Training of some procedures on live patients is no longer ethically justified or acceptable to the patient. Patients expect that health professionals have fully mastered a procedure before using it in clinical practise. Procedures performed on a patient simulator can be interrupted, improved, repeated and, unlike in real life, no harm is done when a mistake is made. (1)
Key words: clinical simulation, practical skills, lung isolation techniques
Simulation – based education in thoracic anaesthesia
In the University Medical Centre Ljubljana, Medical Simulation Unit was officially open on 29th June 2011. It is multidisciplinary skills centre which can deliver a diverse number of training activities to national and international medical practitioners and healthcare workers. The centre has one operating theatre with associated control room, one intensive care unit with associated control room, two briefing – debriefing rooms with e-learning pods, storing space, wardrobe and external training area.
Like in many other countries, also in our Simulation Unit, Anaesthesiology is one of first medical speciality which started simulation as an education technique, with aim to improve patient safety and care. The knowledge of our anaesthesiologists is improved by lectures. The acquisition of skills is facilitated by practicing specific manoeuvres and procedures using different part task trainers and full scale simulation with high fidelity patient simulator specifically designed for training in anaesthesia and intensive care medicine.
Thoracic epidural anaesthesia is often used for thoracic procedures. Our anaesthesia trainees have the opportunity to practice thoracic epidural needle and catheter placement on the training model.
The practice of thoracic anaesthesia requires understanding of the techniques and technical skills for one lung ventilation. The most important knowledge for successful placement of devices for lung isolation is bronchial anatomy (2). By teaching process free online bronchoscopy simulator /www.thoracic-anesthesia.com/ is used to learn bronchoscopic anatomy.
Under the guidance of experienced thoracic anaesthesiologist we organise Workshops on Lung Isolation technique with double-lumen tube and bronchial blockers using simulator training facility.
For full scale simulation we have high fidelity patient simulator specifically designed for training in anaesthesia. This patient simulator clinicaly responds as a real human, parameters of vital functions can be measured using normal equipment. In simulated op. theater different thoracic clinical events can be rehearsed, on patient simulator.
It has been demonstrated, that most powerful outcome of simulation exercises are achieved when they become part of standard curriculum (3).
The Slovenian specialist national training program of Anaesthesiology, Reanimatology and Perioperative Intensive Care Medicine was this year implemented with simulation – based education integration.
- Glavin R Simulation in anesthesia and acute care settings. Euroanaesthesia 2005, Vienna Austria. Refresher course lectures: 155-161
- Campos, Lung isolation 227 – 246 in Principles and Practice of Anesthesia for Thoracic Surgery, 2011, Editor: P Slinger
- S. Barry Issenberg et al. (2005) Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review, Medical Teacher, Vol. 27, NO. 1, pp. 10-28
Fig 1. Workshop on lung isolation techniques.
Fig 2. Workshop on lung isolation techniques.
Fig 3. Simulated clinical scenario of thoracic anaesthesia is rehearsed
Medical Simulation Unit, University Medical Centre Ljubljana, Slovenia
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