Emergency medicine physicians and simulation experts from Rhode Island Hospital discuss the benefits of advanced medical simulation in five manuscripts appearing in the November 2008 issue of Academic Emergency Medicine (now available online).
The articles describe how simulation centers, along with new portable simulation technology, offer unique training opportunities for dynamic, complex and unanticipated medical situations in acute care fields. At the same time, the authors show how to guide team training and create new tools to measure teamwork effectiveness.
New advances are taking standard simulation techniques and manikin technologies currently used in simulation centers to a portable platform. In the first article, "Educational and Research Implications of Portable Human Patient Simulation in Acute Care Medicine," the researchers describe the adaptation of simulation techniques and manikin technologies for portable function. These new programs can relieve some limitations of traditional simulation, with an emphasis on the effects on acute care and disaster training. For example, mobile portable simulation allows on-site training in highly specialized clinical practice such as critical care transport medicine. Progressive simulations, i.e., longer-duration events that follow a simulated patient through sequential care environments, are also highlighted. These create an opportunity to study healthcare systems integration, continuity of care and transitions as well as the medical care delivered at each point of care. Lead author Leo Kobayashi, MD, notes, "Areas of education and research in acute care medicine are expanded by portable simulation's introduction of new topics, fresh perspectives and innovative methods."
The second article focuses on team performance in emergency medicine − "Defining Team Performance: Methodology, Metrics and Opportunities for Emergency Medicine." Rhode Island Hospital physicians Marc Shapiro, MD, and Gregory Jay, MD, PhD, led a consensus panel which identifies that "teamwork is a complex construct requiring metrics broad enough to capture the cycles of performance and yet sensitive and precise enough to assess a single behavior. No single measure can capture overall individual or team performance; it is helpful to measure both team process and outcomes to avoid the pitfalls in relying on 'one single inadequate criterion.'"