Healthcare Education

To err is human . . . .

• 100‘000 americans die due to „medical errors“ each

year
• More than caused by
– Traffic Accidents
– Breast cancer
– AIDS

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 Incidents in anesthesia

???
12%
TEC
22%
HUM
66%

Review: 419 Reports by

Anaesthestic Incident Monitoring Study (AIMS)

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 Human Factor as main cause for
accidents

ENVIRONMENT
26,1%

HUMAN 60,9%

TECNICAL
16,3%

Statistik – Lufthansa Flight Training. FFM. Source AQAI

Same problem: different outcome

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 One difference: Simulation training

 Training in standardized conditions

 Training corresponding to progress of
trainee
 Training of critical procedures without risks
 Training to resolve problems
 Training with structured escalation
 Training of team-interaction

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 Performance in critical situations and
Performanc emergencies

simulator simulator
e

time 7
 Why Simulation ?

 Lessons from aviation

 Nursing students have less opportunities to directly practice
since patient safety and patient right consideration, including
psychomotor skills and attitude to patients
 Nursing students have less opportunities to participant in or
aware the situation of patient safety
 The first time to aware the situation may be in the real world
 Nurses are expected to know more and do more than ever
before, making the demand for quality nurses a top priority
in the healthcare community.
 As result, nursing schools around the world are looking for
ways to better educate and prepare nursing students for the
important roles they will play in the healthcare industry.

 Quality of EDUCATION = Quality of SERVICE

 Quality of NURSING EDUCATION = Quality of PATIENT
CARE
 Definitions of Simulation

McGaghie (1999) defines simulation as:

“ A person, device or set of conditions that tries to present

problems authentically. The student or trainee is required to
respond to the problems as he or she would under natural
circumstance”
 Anatomy of a full-scale
simulator

The Simulator is an
artificial Patient.

We define his condition:

E.g. Hypertension
E.g. Pregnancy.

We define the
problems in a case
E.g. Acute Lung
Failure

This is possible due

to Physiologic
models
 Human Patient Simulation (HPS)

 Incorporates the use of a full sized manikin

 Programmed to provide realistic responses to actions by a
student
 Includes bedside monitor with :
– Realistic heart, lung and bowel sounds
– Blood pressure, pulses, pulse oximetry
– Hemodynamic and respiratory monitoring on a bedside monitor
 Voice responses can be programmed in or can be done in
real time
 Video and Audio recording can be made of the simulations
– Can be a vital part of the reccomended debriefing session

(Decker, Sportsman, Puetz, & Billings, 2008)

Cockpit simulator vs. Patient
simulator
It can be simple in fundamental
nursing teaching
Or More complex in critical care teaching
 Moulage - Trauma

BURNED FOREARM FULL ARM AMPUTATION

PARTIAL ARM AMPUTATON PARTIAL LEG AMPUTATION

 Moulage - Trauma

FACE/HEAD INJURY - ISTAN BRUISED CHEST SKIN - ISTAN

 Advantage of Simulation

 There is no risk to a patient

 Scenarios can be presented at will
– Routine procedures can be repeated intensively
 Specific Learning Opportunities - GUARANTEED
 The same known scenario can be presented independently
to multiple subjects
 Errors can be allowed to occur, confidence & technical skills
improved
 The simulation can be paused, restarted, or begun a new, to
demonstrate clinical alternatives. Performance can be
observed/recorded
 Participants use actual, complex, clinical devices
 Recording, replay and critique of performance are facilitated
 What should simulations programs achieve ?

 Micro Skills
– Programs that are focused on individual clinicians, technical
skills
 Meso Skills
– Programs that are focused on Clinical teams, Human Factors,
Non- Technical Skills
 Macro Skills
– Programs that focus Organizations, Institutional Preparation,
Redesign
 We Believe

“ I hear and i forget,

I see and i remember,
I DO and I
UNDERSTAND”
(Confusius)
 Healthcare Education Products:

• Human Patient Simulators  METI

• USG Simulator  CAE Healthcare
• Surgical Simulators  CAE Healthcare
 METI, CAE Healthcare ??

● METI:
o Medical Education Technologies Inc., Florida, USA
o Est. 1996, specializing in Human Patient Simulators
o Patented human physiological and pharmacological models
permits life-like simulator reactions to treatments and
interventions
o Acquired by CAE Healthcare in August 2011
● CAE Healthcare:
o CAE (Canadian Aviation Electronics Ltd.), 1947
o Part of CAE Corporate (Flight Simulation, Mining Technology,
Military Training, Public Safety & Services)
o Patient Simulator for Military, Surgical and USG Simulators
o Previously based in Canada, now shift all manufacturing in
Sarasota, Fl, USA
METI – Human Patient Simulator

HPS (Human Patient Simulator)

Top-of-the-line; the only simulator capable
of anesthesia gas delivery, respiratory
training and critical care

iSTAN
Full wireless and theterless; real-like skin
and physiology (hair folicles and secretion);
suitable for evacuation, transportation and
military training

ECS (Emergency Care Simulator)

Rich in features (bleeding, breathing,
blinking, and convulsion); suitable for
emergency training
METIman
Affordable solution to simulation; full
wireless and theterless; combination of
portability and basic features of a
simulator; suitable for nursing and
transportation training

PediaSIM
Full automatic response to treatment
received; distinction in anatomy, response
to drugs and clinical problems

BabySIM
Representation of a 6-9 months old; adapts
METI’s advanced feature of accurate airway;
capable of incubation training
 CAESAR (CAE Healthcare)

● Trauma patient simulator

● Rugged, durable, wireless, water-resistant
● 21 pre-programmed trauma scenarios: airways,
hemorrhaging, chest injuries
● Modular change of limbs
 Learning Modules

 METI’s Learning Modules include a collection of carefully

defined Simulated Clinical Experiences (SCEs™) that allow
easy integration of specific learning content into educational
curricula and add critical learning opportunities to real-life
simulated environments quickly and easily.
 Learning Modules
Adult Nursing
Advanced Cardiac Life Support
Combat Medic Advanced
Skills Training
Disaster Medical Readiness
Emergency Medical Services
Foundations of Nursing Practice
Infant Emergencies
Infant Nursing
Nurse Residency Program
Patient-Centered Acute Care Training
Pediatric Emergencies
Pediatric Advanced Life Support
Pediatric Nursing
Perioperative Management
Program for Nursing Curriculum
Integration
Respiratory Education Simulation
Program Module
Trauma Medical Care
VIMEDIX™ Ultrasound Simulator
Real-time interactive capabilities; features
TTE, TEE and FAST examinations; a wide
range of cardiac pathologies; augmented
reality for anatomical knowledge

CathLabVR Endovascular Simulator

Most accurate physiology and most
advanced cardiovascular content;
hemodynamic wave tracings; superior
force feedback
EndoscopyVR Simulator
Capable of bronchoscopic and endoscopic
procedures; features complete examination of
bronchial and gastrointestinal tracts

LaparoscopyVR Simulator
Features an advanced modular curriculum
derived from actual patient data; provides
multisensory feedback (visual, audio and tactile);
frequently performed cases such as, gall bladder
removal and tubal occlusion
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