Symposium 10 - Recent Trend on Simulation Training

Globally the healthcare simulation market is driven by the growing need to curtail healthcare costs which are partially attributed to the shortage of healthcare professionals, increased healthcare spending, and increased administrative expenses. In this environment there is also a growing need for healthcare simulation and advancements in technique and technology. Some driving forces include healthcare payers, healthcare buyers, and professional organizations. Recent trends include focuses on improving patient safety, enhancing systems integration, and more individualized training solutions for learners.

Simulation-based education (SBE) provides a safe and effective learning environment for learners. Historically, simulation has been widely used in military and aviation training, and was only introduced into medical education in the 1960s. In the last 20 years, concerns about patient safety have given the impetus to develop SBE in healthcare professionals training. This method of learning allows specific clinical task and situation to be created in a simulated environment with mannequins, part-task trainers, and standardised patients, or with computer-generated simulations and even virtual reality to provide a realistic experience for the learners. Simulation provides a learning experience without the risks associated with the real event that may cause harm to learners themselves, their patients or others. The experience may be repeated until competence is achieved, while different level of difficulty may be introduced to challenge the learners. The experiential simulated event coupled with a structured approached to debrief the experience have been shown to be an effective learning method. Simulation is now commonly used in the training of clinical skills, problem solving, decision making, and team communication and interaction. Despite its popularity, significant challenges remained in the appropriate use of simulation in medical education and healthcare professional training where consistent standards of training must be assured and maintained, and that best practices in the application of simulation are supported by evidence of effectiveness. The lecture will explore the historical perspectives, current practices and challenges in the development of simulation training for healthcare professionals.
 

Based on ancient techniques, mindfulness is a powerful psychological intervention/coping skill that has been shown to improve mood and reduce stress. Mindfulness involves bringing one’s attention into the present moment; bringing full awareness into present experiences on purpose and nonjudgmentally.  Dialectical Behavioral Therapy® (DBT®) uses mindfulness to help patients learn valuable skills to overcome psychologically unhealthy thought processes and behaviors. Patients start by directing their attention towards simple perceptual stimuli (e.g., sights and sounds), without self-criticism. They later learn how to experience emotions, thoughts, and sensations while still being able to focus their attention on an activity. Unfortunately, many patients have attention deficits that make mindfulness challenging.  Our team developed a new treatment that teaches patients mindfulness skills while they are in virtual reality.  Immersive virtual reality involves wearing/looking into VR goggles as a window into a 3D simulation designed to make the patient feel “present” in the virtual world, as if the computer-generated world is a place they are visiting.  One of the first patients to try this new technique was a 39-year-old male patient hospitalized with a traumatic spinal cord injury C4-5 resulting in quadriplegia and respiratory failure requiring trachiotomy (breathing through a hole in his throat) after falling out of 4 story building.  He had severe depression, and anxiety symptoms.  

Methods: The patient looked into VR goggles, and had the illusion of slowly “floating down” a river in virtual reality while listening to DBT® Mindfulness Skills training instructions. The patient filled out brief psychological ratings before and after each VR session, after four sessions.  

Results: As predicted, the patient reported reductions in negative emotions after each VR DBT® Mindfulness session.

Conclusion:  Results were encouraging.  Additional research and development will be needed to determine whether VR DBT® Mindfulness Skills training leads to any long term improvements in outcome.