Simulation in health care and patient safety
Simulation is growing fast in the health care industry especially in developed countries; it is helping to reduce medical errors significantly and should be highly considered in developing countries for the same gains.
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Patient safety is protecting and preventing the patient from harm or injury in healthcare delivery. One of the methodologies to achieve patient safety is the use of simulation and can be employed for both students in health care institutions and in-service training for qualified health professionals.
Simulation-based learning is an educational strategy that replicates clinical experience from its real setting and can be used to promote patient safety by employing measures that do not expose the patient to harm or injury. It has an added benefit of protecting the patient from being inconvenienced on the wards.
Some patients have been complaining time and time again that they are reduced to teaching models when they report or gain admission to health care facilities especially the bigger or teaching hospitals. In view of this, they would not like to report to the hospital when they are sick. Those who are able to attend primary health care facilities often plead with doctors to do all in their capacity to treat them especially if they are to be referred to bigger or specialist hospitals because of the nature of their condition.
Consent for these patients to be used for teaching purposes is not formal, usually oral, and most often in a way that the patient cannot refuse, knowing that their lives are in the hands of the health providers they easily give their consent. The possibility of a patient being used for teaching in the hospital is certain because other alternatives are not well developed or non- existent.
Benefits
Simulation-based learning can be replicated in health care settings in developing countries to protect patients from such humiliating encounters, and help trainee medical, nursing or health professionals to practice and build their skills until they are competent enough, and feel confident to offer efficient and safe care to live patients. The use of simulation-based learning has been proved to promote patient safety by enhancing proficiency through skill building for proficient competencies.
Traditional service-based apprenticeship at the expense of the lives of patients has extended over many years in developing countries and the need for a turnaround to more focused learner-centered programes that aim at achieving specific educational objectives in a much shorter time should be considered. The potential benefits of simulation are widely acknowledged and offer opportunities to practice repeatedly for proficiency to ensure patient safety.
Simulation is a technique and not a technology; it is to amplify real experiences with guided experiences that replicate substantial aspects of the real world in a fully interactive manner. Simulation of clinical settings offer the appropriate environment to combine and integrate learner’s psychomotor skills to acquire expected competencies for safe care. The opportunity to practice in a simulated setting and to a clinical environment can improve trainee educational experience and transfer of learning is likely to be proficient because of the competency gained.
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Knowledge transfer
Simulators are used in simulation-based learning to assist in transferring cognitive knowledge to achieve psychomotor skills in a safe environment. Simulators are usually devices that present a simulated full- bodied patient, or part of a body, that the user appropriately interacts with and manipulates to gain the required competencies. Clinical procedures vary in nature and complexity. Different groups or professional disciplines will use simulators in different ways according to their needs. The approach and methods used in simulation are several and include use of standardised patient, part task trainers, virtual reality simulators and mannequin-based immersive simulation. To decide on the choice of a simulator to meet learning objectives there should be an orientation for comprehensive understanding of the diversity of simulators and their applications to acquire particular procedural skill.
Simulation-based learning is known to capture all the three learning styles; auditory, kinesthetic and visual because they are activated to maximise learning experience, people learn not only from information but also from experience.
Simulation as an instructional methodology is a good approach to patient safety and developing countries should be willing to adopt for effective teaching and learning of health staff.
Health training institutions therefore need to have well equipped simulation centers. These centres should have trained simulation educators, technicians and research personal to ensure that the center is managed to serve its purpose. Learners should not leave the Simulation Center incompetent but more knowledgeable having been involved or facilitated their own learning experience. If this is observed the health workforce would be proficient and work to reduce adverse events for good patient outcomes. Simulation in health care would then achieve its role of promoting patient safety.