Growth Prospect: Simulation

Posted on April 6, 2011

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The University of Virgina’s (UVA) new medical school is a showcase in technology believed to be ubiquitous in the future: simulation.

Simulation has been a learning tool employed in the past in everything from student driving to pilot and military training. Currently, simulation also presents itself in healthcare design. Healthcare designers execute mock-ups and scenarios to watch people interact in space. This assessment helps architects and engineers design more effective work environments for care providers and patients.

In the medical milieu, simulation is really taking hold also. As noted, UVA has invested heavily in healthcare provider education. According to the UVA Alumni magazine, some of the highlights of their Medical Simulation Center:

  • 10,000 s.f. space occupying an entire floor in the new medical school
  • Allows med students to learn in more effective ways—application, problem solving, hands-on—instead of less effective means like regurgitation, rote learning and passive listening
  • Includes operating room, emergency room, intensive care unit, and labor and delivery room simulators
  • Includes six procedure rooms for skills workshops, and ambulance, triage and decontamination bay interfaces
  • Sophisticated patient simulators that blink, breathe, talk, have vital signs (pulse, etc.) and can be anesthetized

The simulation is not all virtual or fake, as there are also actors who are hired to act out certain symptoms and scenarios for medical students to react to and learn.

For medical training, simulation allows for a safe environment to learn and make mistakes, a place to rapidly test ideas and scenarios, and a way to record and observe actions for critical analysis and discussion. Simulation in a hospital treatment environment has several benefits, only some of which are shared with the education realm.

Clinical simulation allows for learning and analysis in a safe learning environment. But perhaps more importantly, simulation in a hospital or clinic allows for education of highly unique scenarios, scenarios which are rare in real life and are difficult to find in real people. A specialist who needs repetition of a certain procedure to achieve expertise may not be able to find dozens or hundreds of actual humans to learn on “in the field”. Therefore, simulation allows for efficient and safe repetition and practice.

Also, simulation can be used to keep skills fresh—something crucial for doctors in rural areas who are without access to large populations. For instance, a doctor who rarely practices a certain orthopedic procedure or delivers babies will be able to keep skills sharp for the time when they are called to replace a joint or deliver a baby in a rural facility. This “continuing education” or “maintenance” use is highly desirable because much of our population is in suburban or rural areas, which do not have hundreds or thousands of cases in which to become an expert.

I see simulation in design and healthcare as having two growth opportunities.  First, as running scenarios to predict outcomes, as in a Monte Carlo simulation, where thousands of examples are played out by computer to figure out the most likely case(s) around which to plan.  I can see this being used in conjunction with evidence-based design to better figure out debatable aspects of healthcare planning, like the best location(s) for a nurse station on a med-surg floor. Second, the concept of simulation is becoming more evident in 3D modeling and eventually in virtual reality, which simulate the experience of a proposed design. Through this simulation technology, designers and owners can experience a space by virtually occupying it, critique it, and make design changes without the expense of physically building the space.

Simulation is at its most effective when it most closely resembles reality, including the stress and emotional response generated by the doctor or designer who is tasked with performing. Simulation will not grow in frequency of use simply because we can create these scenarios through technology, but because it may be a more effective way to acquire knowledge and improve skills—both of which improve care, and design, at a fraction of the risk or expense of old methods.

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Posted in: Growth Prospect