Monday, April 12, 2010

Simulated Teaching

Simulated Teaching
Simulation is the imitation of some real thing, state of affairs, or process. The act of simulating something generally entails representing certain key characteristics or behaviours of a selected physical or abstract system.
Simulation is used in many contexts, including the modeling of natural systems or human systems in order to gain insight into their functioning. Other contexts include simulation of technology for performance optimization, safety engineering, testing, training and education. Simulation can be used to show the eventual real effects of alternative conditions and courses of action.
Simulation in Education and Training
Simulation is often used in the training of civilian and military personnel. This usually occurs when it is prohibitively expensive or simply too dangerous to allow trainees to use the real equipment in the real world. In such situations they will spend time learning valuable lessons in a "safe" virtual environment. Often the convenience is to permit mistakes during training for a safety-critical system.
Training simulations typically come in one of three categories:
• "live" simulation (where real people use simulated (or "dummy") equipment in the real world);
• "virtual" simulation (where real people use simulated equipment in a simulated world, or virtual environment), or
• "constructive" simulation (where simulated people use simulated equipment in a simulated environment). Constructive simulation is often referred to as "wargaming" since it bears some resemblance to table-top war games in which players command armies of soldiers and equipment that move around a board.
Simulations in education are somewhat like training simulations. They focus on specific tasks. The term 'microworld' is used to refer to educational simulations which model some abstract concept rather than simulating a realistic object or environment, or in some cases model a real world environment in a simplistic way so as to help a learner develop an understanding of the key concepts.
Management games (or business simulations) have been finding favour in business education in recent years.[8] Business simulations that incorporate a dynamic model enable experimentation with business strategies in a risk free environment and provide a useful extension to case study discussions.
Social simulations may be used in social science classrooms to illustrate social and political processes in anthropology, economics, history, political science, or sociology courses, typically at the high school or university level. These may, for example, take the form of civics simulations, in which participants assume roles in a simulated society, or international relations simulations in which participants engage in negotiations, alliance formation, trade, diplomacy, and the use of force. Such simulations might be based on fictitious political systems, or be based on current or historical events.
In recent years, there has been increasing use of social simulations for staff training in aid and development agencies. The Carana simulation, for example, was first developed by the United Nations Development Programme, and is now used in a very revised form by the World Bank for training staff to deal with fragile and conflict-affected countries.
Clinical Healthcare Simulators
Medical simulators are increasingly being developed and deployed to teach therapeutic and diagnostic procedures as well as medical concepts and decision making to personnel in the health professions. Simulators have been developed for training procedures ranging from the basics such as blood draw, to laparoscopic surgery and trauma care. They are also important to help on prototyping new devices for biomedical engineering problems. Currently, simulators are applied to research and development of tools for new therapies, treatments and early diagnosis in medicine.
Many medical simulators involve a computer connected to a plastic simulation of the relevant anatomy. Sophisticated simulators of this type employ a life size mannequin that responds to injected drugs and can be programmed to create simulations of life-threatening emergencies. In other simulations, visual components of the procedure are reproduced by computer graphics techniques, while touch-based components are reproduced by haptic feedback devices combined with physical simulation routines computed in response to the user's actions. Medical simulations of this sort will often use 3D CT or MRI scans of patient data to enhance realism. Some medical simulations are developed to be widely distributed (such as web-enabled simulations that can be viewed via standard web browsers) and can be interacted with using standard computer interfaces, such as the keyboard and mouse.
Another important medical application of a simulator — although, perhaps, denoting a slightly different meaning of simulator — is the use of a placebo drug, a formulation that simulates the active drug in trials of drug efficacy (see Placebo-origins of technical term).
Improving Patient Safety through New Innovations
Patient safety is a concern in the medical industry. Patients have been known to suffer injuries and even death due to management error, and lack of using best standards of care and training. According to Building a National Agenda for Simulation-Based Medical Education (Eder-Van Hook, Jackie, 2004) , “A health care provider’s ability to react prudently in an unexpected situation is one of the most critical factors in creating a positive outcome in medical emergency, regardless of whether it occurs on the battlefield, freeway, or hospital emergency room.” simulation. “Deaths due to preventable adverse events exceed deaths attributable to motor vehicle accidents, breast cancer, or AIDS” Eder-Van Hook (2004). With these types of statistics it is no wonder that improving patient safety is a prevalent concern in the industry.
New innovative simulation training solutions are now being used to train medical professionals in an attempt to reduce the number of safety concerns that have adverse effects on the patients. However, according to the article Does Simulation Improve Patient Safety? Self-efficacy, Competence, Operational Performance, and Patient Safety (Nishisaki A., Keren R., and Nadkarni, V., 2007), the jury is still out.
One such attempt to improve patient safety through the use of simulations training is pediatric care to deliver just-in-time service or/and just-in-place. This training consists of 20 minutes of simulated training just before workers report to shift. It is hoped that the recentness of the training will increase the positive and reduce the negative results that have generally been associated with the procedure.
History of Simulation in Healthcare
The first medical simulators were simple models of human patients. Since antiquity, these representations in clay and stone were used to demonstrate clinical features of disease states and their effects on humans. Models have been found from many cultures and continents. These models have been used in some cultures (e.g., Chinese culture) as a "diagnostic" instrument, allowing women to consult male physicians while maintaining social laws of modesty. Models are used today to help students learn the anatomy of the musculoskeletal system and organ systems.[12]
Type of models
Active models
Active models that attempt to reproduce living anatomy or physiology are recent developments. The famous “Harvey” mannikin was developed at the University of Miami and is able to recreate many of the physical findings of the cardiology examination, including palpation, auscultation, and electrocardiography.
Interactive models
More recently, interactive models have been developed that respond to actions taken by a student or physician. Until recently, these simulations were two dimensional computer programs that acted more like a textbook than a patient. Computer simulations have the advantage of allowing a student to make judgements, and also to make errors. The process of iterative learning through assessment, evaluation, decision making, and error correction creates a much stronger learning environment than passive instruction.
Computer simulators
Simulators have been proposed as an ideal tool for assessment of students for clinical skills. Programmed patients and simulated clinical situations, including mock disaster drills, have been used extensively for education and evaluation. These “lifelike” simulations are expensive, and lack reproducibility.
Immersive disease state simulations allow a doctor or HCP to experience what a disease actually feels like. Using sensors and transducers symptomatic effects can be delivered to a participant allowing them to experience the patients disease state. Such a simulator meets the goals of an objective and standardized examination for clinical competence. This system is superior to examinations that use "standard patients" because it permits the quantitative measurement of competence, as well as reproducing the same objective findings.

1 comment:

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