Simulation in anaesthesia

Simulation is the imitation of the operation of a real-world process or system over time.

The act of simulating something first requires that a model be developed. The model represents a system, whereas the simulation represents the operation over the system over time.

Modern day simulators have roots in early aviation trainers.

Classification of Healthcare Simulators:

·        Interaction  A simulator can be screen based, hardware based or VR based depending on how the user interacts with it. One can interact with the simulator in the same way as with a patient.

·         Physiology  A simulator can have a script-controlled or model-controlled physiology.

·         Use Simulators are used to teach procedural skills, psychomotor skills and cognitive skills

Applications

1. In Australia and New Zealand, it is an integral part of anaesthetic training.
2. Standardised patients (SP) have been used in assessing undergraduate medical students.
3. Software-based manipulation of mannequin can be used to show changes in physiology brought about by various drugs and procedures.
4. Procedures like chest drain insertion and surgical crico-thyrotomy are very rarely performed in day-to-day anaesthetic practice. Simulation offers a chance to rehearse these rare procedural skills.
5. Anaesthesia Crisis Resource Management (ACRM) programme à It teaches the principles of team behaviour in crisis situations and assesses decision making, interpersonal communication and team management.

Advantages:

1. Reduces the risk to patients and inconvenience to participants
2. optimal manipulation of environment allows realistic replication
3. allows standardized repeated training
4. controlled pace of training can be achieved
5. recorded events make individual performance assessment and feedback possible

Limitations:

One of the criticisms is the extent to which a simulator can reproduce the real-life situations. In the healthcare setup, we should be aware of the differences between simulated and real patient anatomy to maximally utilise the benefit of such training.