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Simulator-Based Education: The Future of CME

Charles W. Otto, M.D.

Simulation-based health care education is a field that was pioneered by anesthesiologists nearly 40 years ago. Numerous advances in technology and educational organization have occurred since the early manikin-based models. Simulators now use highly sophisticated computer algorithms to model many different medical circumstances and employ multiple technologies, including virtual reality, to demonstrate clinical techniques. Simulation centers exist in nearly every state, many firmly anchored in anesthesiology departments of our academic institutions. Simulation has become an important modality for introducing medical, nursing and paramedical students to clinical situations. Many anesthesiology departments incorporate simulation into residency training, although human resource constraints and clinical workload have limited the time available for these experiences.

In spite of these major advances in technology and education science, only recently has health care simulation begun to develop into the major educational tool that its progenitors envisioned. A number of factors account for the increasing popularity of simulator-based education. The recent introduction of multiple, new, invasive surgical and radiological techniques requires innovative methods to train and retrain large numbers of individuals in a relatively short period of time. The widespread introduction of problem-based learning to the medical education curriculum fosters a style of learning that is well-suited to the simulator center environment. Recent Institute of Medicine reports on patient safety stimulated interest in health care simulation because of the success of simulators in improving safety within the airline industry over the past half century. Educational research is demonstrating the success of simulation-based learning.

Although simulation appears to have great potential, its use in anesthesiology education has remained primarily at the medical student and resident levels. ASA, in conjunction with its members in the simulation community, is working to expand the scope of simulator-based learning experience to all members. Two reports in this issue of the NEWSLETTER describe some of these activities. The “FAER Report” on page 43 details the work of young investigators using simulators as research tools into educational methods, while Jeffrey M. Taekman, M.D. (page 14) gives a summary of the ambitious activities of the Workgroup on Simulation Education as it develops a program that will allow our members to incorporate simulation education into their continuing anesthesiology education and lifelong learning. Please read these reports. In addition you are encouraged to read the workgroup’s white paper in its entirety on the ASA Web site and provide your feedback on the proposals by completing the brief survey.

Simulation-based anesthesiology education holds great promise as a continuing education tool for the practicing anesthesiologist. It can provide a safe environment to learn new techniques or become exposed to new drugs. It can provide experience in crisis management of infrequent or rare events such as malignant hyperthermia or sudden tension pneumothorax. Its greatest contribution may be in the areas of patient safety and professional teamwork in the operating room environment. The simulation center provides a place where teamwork and team management skills can be learned and refined, a program that is difficult to teach in the active workplace.

ASA is excited about the opportunity to help expand simulator-based anesthesiology education to its members. We hope that you will make a special effort to attend the simulation demonstration to be held on Saturday, October 14, 2006, during the ASA Annual Meeting in Chicago. And we encourage you to take advantage of other simulator-based educational opportunities as they become available. Watch the ASA Web site for further information on the workgroup’s activities. Simulation-based education can only improve your anesthesiology skills.