Medical Simulation Training: How Recent Advancements Have Saved Thousands of Lives
By Peter Buxbaum, M2VA Correspondent
Surgical training has long involved the use of simulators. Practicing procedures on human cadavers is a time-honored part of medical training and represents a simulation of sorts. Surgeons have also trained on live animals such as goats and pigs.
The advancement in military medical training in recent years has resulted in the saving of thousands of lives on the battlefields of Iraq and Afghanistan. The skills and success of military medics and surgeons are attributable to their training and that training has increasingly revolved around the advanced simulators that have been developed in recent years.
Today's simulators feature a realistic look, feel and function to skin, organs and blood. Some are actually designed to be worn by live human actors who can simulate the totality of the patient treatment process.
"The IEDs, poly-trauma, the multiple traumatic amputations that you would encounter in theater can't be replicated for training unless you use simulation," stated Paul Bernal, director of global government business development for CAE Healthcare.
However, the needs of military and veterans medicine are by no means limited to combat casualty care: They run the gamut of medical problems and surgical procedures.
The military and veterans medical communities therefore make use of general training simulation as well, such as those designed to train for minimally invasive procedures.
Traditional classroom methods for medical training revolve around textbooks and PowerPoint presentations, noted Dr. Haru Okuda, national medical director for the Department of Veterans Affairs SimLEARN program. "Then the students go to the ward for hands-on training," he said. "Simulations allow a more proactive approach to training. Trainees can then apply what learn the learned on the simulation."
"Training represents a precursor to actions on the battlefield," said Mark Owens, a military strategic account manager at Laerdal Medical, a developer of medical training simulators. "Medics can be presented with realistic training simulations and that this results in better combat care for U.S. warfighters on the battlefield."
"There is a revolution in surgical education that is now underway and that this is being led by the U.S. armed forces," said Dr. Robert Buckman, chief executive officer of Operative Experience Inc. "It's going to have an impact on worldwide health. Simulations allow training midwives to do a C-section in four months or even four weeks instead of four years. This is going to have an impact around the world in areas underserved by health care infrastructures. Simulations rapidly train civilian surgeons to be prepared for combat situations that they rarely if ever encounter in civilian practice."
The use of medical training simulators could reduce or eliminate the need for training on live animals. "A research team at the University of Minnesota is evaluating this situation," said Kit Lavell, executive vice president of Strategic Operations Inc. There is also legislation pending before the U.S. Congress which would eliminate live tissue training by 2017.
"An animal is a simulator of sort because their tissues are great to work with," said Buckman, "but they don’t have the same anatomical architecture as humans. Simulators represent as closely as possible the anatomy, tissues and pathologies represented by combat trauma." But combat trauma is not the only training requirement for the military medicine.
"Military and veterans military hospitals and organizations have a wide range of needs and requirements for training," noted Dror Paz, vice president of North American sales at Simbionix USA Corp. "It is not limited to combat and disaster relief." Simbionix specializes in developing and marketing simulators for training practitioners for minimally invasive procedures.
The same logic applies to the VA. "The number of female veterans has doubled over the last 10 years," said Okuda. "Some of our practitioners needed additional training on procedures involving women's health." To that end, the VA has invested in simulations that train practitioners to perform proper pelvic and breast examinations. Operative Experience Inc. (OEI) recently participated in Operation Bushmasters, an annual training exercise of the Uniform Services University Medical School.
"They used our simulators for almost every aspect of training from point of injury to Level 2 care," said Buckman. "We trained in excess of 150 students."
Copyright: Military Medical & Veterans Affairs Forum 2012