The COVID-19 pandemic caused a major shift in medical education. Since students were not classified as critical employees of hospitals, it became difficult for them to gain clinical hours with patients. With soaring demand for medical professionals to address the pandemic and students without access to hands-on training in hospitals, a new technique rose to prominence: remote learning with patient simulators.
Patient simulators for healthcare providers and educators
For many years, patient simulators have provided incredible value in medical education. Much like airplane pilots who train in flight simulators before ever getting into an aircraft’s cockpit, medical simulation allows learners to experience realistic training scenarios first-hand prior to treating live patients. The National Nursing Board has recognized the value of simulation by allowing nursing students to earn up to 50% of their clinical time on simulation.1 Simulation allows nursing students to review and repeat low-frequency, high-risk scenarios until they develop the muscle memory and technique that is required to handle critical situations.
In another study by Harvard scientists, the monetary value of simulation training was assessed by examining malpractice claims.2 The researchers observed a statistically significant reduction in malpractice claims for trained gynecologists and obstetricians who have participated in simulation training. Furthermore, the study demonstrated that when these physicians went through follow-up simulation training scenarios, the number of malpractice claims reduced even further. Not only do these data support clinical simulation as an effective training method for OB/GYNs, but also documents the financial impact of clinical simulation.
There are different types of patient simulators
Patient simulators come in a variety of forms depending on the educational need. They range from basic types of skills trainers to more sophisticated high-fidelity simulators that mimic a real patient’s response to treatment.
Skills trainers are a low-cost solution that allows students to practice basic procedures and techniques, such as phlebotomy, for example, a skills trainer, in this case, a mold of a human arm with synthetic veins allows the learner to practice inserting the needle into a vein until they become proficient. Similar skills trainers are used to practice intramuscular injections, lumbar puncture for an epidural, gynecological examination, and many other techniques. Skills trainers are portable and easy to use.
Conversely, more sophisticated patient simulators offer hyper-realistic training that allows learners to fully experience critical procedures before ever performing them on a patient. Childbirth is an example of an application of this sophisticated technology. Birthing simulators come in various forms, culminating with an adult female who is life-size, can speak and portray emotion, and can deliver a baby simulator that cries. Technologically, these simulators are highly equipped with circuits, pumps, and motors that not only allow her to mimic the physicality of a real patient but to interact with real clinical equipment. This high level of immersion ensures optimal preparedness among students when faced with a real clinical scenario.
These high-fidelity simulators are controlled by a tablet, they are portable and can be used to simulate a variety of medical scenarios in any location. In the case of childbirth, these simulators can be set up to mimic normal vaginal birth, shoulder dystocia, postpartum hemorrhage, and breach scenarios. This allows students to experience the dynamic physiology underlying complicated deliveries.
Evolving medical education
At its most basic, medical education is a combination of didactic learning and hands-on clinical learning. With advanced technology available, much of the didactic component can be held remotely. A professor may lecture online with students in attendance virtually. As remote learning became more common through the global pandemic, medical education pivoted to virtual activities wherever possible. Even with remote didactic sessions, the value of the hands-on component of medical training cannot be understated. To ensure clinical competencies, residency programs typically have a minimum duration of three years, and depending on the subspecialty, a fellowship may take an additional five years. Simulation offered the perfect solution to conduct hands-on training during the pandemic.
COVID-19 patient care training
Simulators also played a significant role in preparing medical professionals to treat COVID-19 patients. At the onset of the pandemic, the rapid escalation in cases caught many facilities and staff unprepared. Suddenly EDs, ICUs and CCUs were at or over capacity and the need for nurses and respiratory therapists was higher than ever. Because healthcare professionals working in critical care have a vastly different skillset from those in the emergency department or the medical surgery floor, many did not have the skills needed to properly treat patients with COVID-19. This resulted in increased demand for simulators and skills trainers, not only to train new providers but also to cross-train healthcare professionals from other departments who were helping to meet the demands of COVID-19.
As technology advances so do the simulators
Technological advancement has been a major catalyst for innovation in simulation. At Gaumard, our most advanced product combines mixed reality technology with a high-fidelity birthing simulator. With mixed reality goggles, a learner has the opportunity to actually visualize the baby and cardinal movements during decent, while engaging in the hands-on exercise of delivering the baby. In the event of a complication, the learner can observe the anatomy of both the mother and baby. If the baby is not descending through the birth canal, learners now have the ability to manipulate the simulator in a specific way and receive visual feedback indicating that her legs have been moved to the proper position. With patient simulators, learners can practice these skills repeatedly to gain the muscle memory and critical thinking skills needed to react quickly during complicated procedures.
Mixed reality is only the beginning
As we look at the continuum of technology where we are today, it’s not an endpoint. In fact, it’s not even a pause, period, or a comma. It’s a timeline, so it just continues. As technology continues to advance, learners continue to become more sophisticated. Ultimately, the goal is to ensure that the next generation of medical professionals are as competent as possible when they enter a clinical setting. Technological innovation is the tool to optimize clinical competency.
About James Archetto
James Archetto is Vice President at Gaumard Scientific. He received a BS degree in biology from the University of Vermont, and his MBA in marketing and international finance from the University of Rhode Island. He has more than 25 years of medical device, international business, and medical research expertise. Mr. Archetto currently leads Gaumard’s domestic sales team ensuring that each customer receives the optimal simulation solution and the best support in the industry.
References
- Hayden, JK. (2014). The NCSBN National Simulation Study: A Longitudinal, Randomized, Controlled Study Replacing Clinical Hours with Simulation in Prelicensure Nursing Education. Journal of Nursing Regulation. 5(2), S3-S40.
- Schaffer, AC. (2021). Association of Simulation Training with Rates of Medical Malpractice Claims Among Obstetrician-Gynecologists. Obstetrics & Gynecology. 138(2), 246-252.
