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Practicing Patient Procedures

If you've ever had a student doctor or nurse perform a procedure on you, you know it isn't much fun. The student may need to make several attempts before the procedure is performed just so, and this can cause much distress to both patient and student. Now there's an easier way: simulation training.

The newest technology allows medical students to practice surgeries and other medical procedures on simulators before they have to try them out on real, human patients. Pilots have long used simulation training for practicing aircraft emergency measures. This technology has at long last been extended to med students.

Lifelike Enough?

But while some physician educators feel that simulation training increases student confidence as well as patient safety, since patients are spared first-time-out mistakes, others wonder if the simulators are lifelike enough to provide a proper educational model. In short, some educators aren't sure the simulations serve their purpose, and the more skeptical among these teachers are insisting that doctors must practice on humans, only.

Dr. Leigh Evans led a team of Yale University researchers to find out if the simulators work as well as live humans for doctors practicing medical procedures. Half of a group of student doctors learned a new medical skill with simulation training, while the other half learned the same skill in the traditional manner, with a live human being. The procedure studied was inserting a central line into a major vein. This is a medical skill that is a crucial one for doctors in a variety of specialties.

At the end of the training period, the researchers observed the doctors as they performed the procedure on close to five hundred patients. The researchers discovered that doctors trained with the simulators had a much higher success rate in inserting the central line. The rates for errors and complications were about the same during the training, no matter which training method had been employed, which suggested that there was no greater risk in teaching doctors with simulation training as opposed to live patients.

Complicated Skills

Evans and his research team feel that these findings suggest that using simulation training for teaching complicated medical skills to junior doctors avoids the risk of errors incurred during the doctor's first-time performance of a technique on a live patient.

Dr. Evans presented the findings of the team in a lecture entitled, “Simulation Training for Central Venous Catheter Insertion on a Partial Task Trainer Improves Skills Transfer to the Clinical Setting,” at a plenary paper session held at the Sheraton New Orleans on May 14, 2009 SAEM Annual Meeting. Abstracts were published in the April issue of Academic Emergency Medicine.


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