It’s been nearly a decade and I can still recall the day that simulation-based education and training made sense to me and witnessed the profound benefits for healthcare practitioners, workers, and patient safety.
I had never observed a simulated training event and was curious what was going to happen. The concept of using patient simulators was intriguing and I was optimistic about how the learner was going to perform. The cohort had completed their traditional lecture and lab-based education and was “ready” to deliver care.
The simulation experience was based on Advanced Cardiac Life Support (ACLS) guidelines and the learning objectives were:
- Recognize a life-threatening ECG rhythm
- Activate emergency system and call for assistance
- Administer appropriate ACLS medications and perform CPR
Before the experience, I observed the learner’s behavior and they appeared very confident. “Let’s see what happens,” I thought to myself. The lights went out and the simulation began.
The patient simulator was breathing, showing signs of distress and the software performed spectacularly according to the preset programming (shout out to engineers). The learner entered the event area and began to assess the simulated casualty. The ECG was set up and displayed a life-threatening rhythm that needed defibrillation and immediate drug therapy. Something wasn’t right; the learner interpreted the incorrect ECG rhythm and started giving the wrong medication. The simulator responded in real-time, vital signs became more complicated and the patient simulator condition worsened. Within a very short time, the situation became unmanageable for one person, yet there was no call for support. There was no call for help. The scenario continued and ultimately the experience had concluded. In this case, things did not end well.
In the debriefing phase, the facilitator went into more detail about what happened; based on the learner’s performance and connected the pieces to a meaningful learning experience. The scenario was repeated and the learner’s performance was dramatically improved, resulting in better outcomes for the simulated patient. Truly remarkable learning.
Why does this matter? The immersive experience in a controlled environment provided an additional layer of safety, where potential errors could be addressed and corrected well out of harm’s way.
Simulation-based experiences have the ability to positively impact patient safety, help people and teams deliver appropriate interventions. Simulation – the replication of an experience, can also expose system weaknesses and provide opportunities for healthcare quality improvement.
By designing and facilitating experiences based on models of current and best practices, we have the opportunity to address current challenges and impact the future of healthcare delivery.
Even after thousands of simulation experiences, I remain passionately curious about how people interact with complex systems. Failure can be an enormous learning experience, especially in a setting where there is absolutely no risk to patients.
I believe that we can make a difference in creating safer and effective systems.
About the Author: Matthew Jubelius wants to change the future of education and training. He has championed the design, implementation, and evaluation of simulation-based education and training programs, including quality improvement measures for post-secondary institutions, private industry, and the federal government. Matthew can be reached through www.amoveotraining.ca