|Dr Ram Nataraja|
In the same way that flight simulators are used to prepare pilots for emergencies a new world-class facility at Monash Children’s Hospital is preparing the next generation of paediatricians and paediatric surgeons to predict, prevent and manage emergencies in a busy hospital environment.
Monash University’s Paediatric Simulation Centre, which operates fully in the new Monash Children’s Hospital, has a purpose built operating theatre, paediatric and neonatal ward and procedures rooms. These are controlled, videoed and monitored remotely to provide students with “real life” emergencies such as resuscitating a baby in a ward, or inserting a catheter into a child with cancer (a major source of infection if done poorly).
Monash University medical intern, Dr Sam Alexander, recently completed a study, to be published later this year, that compared experienced paediatric surgeons, surgical trainees and medical students on how they performed two types of complex laparoscopic procedures using a surgical simulation model.
The models have been designed to easily and cheaply produced and able to be taken home by students for practice.
The study found that the scores achieved by each of the three groups mirrored the level of surgical experience.
According to Dr Alexander, the study showed that simple surgical models like the ones developed by him – which included high tensile plastic to simulate muscle and thin, tearable material to represent more delicate tissue – can assist in the training of medical students.
“As a student I would have had access to the expensive surgical models at best 4 times during my training, and always under supervision,” he said.
“Developing new, transportable, cheap simulation models means that students can develop strong surgical techniques at home, and they can also be used in training doctors in remote areas.”
Director of the Surgical Simulation Unit and Co-Chair of MCH Simulation, Dr Ram Nataraja, says the facilities are unique in Australia and have been designed with the goal of training students in all types of paediatric emergencies, “so that they are better prepared when the real event happens.”
The simulation rooms –simulating wards for either a newborn and/or a child and the operating room – are set up exactly as they would be in a hospital.
“My experience is that medical students, put into a hospital or surgical environment tend to stay in corners, often too intimidated by their environment to ask questions or even come forward and observe,” Dr Nataraja said.
“This is something that I remember from my student days, and these educational spaces allows students to become familiar with these clinical environments earlier than usual”.
“These facilities also allow us to let students make mistakes in a safe environment, to find their role in an emergency.”
The rooms are monitored through a one-way mirror and the supervisor can trigger an emergency, using a very life like model of a child or baby, that sends a normal ward room into one where a child needs emergency resuscitation.
The whole process is filmed and then the students review how the procedure went with their supervisor. In some cases, according to Dr Nataraja, the situations are so life like that students can become very distressed, “and we have a private debriefing room for those students who may become a bit overwhelmed, in addition to the normal debriefing room following the simulation activities”
MCH Simulation with Monash University will also become a centre for research into Simulation-Based Medical Education, helping to improve the evidence base for this important part of medical education.