The future of clinical medicine lies in simulation-based training. Simulation has been used for centuries to teach various skills. It involves a life-like model of a process or system.
It is an activity or event with ability to replicate clinical practice using scenarios, manikins (both high-fidelity and medium-fidelity), standardised patients, role-playing, skills stations, and computer-based critical thinking simulations.
In Kenya, simulation labs are referred to as skills-labs. Currently, simulations are used to conduct training in nursing and clinical medicine, aviation (flight simulators), engineering, information technology, nuclear energy and law enforcement.
Just like in healthcare training, the use of simulation in military training, flight instruction, and other educational contexts is largely driven by need for enhanced public safety.
Simulations eliminate geographical boundaries, while providing a safe learning environment. Although they cannot completely replace clinical experiences, simulations offer opportunities for experiential learning that supplement clinical experiences.
While direct contact is critically needed to produce the best health professionals for the community, today’s patient expects to be treated and operated on by highly trained health professional. This dilemma is solved through simulation-based training, which provides realistic health training within a safe, error-tolerant environment with known convenience and advantages over conventional bed-side training.
Several factors have led to increased use of virtual simulations in health training across the world. Difficulties associated with securing clinical placement sites have become prevalent.
Following a surge in population, and demand for more health workers, there has been a sharp rise in training institutions. As a result, class sizes and training programmes have also increased, leading to greater competition for clinical sites. The number of clinical sites available for training such as nursing and clinical medicine cannot simply meet the demand.
The need for patient safety is another key consideration. Medical errors are not only common in the health care environment but also make a huge potentially preventable cause of morbidity and mortality. As such, driven by the noble concern for patient safety, many health facilities are reducing the number of students allowed access to patient units at any given time. This makes virtual simulation labs crititical.
Simulation labs also encourage students to practice a skill to perfection without putting the lives of patients at risk. With simulations, lecturers and students can investigate critical situations without putting anyone at risk.
With the road network in some regions hindering accessibility, coupled with increased costs of maintenance of vehicles used by training institutions, students have fewer opportunities to access clinical sites.
Research has demonstrated that simulations are just as effective as traditional clinical experiences in health training. Studies also indicate that virtual simulations are effective in terms of learning outcomes.
However, many African countries are not able to use them because of cost, which include establishing and maintaining these simulation or skills labs.
Like with any innovation, the use of simulations requires specialised training, which may not always be readily available even to training institutions.
To train a critical mass in health for our populations in Kenya and for East Africa to meet global standards, the use of simulation is the way to go. The government should not only invest in setting up of simulation labs, but also training of personnel.
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-Kenya Medical Training College CEO