New aspects on critical care medicine training

Abstract

Recently, three fundamental changes have been introduced in medical education, all of particular importance to critical care medicine: (1) clinical teaching and medical practice now emphasize evidence-based medicine, (2) patient safety aspects are increasingly stressed, and (3) use of simulation in medical training is spreading rapidly. In 1999, the disturbingly high frequency of life-threatening or even lethal medical complications was emphasized by the Institute of Medicine in the book To Err Is Human. The Institute of Medicine recommended establishing interdisciplinary team training programs incorporating efficient methods such as simulation. Although simulation has been used by the aviation industry and the military for several decades, only during the past decade has this become a teaching method in medicine. Currently, two full-scale computerized simulators are available: METI, provided by Medical Education Technologies, Sarasota, Florida, and SimMan, manufactured by Laerdal Medical, in Stavanger, Norway. The simulation center at the University of Pittsburgh Medical Center was established in 1994 and has grown quickly to its current large facility, where, in academic year 2003 to 2004, approximately 8000 healthcare professionals were trained on the SimMan. Courses taught include clinical procedures and decision making in perioperative medicine, acute medicine, pharmacology, anesthesiology, airway management, bronchoscopy, pediatric versus adult crisis management, critical events in obstetrics, and crisis team training. Advantages of simulation training over traditional medical education methods include (1) provision of a safe environment for both patient and student during training in risky procedures, (2) unlimited exposure to rare but complicated and important clinical events, (3) the ability to plan and shape training opportunities rather than waiting for a suitable situation to arise clinically, (4) the ability to provide immediate feedback, (5) the opportunity to repeat performance, (6) the opportunity for team training, and (7) lower costs, both direct and indirect. Within the next decade, use of computerized simulators for evidence-based education and training in medicine is expected to develop considerably and spread rapidly into a very important domain of medical schools throughout the entire world.

The Ventriloscope®: ‘Am I hearing things?’

“…Flight simulation was employed during World War II to train military pilots due to its cost effectiveness and time efficiency. Commercial pilots, as well as the National Aeronautics Space Association use simulation for training today (Grenvik et al 2004). The same ideology has recently been transferred to the…”

“…Simulation Based Medical Education (SBME), a method of medical education which employs simulative aids, is integrated with other methods of teaching including lectures, bedside teaching, and problem-based learning with an overall emphasis on enhancing patient safety by learning from mistakes with increased practice to prevent errors in real life (Ziv et al 2005). Unique benefits of simulation in medicine include: providing a safe and controlled environment for the practice of risky procedures, unlimited practice with difficult procedures and situations that rarely appear in uncontrolled clinical settings, development and preparation of specific scenarios and rare events to provide training opportunities, quick feedback to trainee and instructor/evaluator, a system to repeat different types of scenarios, practicing and improving team skills and reducing instructor costs (Grenvik et al 2004). …”

Transitioning the Respiratory Therapy Workforce for 2015 and Beyond

“…27 Preparation of the RT for work in the intensive care unit can be accomplished safely and effectively, and provide immediate feedback for individuals or a team, and clearly should be an integral part of any RT curriculum. 28 The value of simulation has been demonstrated in many different scenarios, such as trauma and the intensive care unit. 29 Given the current variety of simulation platforms and the expanding education needs of future RTs, simulation in didactic and clinical scenarios will be invaluable.…”

Effectiveness of simulation technique in teaching-learning process for prevention of postpartum hemorrhage in obstetrics and gynecology

“…Furthermore with introduction of Work Place Based Assessment (WPBA), teaching, assessment can be done in single sitting. 13 Direct Observation of Procedural Skills (DOPS) is form of WPBA used for evaluating procedural skills by observing students in workplace setting. 14 Despite, clear evidence, observation of clinical work and feedback remains underutilized.…”