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INTRODUCTION

CASE 19-1

Thank you for participating in today's in situ interprofessional simulation. Please make use of any systems, protocols, and tools as you would in your daily practice. I will read you the stem: A 36 yo G4P2 with twins at 32 weeks successfully and spontaneously delivers two viable male infants. Despite administration of oxytocin and an intramuscular dose of Methergine, her uterus continues to feel boggy. The patient's vital signs are shown on the monitor, and chux from the delivery can be found under the patient.

KEY QUESTIONS

  • What is medical simulation, and what are its benefits?

  • What are the different types of simulation?

  • What resources are available to start a simulation program?

Simulation, as defined by the Association of American Medical Colleges (AAMC), is “a method used in healthcare education to replace or amplify real patient experiences with scenarios designed to replicate real health encounters, using lifelike mannequins, physical models, standardized patients, or computers.”1 Although simulation has roots in aviation and warfare training, it also has significant applicability in the realm of healthcare.

When the Institute of Medicine published To Err Is Human, a landmark 1999 paper revealing that medical errors were associated with between 44,000 and 98,000 preventable patient deaths, an increased emphasis emerged on the need for patient safety and to reduce the number of mistakes made while caring for patients.2 Simulation is an educational modality that is seen to enhance both patient safety and learning3 by providing a controlled and constructed environment for medical professionals of all training levels to improve their technical skills, such as laparoscopic techniques as well as communication and interpersonal team-based skills. As evidenced by the creation of an academic society dedicated to this area, the initiation of a simulation journal, and a growing body of research around its use in medical education, the interest in and use of simulation has increased dramatically since the 1990s.4

Simulation, in the most general terms, is simply a teaching technique. By understanding the varying capabilities of simulators, the environments in which each type can be used, and their unique challenges, we can better employ simulators to accomplish intended learning objectives. Simulation is beneficial to the obstetric (OB/GYN) hospitalist because it provides a standardized and safe, yet interactive and experiential learning environment for trainees that can be adapted to the curricular needs of residency and fellowship programs. In particular, simulation can enhance technical and functional expertise through hands-on training as well as problem-solving and decision-making skills based on interpretation of changing patient states. In addition, simulation allows the hospitalist to explore systems and patient safety issues in real time, without putting patients at risk, and provides opportunities for complex, multidisciplinary healthcare teams to practice working together in unity.

This chapter will provide a brief description of simulator fidelity, the simulator sites, and the pros and cons of each. ...

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