Simulation Technologies in Modern World

Simulation is the reproduction of part or all of a clinical encounter through the use of manikins, computer-assisted resources and simulated patients. Advances in learning technologies have seen a massive rise in the availability and employment of high-fidelity simulators and simulation. However, low-fidelity resources have been used successfully for many years and, like the traditional teaching environments, need to be carefully incorporated into the spectrum of learning/training.

Simulation:

• allows learners to practice in a safe, protected environment
• allows observation of a ‘clinical episode’ without disturbing the natural cadence of the interaction
• assists learners’ reflection of their strengths and weaknesses through teacher, peer and ‘patient’ feedback, including video analysis
• allows teachers/staff to assess skills in an objective, reproducible manner
• allows the reproduction of important clinical scenarios that may be rarely encountered in real life, e.g. anaphylaxis

Allows assessment of complex interactions, skills and attributes that may be difficult to reproduce or assess, or are rarely experienced, e.g. working on call, multidisciplinary team working, discussing sensitive and/or important information with patients or careers. Simulations vary in their relation (fidelity) to the real, lived experience.

Low-fidelity simulation might include using manikins to practice clinical examinations or procedures such as ophthalmoscopy or a vaginal examination. Manikins can also be used to rehearse the skills of simple clinical procedures such as suturing or the insertion of urinary catheters, intravenous cannula and nasogastric tubes. Sometimes colleagues use each other to practice simple clinical procedures, e.g. taking a blood pressure or temperature.

The use of these relatively simple simulations may be augmented by incorporating them into clinical scenarios, contextualizing their use and importance. This helps to introduce and reinforce good practice and generic issues such as hygiene, patient and staff safety, team working, communication, clinical reasoning and problem solving.

Low-fidelity simulation has a number of advantages:

• it is easy to ‘house’ – may be used within a purpose-built skills center or a classroom
• it is relatively cheap to purchase, maintain and resource
• it is portable – many of the manikins may be stored in a central location and moved to teaching areas when they are required
• it is easy to store and secure lower costs mean they are easier to duplicate and thus provide larger numbers/groups of learners with practice; they are therefore also easy to use in station-based assessments, where several synchronous circuits may be running
• if sited in secure locations, it can be used for self-directed learning
• It allows learners multiple practice attempts before attempting the skill on a real patient.

High-fidelity simulation refers to structured student learning experiences with the use of a technologically advanced computerized mannequin, the Human Patient Simulator (HPS). HPS is anatomically precise and reproduces physiologic responses. Students are administered sequential decision-making events within an environment that mimics a clinical setting. Instructors can control the mannequin’s responses and the HPS can respond to interventions provided by the student.

Faculty using simulation technology can also ensure that every student has experience in risky situations because threats to patient safety can be part of the simulation experience. In this way, simulation can assist faculty to more clearly and reliably detect effective and ineffective student performance and remediate students when particular Knowledge ,Skill and Attitudes are absent or not fully developed.

Nowadays the enrollment of medical student increase enormously throughout Ethiopia with limited human and infrastructure development. Theoretical teaching 200 and more student in class is becoming common thing but when we come to the practical teaching handling these amount of student in basic science laboratory, and in Hospital is a big problem to most medical schools. Therefore the need for new teaching approach to overcome these problems is a must, so the government and development partners are focusing now the need of simulated teaching approach.