Health Care Simulation

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Health Care Simulation

• Brendan Flanagan FANZCA
• Southern Health Simulation Centre
• Melbourne

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Simulation in Health Care

• Verbal
• Role play
• Standardised patient
• Screen-based
• Part-task Trainers
• Computerised Mannequin
• Virtual Reality

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Standardised Patients
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Laerdal MicroSim
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Part Task TrainersNot True Simulators But Widely
Used

• Part-task trainers, e.g.
• IV arms, skeletons, airway trainers
• ResusciAnne equivalent (CPR, ACLS)
• Harvey (cardiac auscultation)

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Late 1990s - Early 2000sNew Manufacturers for
Simulators

• Laerdal SimMan (Mannequin-based)

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Procedure / Surgery Simulation and Part-Task
Training

• Important in many medical domains
• surgical, endoscopic, cath. procedures

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Development of Simulation CENTRES

• Facility
• simulation room(s), control room(s), debriefing
  room(s)
• support room(s)
• part-task trainers, VR, standardised patients
• offices
• Core faculty
• interdisciplinary

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Human Factors (CRM) Training
... increases the percentage of crews rated as
above average and decreases the percentage of
crews rated as below average.

• Helmreich, RL et al Aviation, Space Environ.Med.
  61576-579 (1990)

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Health Care is a Very Complex Demanding
Industry
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Simulation in Health Care vs. in Other Industries

• Unlike other industries we dont build human
  beings -- we dont even get the manual!
• Pt. simulators inherently less realistic
• But thenthere is no average patient
• In other industries training assessment is
  built into the work over a whole career not
  (yet) in health care

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Patient Simulation Where Are We Now?

• Patient simulation is a maturing new endeavour
• not the end, not the beginning of the end,
  maybe the end of the beginning!
• Manufacturers of diverse products
• Diverse curricula target populations

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Domains using simulation

• Undergraduate Postgraduate
• Paramedics Emergency Medicine
• Anaesthesia, Surgery
• Primary Care Practitioners
• Intensive Care Medicine/ Arrest Teams
• Obstetrics/ Neonatal
• Interventional Radiology Cardiology
• Endoscopy

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Australian Centres

• Melbourne x 2, Sydney, Perth
• RACS in Melbourne
• Brisbane
• Flinders Royal Adelaide Hospital
• Sydney hospitals
• 28 SimMen around Australasia
• inc. 7 Defence Forces installations

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Patient Simulation Where Are We Going?

• Simultaneous innovation and consolidation of
  approaches
• VISION Simulation completely embedded in fabric
  of health care for education, training,
  performance assessment, research, device
  certification, and other applications

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Some mutually important topics!

• Team Training
• Training Transfer
• Human Factors
• Performance Assessment
• Synthetic Environments
• Simulator Fidelity Analysis
• Knowledge Elicitation and Capture
• Validation, Verification and Accreditation
• Cost Benefit Analysis of Simulation Systems
• Policy Issues

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SimTect

• 1-day Health Medical Symposium
• 2000, 2001, 2003
• 2004 a 3-day meeting
• local international keynote speakers
• live feed to Perth simulation centre
• shared haptovisual environment with Stanford
• Standards workshops

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The Way Forward?

• Society
• name
• Australian/A NZ/Asia-Pacific
• Health Care (v. Medical)
• mission/vision
• structure
• relationship with SIAA

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The Way Forward

• Steering Committee to pursue these and
  related issues
• No web page as yet
• www.simtect.com for time being
• Input/questions/comments to b.flanagan_at_southernhea
  lth.org.au