Fourteen years ago, Captain Chesley “Sully” Sullenberger heroically landed. US Airways Flight 1549 Saved everyone on board the Hudson River. Considered a “miracle” on the Hudson, the truth is that Sully’s decision-making during such a historic landing was informed by a combination of decades of experience and countless hours of simulation training. was
Airline pilots are trained on simulators every six months, undergo a rigorous flight review every two yearsleading to the aviation industry’s incredible safety record (the National Transportation Safety Board estimates the probability of death in a plane crash become 1 in 29.4 million).In contrast, the likelihood of adverse events leading to in-hospital death was 1/300. but Almost half of these events due to preventable medical malpractice.
Medicine is a human system, and it is natural that there is variation from person to person.Doctors are people who sometimes display poor judgment, make mistakes, and have amnesia that can lead to complications and poor clinical care.The Family of Comedian Joan Rivers Settlement in medical malpractice lawsuit He claimed doctors had performed “unauthorized procedures” that may have led to her death. increase.
While no single “magic bullet” can fix the healthcare system, there is evidence that simulation-based training is one solution to eliminating variability in clinical skills. After all, years of practice are no substitute for clinical skills.
A recent study found that the main cause of the problem is traditional medical education based on outdated technology and outdated ideas about how doctors learn. Despite revolutionary advances in medical research and clinical care, America’s current medical education model supports learning through passive methods such as the old-fashioned method. apprentice model It was pioneered by William Osler in the 1890s. Its basic premise is that longitudinal and chance clinical experience is the best way to produce good physicians.
Most doctors have little hands-on training when they enter clinical practice. The most common way for physicians to maintain subspecialty board certification is through multiple-choice exams, often open books.
Our research at Northwestern University and other academic medical centers shows that traditional methods of clinical medical education are outdated and need reform to better prepare physicians to serve today’s patients. Medicine must keep up with the training and certification procedures used in aviation and other high-risk industries where professionals frequently simulate.
of Simulation Lab at Northwestern University Feinberg School of Medicine, physicians and other clinicians may require invasive procedures such as surgery, removal of colonic polyps (during routine colonoscopies), insertion and maintenance of central venous catheters, advanced cardiac life support, communications, and other practice some clinical skills skills. Through this process, they undergo rigorous evaluation and feedback, ultimately achieving near-perfect proficiency standards. jobs at northwestern university and Research at other institutions show that clinicians who attain mastery standards in a simulated lab provide safer care to their patients than clinicians trained in conventional methods.
Simulation is now a standard educational tool used across medical schools, but reaping the full benefits from integrating simulation-based education into clinical practice will require cooperation among medical schools, health systems, and regulatory bodies. will be Funding for medical education research should also be a top priority for federal and state grants.
Our patients expect our doctors to be competent. To meet this expectation, clinicians must demonstrate competence using simulation as part of the privilege and entitlement process. Multiple studies show that simulation-based education produces better clinicians (individuals and teams), reduces errors/mistakes, improves patient outcomes and lives, and saves money. The evidence is clear and it is long past to answer this call.
In order to train doctors for today’s high-tech medicine, we must abandon nineteenth-century thinking and techniques. Our patients’ lives depend on it.
Doctor. Jeffrey Barsuk, Diane Wayne, and William McGaghie are professors of medical education at Northwestern University Feinberg School of Medicine in Chicago. Barsuk is the head of Feinberg’s simulation laboratory.
