The Centre of Excellence for Simulation Education and Innovation (CESEI) at Vancouver General Hospital (VGH) represents a revolution in medical teaching. For decades, medicine has been taught on the apprenticeship model. With increasing demand for more medical school graduates, heightened concern for patient safety, and a need for better continuing education to keep practicing physicians up-to-date with new technology, this model is no longer appropriate.
CESEI is a high-tech classroom for medical students , physicians, nurses, Canadian Forces medical technicians and other health care workers. A key part of the medical education system in British Columbia, CESEI provides training at all levels: from basic skills for junior medical students to continuing medical education for experienced surgeons.
At CESEI, patient simulators, innovative teaching software, high-speed Internet connections and highly interactive technology offer a more efficient and effective teaching environment. The facilities provide students with more opportunities to learn, practice, and master procedures and skills in a virtual environment prior to patient contact.
HPS (by METI)
Meet Stan (Standard Man), the Man who saves more lives.
At every level of patient care, hands-on experience is the best teacher. The Human Patient Simulator (HPS) - a computer-model-driven, full-sized mannequin - delivers that experience in true-to-life scenarios that swiftly change to meet instructors' goals. The ultra sophisticated and highly versatile HPS blinks, speaks and breathes, has a heartbeat and a pulse, and accurately mirrors human responses to such procedures as CPR, intravenous medication, intubation, ventilation, and catheterization. This is possible through a painstaking marriage of "high touch" with "high tech," this dramatically functional mannequin exhibits lifelike clinical signals. Add to this a profound array of intricately programmed systems - cardiovascular, pulmonary, pharmacological, metabolic, genitourinary (male and female), and neurological – and you have an easily controlled teaching laboratory where students can practice again and again, until the highest-quality patient care becomes second nature.1
1. HPS. METI. www.meti.comEmergency Care Simulator ECS (by METI)
The ECS provides an anatomically correct, feature-rich mannequin, which allows for the physical demonstration of various clinical signs including bleeding, breathing, blinking eyes and convulsions. The human physiology models at the core of the ECS provide appropriate responses to treatment interventions, including airway and oxygenation management, fluid administration, defibrillation and the administration of drugs. Together, these systems deliver a realistic and objective training ground for learners to practice and perfect patient care without risk to real patients.2
2. ECS www.meti.comPediaSim (by METI)
The little things mean a lot
Children are not small adults. And the nuances of pediatric care cannot be adequately learned on small mannequins hooked up to adult simulation programs. There are minute but crucial differences that make pediatric medicine uniquely challenging – distinctions in anatomy, reactions to drugs, types of injuries and underlying physical conditions. Just as the HPS relies on highly precise computer modeling of human physiology and pharmacology, the PediaSim operates on the basis of delicately calibrated mathematical equations that mirror the parameters and responses of the young patient.3
3. PediaSIM. METI. www.meti.comBabySim (by METI)
Treating a critically ill infant requires a unique skill set that can only come from hands-on, real time experience. Knowing what to look for and how to find answers-quickly and with no mistakes-is essential. But this kind of experience can't come from exposure to critical care situations in practice. The stakes are simply too high and the patients too precious. When a parent hands over their sick baby to a medical professional, they are counting on a miracle. The BabySIM makes it possible to prepare learners for interaction with our most vulnerable patients in a safe, realistic learning environment. Intricate details such as realistic touch and feel, clinched fists and a loving layer of baby fat help create an appropriate representation of a three- to six-month old infant. The educational value of the BabySIM is summed up in the fact that critical care interventions-such as infant CPR, airway management, drug administration and defibrillation, to name a few-can be practiced on the simulator, better preparing healthcare professionals for critical events involving infants.4
4. BabySIM. METI. www.meti.comSimMan (by Laerdal)
SimMan® is a portable and advanced patient simulator for team training. SimMan® has realistic anatomy and clinical functionality. SimMan® provides simulation-based education to challenge and test students' clinical and decision-making skills during realistic patient care scenarios. SimMan® includes well-proven software and an interactive technologically advanced manikin allowing learners to practice the emergency treatment of patients. 5
5. SimMan. Laerdal. www.laerdal.comSimBaby (By Laerdal)
SimBaby is the advanced simulator for training in infant emergencies. This portable advanced infant patient simulator is used for team training. SimBaby has realistic anatomy and clinical functionality that enables simulation training. SimBaby includes software with video debriefing and an interactive technologically advanced manikin allowing learners to practise the emergency treatment of pediatric patients.6
6. SimBaby Laerdal. Laerdal
Procedicus VIST™ (By Mentice)
Procedicus VIST™, Vascular Intervention System Trainer, reproduces the physics and physiology of the human cardiovascular system such that a person can learn to perform various procedures such as cardiac catheterisation. The simulator is a generalized solution to endovascular simulation. The initial content scenarios focus on coronary, carotid, renal intervention and stenting as well as pacemaker lead placement. This simulation is combined with a haptic interface to give the user a natural, correct way to interact with the simulation. In addition there is an instructional system coupled to the simulation that provides a framework for learning from the simulation.The training system consists of the software simulation of the cardiovascular system, the haptic interface device, the instructional system and two monitors, one for the synthetic x-ray and one for the instructional system. The simulation consists of modules replicating the hemodynamics, blood flow and dye contrast media mixing, and catheter-vasculature physical interaction. In addition, a module produces a synthetic x-ray image to replicate the fluoroscopic image used by interventional cardiologists to guide them during their work.7
7. Procedicus VIST. Mentice www.mentice.comHarvey
Harvey is the cardiopulmonary Patient Simulator. It is a proven system to teach bedside skills that transfer to real patients. This full-manikin realistically simulates nearly any cardiac disease at the touch of a button by varying blood pressure, pulses, heart sounds and murmurs. The simulator provides a comprehensive cardiology curriculum by realistically simulating 30 conditions. It is structured to begin with common, less complex conditions and progress to more rare and complex diseases. Findings include blood pressure, venous, arterial and precordial impulses, ascultation in multiple areas that varies with respiration when appropriate and breath sounds. "Harvey" may be used in any environment in which a patient may be examined. Small groups with stethophones may learn without an instructor by using the self-assessment slide programs. Larger groups may learn in a lecture hall by using stethophones for auscultation and video cameras and monitors or a projector for observing other physical findings. "Harvey" is used tot train medical students, residents, fellows, primary care physicians, physician assistants, nurses and para-professionals. Among students, it may be used effectively during each and every year of school, starting with the Introductory or Normal program for a beginning student. This is consistent with the goal of wedding basic sciences and clinical exposure throughout a student's education. In addiction, skills can only be learned and maintained with repetitive practice. Multiple studies have shown that the cardiovascular examination is a sensitive, highly specific and cost-effective skill. At the same time, national studies of Internal Medicine and Family Practice trainees have clearly demonstrated that cardiovascular bedside skills are sorely lacking. The solution suggested in these studies is repetitive practice through simulation technology and testing outcomes.8
8. All-New Harvey. Micheal S. Gordon Centre for Research in Medical Education. www.crme.med.miami.edu/
