It is in the nature of medicine, that you are gonna screw up. You are gonna kill someone. If you can’t handle that reality, pick another profession or finish medical school and teach.
— Dr. Gregory House (Hugh Laurie), House MD, Season 1: Three Stories
Though harsh, a candid remark by a very-well known and revered TV series character, Dr House, reflects a frightful truth about medical profession – malpractice can cost somebody his life. To limit the errors and mistakes of future medical professionals to a possible minimum, in 2014 Medical University in Lublin launched the Centre for Medical Simulation, where, by trial and error, students practice their decision making in a low-risk environment.
Simulation in Medical Education
Medical education based on simulation has revolutionized the way of teaching medicine. It allows students to make decisions in the circumstances close to a real work setting without putting their patients’ lives under jeopardy. In medicine, training via simulation has become a safer alternative for traditional work-based learning practices, e.g. internships and apprenticeships, especially at the early stage of practical skills acquisition. Apart from eliminating the risks related to patients’ safety, simulation has significant advantages in education per se, i.e. it speeds up the learning process, fosters team work and advances students’ capabilities in addressing critical conditions. The Centre for Medical Simulation in Lublin puts a special focus on developing communication skills among their students, as, according to dismal statistics, only a small proportion of the medical mistakes result from miscommunication.
Simulation Practiced at the Centre in Lublin
How does simulation actually happen? Students assume the role of a medical doctor during a virtual meeting with a patient. The role of the patient is played by an actor, so students can observe specific behavioural patterns, e.g. his temper, mood and attitude. Also the Centre in Lublin uses a so-called ‘hybrid patient’, a real person hooked up to phantom equipment. In case of working with the ‘hybrid patient’, students interview a real patient about his medical history, but provide treatment to a phantom.
Students primarily work in groups assisted by a mentor, and pass all the stages of making a diagnosis and planning a therapeutic process. They apply theory into practice when learning about the most commonly performed clinical procedures, e.g. electrocardiography, ophthalmoscopy, otoscopic exam, digital rectal examination, urinary catheterization, medical history, preparation for surgical procedures, physical examination, medical communication as well as breaking unfortunate news. For the latter, students take a separate course on behavioural ethics in which they learn how to appropriately react to different patients’ behaviour. Skills acquired in the simulation environment allow graduates to start their carriers in medical institutions with greater confidence what is an indispensable asset in medical practice.
Simulation Practice Support
The Centre for Simulation in Lublin and its rather costly practices are sponsored by the Ministry of Health and the Ministry of Science and Higher Education in Poland. The Centre has also received numerous EU grants for purchasing the medical equipment.
To keep training programs at the Centre updated, potential employers from stakeholder institutions participate in the University Program Board. The Program Board also provides information on how well graduates do in their professional carrier and what should be changed in the educational process of the Centre to meet the expectation of the employers.
The Centre cooperates with hospitals in Lublin and also other hospitals in the region. Centre’ staff assist hospitals in solving specific medical problems, e.g. related to functioning of the rescue team or assisting hospitals in treating specific pathogens. In return, such cooperation gives the Centre an opportunity to gather information about the expected skills their students need to master.
This article is based on a case study originally written by Mieczyslaw Bak, and developed as a part of the WEXHE Project.