But a potential answer to both cost and complexity issues is the use of low cost and low technology tools like task trainers or other so-called simple simulators. Dr. Malekzadeh herself has invented several inexpensive tools and encourages other otolaryngologists to look into all types of simulation, not just high-end technology. "When people say simulation, they immediately jump to high tech, high fidelity, virtual reality, super computer technology. That’s not [always] the case," Dr. Franzese said. "Low tech stuff is just as valid as high tech stuff. I think sometimes, especially when these smaller programs hear simulation, they assume it’s got to be high tech. There aren’t any studies or literature to say that high tech simulation is better than low tech. It’s just cooler. … Are we getting more bang for buck? It seems like we should, but we don’t really have any proof that that’s the case."
Explore This IssueAugust 2011
In cases where expensive technology is necessary, Dr. Malekzadeh suggested pairing with other departments that use simulation to spread the cost. That can help persuade hospital administrators that the product or program is an interdepartmental resource worth its carrying cost. "ENT is a small specialty," she said. "So [hospital administrators] are not going to invest $250,000 in ENT simulation products. However, they will buy equipment that anesthesia can use and ENT can use and general surgery can use and emergency medicine can use. I think they’re willing to invest in simulation and to buy products that serve a larger group of people."
Dr. Malloy said the boot camps that she and Drs. Deutsch and Malekzadeh have organized promote the potential uses of simulation and could help to promote their value as well. There are boot camps for both junior and senior residents, but the events have also drawn strong attendance and interest from faculty around the country wanting to learn more about how to implement or expand simulation programs at their respective institutions, she said.
The important thing to remember, however, is that simulation is still just one tool in a residency program’s toolbox, she added. "I’m not sure simulation can ever really replace the actual act of treating a patient and performing a procedure," Dr. Malloy said. "But this is designed to enhance and prepare." ENT TODAY