Clinical healthcare simulators

Main article: Medical simulation

Medical simulators are increasingly being developed and deployed to teach therapeutic and diagnostic procedures as well as medical concepts and decision making to personnel in the health professions. Simulators have been developed for training procedures ranging from the basics such as blood draw, to laparoscopic surgery ^[15] and trauma care. They are also important to help on prototyping new devices^[16] for biomedical engineering problems. Currently, simulators are applied to research and development of tools for new therapies,^[17] treatments^[18] and early diagnosis^[19] in medicine.

Many medical simulators involve a computer connected to a plastic simulation of the relevant anatomy.^{[citation needed]} Sophisticated simulators of this type employ a life size mannequin that responds to injected drugs and can be programmed to create simulations of life-threatening emergencies. In other simulations, visual components of the procedure are reproduced by computer graphics techniques, while touch-based components are reproduced by haptic feedback devices combined with physical simulation routines computed in response to the user's actions. Medical simulations of this sort will often use 3D CT or MRI scans of patient data to enhance realism. Some medical simulations are developed to be widely distributed (such as web-enabled simulations that can be viewed via standard web browsers) and can be interacted with using standard computer interfaces, such as the keyboard and mouse.

Another important medical application of a simulator — although, perhaps, denoting a slightly different meaning of simulator — is the use of a placebo drug, a formulation that simulates the active drug in trials of drug efficacy (see Placebo (origins of technical term)).

[edit]Improving Patient Safety through New Innovations

Patient safety is a concern in the medical industry. Patients have been known to suffer injuries and even death due to management error, and lack of using best standards of care and training. According to Building a National Agenda for Simulation-Based Medical Education (Eder-Van Hook, Jackie, 2004) , “A health care provider’s ability to react prudently in an unexpected situation is one of the most critical factors in creating a positive outcome in medical emergency, regardless of whether it occurs on the battlefield, freeway, or hospital emergency room.” simulation. Eder-Van Hook (2004) also noted that medical errors kill up to 98,000 with an estimated cost between $37 and $50 million and $17 to $29 billion for preventable adverse events dollars per year. “Deaths due to preventable adverse events exceed deaths attributable to motor vehicle accidents, breast cancer, or AIDS” Eder-Van Hook (2004). With these types of statistics it is no wonder that improving patient safety is a prevalent concern in the industry.

New innovative simulation training solutions are now being used to train medical professionals in an attempt to reduce the number of safety concerns that have adverse effects on the patients. However, according to the article Does Simulation Improve Patient Safety? Self-efficacy, Competence, Operational Performance, and Patient Safety (Nishisaki A., Keren R., and Nadkarni, V., 2007), the jury is still out. Nishisaki states that “There is good evidence that simulation training improves provider and team self-efficacy and competence on manikins. There is also good evidence that procedural simulation improves actual operational performance in clinical settings.^[20] However, no evidence yet shows that crew resource management training through simulation, despite its promise, improves team operational performance at the bedside. Also, no evidence to date proves that simulation training actually improves patient outcome. Even so, confidence is growing in the validity of medical simulation as the training tool of the future.” This could be because there are not enough research studies yet conducted to effectively determine the success of simulation initiatives to improve patient safety. Examples of [recently implemented] research simulations used to improve patient care [and its funding] can be found at Improving Patient Safety through Simulation Research (US Department of Human Health Services) http://www.ahrq.gov/qual/simulproj.htm.

One such attempt to improve patient safety through the use of simulations training is pediatric care to deliver just-in-time service or/and just-in-place. This training consists of 20 minutes of simulated training just before workers report to shift. It is hoped that the recentness of the training will increase the positive and reduce the negative results that have generally been associated with the procedure. The purpose of this study is to determine if just-in-time training improves patient safety and operational performance of orotracheal intubation and decrease occurrences of undesired associated events and “to test the hypothesis that high fidelity simulation may enhance the training efficacy and patient safety in simulation settings.” The conclusion as reported in Abstract P38: Just-In-Time Simulation Training Improves ICU Physician Trainee Airway Resuscitation Participation without Compromising Procedural Success or Safety (Nishisaki A., 2008), were that simulation training improved resident participation in real cases; but did not sacrifice the quality of service. It could be therefore hypothesized that by increasing the number of highly trained residents through the use of simulation training, that the simulation training does in fact increase patient safety. This hypothesis would have to be researched for validation and the results may or may not generalize to other situations.