Simulation training: a growing, life-saving trend


High tech mannequins bleed, cough, speak, cry and teach students, nurses and physicians every day in environments where mistakes aren't deadly. They are used in hospital and university simulation centers and they are increasingly becoming a part of the training and continuing education of health care professionals.

Nearly 100,000 patients die as a result of medical errors in the United States each year, according to the National Institutes of Health. In an effort to address this startling statistic, medical institutions and universities are seeking ways to improve patient safety, reduce medical errors and keep costs down. Simulation training is a valuable and proven tool that not only helps medical professionals with skill development, but also improves patient outcomes.

Once offered only at select teaching hospitals, simulation (or "sim") labs are growing in popularity in mainstream medical facilities, and are now becoming a trend at universities, as well.

Phoenix-based Grand Canyon University (www.gcu.edu) is one example. GCU's College of Nursing and Health Sciences recently opened a state-of-the-art simulation lab featuring mannequins with lifelike qualities such as blood pressure points, pupils that respond to light, pores, heartbeats and breathing lungs. The SimMan3G is controlled through a wireless computer network and is connected to working monitors to add to the realistic training.

The sim lab also includes an obstetrics room with a birthing mother and babies, a pediatrics room with a child mannequin, three exam rooms, and an apartment for home health care and hospice training. The apartment allows for staged scenarios where nursing students identify potential safety and medical hazards in a home environment and have the opportunity to interact with a live patient. Specially trained theater students serve as patients, helping future nurses learn to read facial expressions and bridge the gap between education and clinical practice.

"Using simulated case scenarios in nursing allows students to experience 'real life' situations in a controlled environment before they care for patients and families," says Anne McNamara, dean and professor of nursing at GCU's College of Nursing and Health Sciences. "When students are then placed in the clinical setting, their confidence is greater."

Many studies show that clinical skills are enhanced through simulation. In a 2009 Northwestern University study, medical residents with sim lab experience needed fewer needle passes to insert an IV and were more confident about their procedural skills compared with residents who received traditional training. In another Northwestern study, the rate of infection from resident-inserted catheters in the ICU decreased from 3.20 to 0.50 per 1,000 following simulation instruction.

Sophisticated mannequin training systems can cost as much as $250,000 apiece. Simpler, less expensive, options include partial task trainers, such as a mannequin arm or foot, which allows clinicians to focus on specialty training. Procedures can be captured on video and errors can be caught, reviewed and addressed - before it really counts.

Sim labs are on a major upswing in popularity and precision as the practice provides consistent, reliable and measurable results. In 2003, only 29 percent of emergency medicine residency programs used some form of simulation in training. In 2008, that number rose to 85 percent, with 43 percent owning their own mannequins.

While simulation facilities can be costly to build and operate, industry leaders and educators agree the investment pays off through reduced medical errors and the ability to provide better patient care.

GCU Simulation Lab Director Sheila Searles explained that students often feel intimidated when first asked to interact with a "plastic dummy." However, once simulation begins, they suspend their disbelief and get emotionally involved. "It's amazing to watch their skills grow over time. They begin to think of the mannequins as real patients and will sometimes even cry after interacting with them."

 

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