Simulation-Based Training in Healthcare

February 1, 2010 | Healthcare Risk, Quality, & Safety Guidance


During a surgical procedure, the anesthesiologist sees that the main gas system is starting to fail. Realizing that he forgot to check the oxygen cylinder before the procedure, he calls to other members of the operating room (OR) staff to retrieve another cylinder. The OR staff, who are busy performing other tasks for the procedure, do not hear the anesthesiologist, and no one goes to retrieve the cylinder. The anesthesiologist becomes visibly stressed, and, due to the lapse in time before another oxygen cylinder is retrieved, the gas system fails and the patient is put at serious risk. Later, the anesthesiologist realizes that because he was stressed and not thinking clearly during the event, he did not realize that another oxygen cylinder was located near him in the same room.

This situation, although possible in a real-life healthcare environment, is a simulated OR scenario used to teach techniques and teamwork to surgical staff. When conducted effectively, the simulation and emotions can feel real to the participants. In this case, the instructors who administered the simulation noticed that the anesthesiologist did not check the oxygen cylinder before the procedure and, using a high-tech simulator, caused the gas system fail. Simulations such as the one described above may help prevent similar situations from happening during real-life surgical procedures, which would then prevent serious consequences for real patients.

Simulation has been used for years in aviation and in the military to train individuals to effectively respond to certain scenarios or emergencies (Weinschreider and Dadiz). In recent years, the healthcare industry has begun to adapt simulation exercises to teach medical students and healthcare staff to perform certain procedures or respond to patient care scenarios or events.

Various medical organizations have recognized the value of simulation-based training as an educational method in healthcare. In its program requirements for graduate medical education in surgery, the American Council for Graduate Medical Education states that program resources for resident education should include simulation and skills laboratories (ACGME). In addition, the American Society of Anesthesiologists endorses the mandatory use of simulation programs in training for anesthesiologists’ recertification beginning in 2010. The American College of Surgeons also supports simulation-based technology and has developed two levels of certification for medical education institutes with simulation programs: Level I, which is the highest level of accreditation and includes centers that provide comprehensive training to multiple medical specialties, and Level II, which includes centers that provide basic training on fundamental skills to surgeons and surgical residents (Satava). The Society for Simulation in Healthcare, organized in 2004, is a group of medical educators and researchers who support the use of simulation in healthcare for education, testing, and research. More information about the society is...

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