Training
Interdisciplinary Training
Risk Management - Error Analysis and Avoidance
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DEBRIEFING
Most powerful use of simulation includes a debriefing session immediately after the
simulated event. Facilitated by trained simulation
specialists.
Participants self-assess and provide peer assessment.
Provides opportunity for reflective learning.
May include observers as well as participants.
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WHAT DO YOU KNOW ABOUT DEBRIEFING?
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DISCUSS: VIDEO TAPING
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SHOULD ACLS AND PALS BE CONDUCTED IN THE SIM LAB?
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WHAT IS A CPR FRACTION?
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“Enthusiasm is one of the most powerful engines of success. When you do a thing, do it with all your might. Put your whole soul into it. Stamp it with your own personality. Be active, be
energetic, be enthusiastic and faithful, and you will accomplish your object. Nothing great was ever achieved without
enthusiasm.”
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DOES THIS FIT ANYWHERE?
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QUESTIONS?
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