Medical Simulation

There is a lot of discussion at the University of Saskatchewan about the use of medical simulation in health science education. To understand the decisions being made in this area, you need to understand that there are four distinct categories of simulation:
1. Physical Simulators
2. Human Manipulated Physical Simulators
3. Virtual Simulators
4. Virtual Environment Simulators

Physical Simulators

Physical simulators are reusable mannequins that students practise skills on such as physical examinations, injections and other invasive treatments. Using this type of simulator provides initial practice when willing patients are in short supply or when practise could be invasive, unpleasant or painful to patients. Once the student has developed an acceptable level of skill, they complete their learning with human patients. Below you can see some examples of physical simulators manufactured by Kyoto Kagaku Co. Ltd., which were recently displayed at the university.
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Human Manipulated Physical Simulators

A more sophisticated level of simulator is a full body mannequin that can be manipulated by a human operator located behind a two-way mirror. This type of simulator can answer questions, raise limbs as well as be examined/draped/treated. This provides students with a more holistic simulation in which they role-play interactions with the patient. The draw back here is a high initial cost as well as an ongoing expense of an operator.

Virtual Simulators

Virtual Simulators use 3D animation to teach parts of the body (Guide to a Healthy Heart) or to teach steps in a procedure (Sim Praxis video )
Costs to create these simulations can be very high, therefore, they are often purchased as CD’s with a textbook or accessed through sponsored online sites. See also The Visible Human

Virtual Environment Simulators

The Virtual Environment Simulators are computer-based medical scenarios that usually include a 3D model of a location, equipment, personnel and patients that students enter with an Avatar. They work well for “What if?” case studies such as disaster training, pandemic planning, problem solving and modeling of unusual diagnosis that students might not encounter in their clinical experience. Costs of initial production can be lowered by using already existing virtual worlds such as Second Life, a virtual world with a higher population than the prairies. Cost per student is frequently minimal.
The video below demonstrates how science is being taught in Second Life.

For more information, see:

Medical Modeling & Simulation
A Typology of Simulators for Medical Education
Clinical Skills Training in a Skills Lab Compared with Skills Training in Internships: Comparison of Skills Development Curricula
Emergency Medicine and Patient Simulation:Opportunities for Teaching, Evaluation, and Scholarship
Ethics Involved in Simulation-based Medical Planning
The Use of Simulation in Emergency Medicine: A Research Agenda
Simulation medicine in intensive care and coronary care education.
Simulation: The New Teaching Tool.
Simulation Technology in Physician Training (a podcast)
Simulation and the future of military medicine
Simulation and Modelling Applied to Medicine
Using Human Patient Simulation to instruct Emergency Medicine Residents in Cognitive Forcing Strategies
Value of a cognitive simulation in medicine: towards optimizing decision making performance of healthcare personnel.
Virtual reality simulation in carotid stenting: a new paradigm for procedural training
Anne Meyer Medical Centre Blog about the Second Life medical course
Top 10 Medical Sites in Second Life
A video about the Heart Murmur Sim in Second Life
A video about Virtual Social Worlds and the Future of Learning
A video about using Second Life for training.

Simulations

This is an image of Noelle, the pregnant robot from http://medgadget.com/archives/2006/04/noelle_maternal.html
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Simulation is the latest buzzword in medical education. Listed below are websites for groups that are investigating how simulations are and might be used in medical education.
Advanced Initiatives in Medical Simulation or AIMS is a coalition of individuals and organizations committed to promoting medical simulation. http://www.medsim.org/aboutaims.asp
BMJ Learning -module on Simulation Centres http://www.learning.bmj.com/learning/search-result.html?moduleId=6080077
Emergency Medicine Simulation Interest Group has been formed to discuss and advance research and educational opportunities provided by the use of high-fidelity simulators. http://www.emedu.org/sim/
Future Making Serious Games (health tab) reports on the latest developments in game technology for healthcare http://elianealhadeff.blogspot.com/search/label/Health%20Games
The Internet Journal of Medical Simulation http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijms/front.xml
InVision Guide to a Healthy Heart http://www.invisionguide.com/heart/flash/index_reg.html
Medgadget.com is an independent journal of the latest medical gadgets, technologies and discoveries. Updated every weekday. Written, edited and published by a group of MDs and biomed engineers. http://www.medgadget.com/
The National Center for Simulation is a member supported non-profit organization formed in 1993 as the link among the defense industry, government, and academia on behalf of the entire simulation, training, and modeling community. http://www.simulationinformation.com/cms/index.php?option=com_content&task=view&id=40&Itemid=37
The SIM Group -Based in Boston at the Massachusetts General Hospital, The Simulation Group represents a vast array of disciplines involved in discovering the fundamental science necessary for medical simulation to “break through” into established medicine by improving medical education and increasing patient safety. http://www.medicalsim.org/
Society for Simulation in Healthcare (SSH), was established in January 2004 to represent the rapidly growing group of educators and researchers who utilize a variety of simulation techniques for education, testing, and research in health care. http://www.ssih.org/public/
Society in Europe for Simulation Applied to Medicine mission is to encourage and support the use of simulation in medicine for the purpose of training and research. http://www.sesam.ws/ Simulation Centers are being developed worldwide as the value of simulation is more broadly appreciated.
Stanford Simulation Centre The VA Simulation Center has pioneered the use of mannequin-based, fully interactive simulators in anesthesiology, intensive care, emergency medicine and other clinical settings. http://med.stanford.edu/VAsimulator/
Virtual Surgery http://www.edheads.org/activities/hip/index.htm
Worldwide CCM Simulation Database http://med.stanford.edu/criticalcare/Simulation.html