Medical Simulation Growing Part of Medical Residents’ Education, Training

Perform a cost-benefit analysis: Before asking your institution to spend thousands of dollars on a simulation device, do some research. The cost of simulators can vary significantly, Dr. Deutsch said, but even some of the high-tech simulators are about half as expensive as an operating microscope. “You have to keep the cost in proportion with what you’re accomplishing,” she said. “If you’re improving patient outcomes and decreasing the risk of patient complications, that cost is an investment.”

Also, creating a successful simulation program requires more than just investing in a simulator, Dr. Deutsch said. “The educator needs to have, or be able to assemble, content expertise and simulation knowledge as well as a simulator,” she said. “The simulator itself could be a simple gadget, a sophisticated construction, equipment with a virtual (computer) interface, a high-technology human replica, animal tissue, or even a person trained to act as a patient, a family member, or another healthcare provider.

Sign up for existing programs: Rather than reinvent the wheel, you could attend or send residents to the numerous simulation boot camps that are held throughout the year around the country, said Kelly Michele Malloy, MD, clinical assistant professor of otolaryngology at the University of Michigan in Ann Arbor. Dr. Malloy collaborated with Drs. Deutsch and Malekzadeh to create the original Otorhinolaryngology (ORL) Emergencies Boot Camp in 2010 in Washington, DC. The program, now in its fifth year, uses simulators to teach skills ranging from endoscopy and emergency airway management to control of epistaxis and drainage of peritonsillar abscess. The participants then work through various clinical scenarios using high-tech manikins that mimic, for example, a patient with an airway or post-surgical concern.

Dr. Malloy said the DC course is directed at the new PGY2 resident, but other courses have been developed for other target learner groups. One of these includes ORL SimFest, a course held annually at the University of Pennsylvania that uses simulation to teach PGY3 residents more advanced surgical skills such as microlaryngeal surgery, local flap design, and temporal bone surgery. Course fees for these programs are kept low to remain affordable for residency programs—between $150 and $240 for each day-long intensive course, she said.

“The best way to learn about simulation is to see it from people who are already using it,” Dr. Malloy said. “Then you are equipped to implement simulation in your home institution, as well as develop new ideas for future simulators.”