Medical simulation – history
The beginnings of the use of the simulation method to teach practical skills date back to 1929, when the American Edwin Albert Link built an aircraft simulator called the “Blue Box”. It consisted of a part of the fuselage and a cockpit with a full control system. At first, only amusement parks were interested in the new device. In 1934, a series of mail plane crashes occurred in the United States. After the problem was analyzed by experts, the military decided to buy 6 Blue Box simulators, which soon became an indispensable tool for training pilots around the world.
Several decades of using simulators in pilot education and developing many teaching standards show that it is possible to create a safe environment that realistically reflects reality, the complexity of which can be adjusted to the level of training of the participant. Thanks to this, pilot training becomes even more effective and allows for gaining practical experience, which is not always possible when using other methods.
In the 1960s, the creator of plastic dolls, Ausmund Laerdal, designed a dummy for learning artificial respiration – Resusci-Anne. The dummy allowed for training two basic skills for every medic: tilting the head back and lifting the jaw. Over time, it was improved with a spring that allowed for training chest compressions. Resusci-Anne is currently the most commonly used trainer in the world. In 1968, Michael Gordon presented the first patient simulator, Harvey. Its functions allowed for reproducing various conditions related to the circulatory system, e.g. blood pressure measurement, heart auscultation, or pulse measurement.
The two mannequins described above are considered to be milestones in the development of simulators for training medical personnel. With the development of computer science, plastics technology, and electronics, modern phantoms/simulators are able to reflect more and more new functions, more faithfully reproduce older ones, and their appearance increasingly resembles a real human being.
Medical simulation – short description
High-fidelity simulations are the most advanced type of simulation classes. They require the preparation of an appropriate scenario, taking into account many details, e.g.: the issues that participants are to learn, the patient’s medical history, the roles of participants, the necessary equipment, the characterization of the mannequin, the results of additional tests, etc. This type of class should take place in a faithfully reproduced environment, e.g. an emergency room or an operating room, and the mannequin (patient simulator) should realistically reflect the vital functions of a human being. The medical equipment that the participants will use is, in the vast majority, real equipment used in reality. The basic equipment of a high-fidelity simulation room also includes audio-video equipment for recording the simulation course and a room (debriefing room) in which such a recording can be played back, thus allowing for a comfortable discussion of the exercises in the form of a so-called debriefing.
Low-fidelity simulations are classes during which participants acquire or improve the quality of a specific skill. These can be various manual activities (catheterization, airway management, intraosseous access, etc.) or learning how to use a device (electrotherapy, ventilator management, etc.). A faithfully recreated training room is not necessary for conducting this type of class, and advanced patient simulators are not used either. During low-fidelity simulation classes, participants use cheaper trainers, i.e. simple phantoms designed for practicing a specific skill (an upper limb for learning how to establish intravenous access, a head for instrumental airway management, etc.).