Paramedic and Advanced Paramedic High Fidelity Simulation Training

For many years simulation has been used in aviation, nuclear power, military and aerospace industries as a training tool. Analysis of a large number of aircraft accidents in the 1970’s and 1980’s showed that many pilots with highly developed technical skills and a high level of technical knowledge had failed to manage critical situations effectively.

This was due to inadequate ‘nontechnical skills’. They had failed to manage their teams effectively and use the resources of their crew effectively. This lead the way to introduction of crew resource management and human factors training incorporated into the industries simulation programmes. All airlines in the Western world expose their crew to regular life-long retraining in both technical and non-technical skills. Recently, the use of simulation in healthcare has increased markedly, in part due to greater awareness of the importance of patient safety and human error. Simulation improves patient safety by allowing healthcare professionals to become better trained without putting real patients at risk. In simulated clinical scenarios errors can be allowed to occur and reach their endpoint. This allows participants to see the results of their decisions and actions. Complete interpersonal interactions with other clinical staff can be explored and training in teamwork, leadership and communication provided. This type of human factors training with simulation has been developing in the healthcare setting for more than decade, beginning in anaesthesia and now moving throughout all disciplines of healthcare.

The ASSET Simulation Centre at University College Cork provides high quality education and training through high fidelity simulation to a wide range of healthcare professionals. The ASSET Centre uses a combination of highly trained clinical experts and state of the art technology to allow us to realistically simulate real life high stake events, where healthcare professionals can practice their skills and patient management in a safe non judgemental environment, without risk to real patients. Simulation is a unique form of learning to reduce error, improve patient safety and improve team dynamics. The simulation centre is to train healthcare professionals such as anaesthetists, interns, dentists and medical students to date. The UCC district for intern training which incorporates the Southern Region has recognised the unique potential of simulation to improve patient safety, reduce errors and improve team working by becoming the first region in Ireland to mandate the 
training for all trainees. Interns from other regions where this training is not available are now voluntarily travelling to Cork to attend. The College of Anaesthetists is the first post graduate training body to mandate simulation training for their trainees, who partake every six months.

The ASSET Centre uses the latest manikin based simulators that can be programmed to almost any physiology and will respond to therapeutic intervention. This is due to the advanced cardiovascular, pulmonary, metabolic, neurological and pharmacological systems incorporated into the programming of the simulators. (Continued in next column..)
  With realistic airways and lung functionality the simulators can be intubated and ventilated realistically. The powerful gas analyser allows the simulators to recognise the O2 concentration, anaesthetic agents and exhale CO2.

The manikins can even recognise IV drug administration and respond accurately to a particular drug. The simulators realistically breaths, talks and its eyes respond to light. The simulators capabilities allow for chest drain insertion, needle decompression of a pneumothorax, urinary catheter insertion. The simulators are housed in specially adapted rooms that replicate the clinical environment. All the necessary clinical equipment is to hand to allow accurate replication of real life situations. The ASSET Centre uses state of the art video and audio equipment to record the event live and in real time; to aid the debriefing and learning session after every simulated scenario.Recently the ASSET Centre with the support of PHECC piloted a three day mobile simulation training event for both paramedics and advanced paramedics. The ASSET Centre worked closely with clinical paramedics, advanced paramedics, emergency physicians and liaised with the HSE and other agencies to ensure that clear learning objectives were identified; the scenarios were realistic and relevant to everyday paramedical work. The participant’s evaluation of the training was overwhelming positive. The participants found the training relevant, useful and enjoyable. The vast majority believed that the training will impact on their future practice to the benefit of patient care. A full report on the evaluation will be published later in the year. There were twelve clinical scenarios over the days. The events occurred in real time in both indoor and outdoor locations, transit to hospital and handover to the receiving emergency team was incorporated into the scenario design. Video assisted debriefing sessions occurred directly after each scenario which was led by both simulation and clinical experts. As always with the ASSET Centres course, there was no assessment and only positive feedback was given to facilitate the participants to reflect on their own practice. The ASSET Centre, UCC sees simulation and technology enhanced learning as a priority for training healthcare professionals and is currently significantly investing in expanding our simulation facilities here at Cork. Our mobile simulation technology and expertise allows us to provide high standards of simulation education and training anywhere in the country.

For more information on simulation please contact: David Power Simulation Manager

Feedback from Postgraduate Simulation Training at ASSET, UCC for Year 2011-2012