Abstract:

For decades, medicine has been taught on the apprenticeship model. With increasing demand for more medical school graduates, heightened concern for patient safety, and a need for better continuing education to keep practicing physicians up-to-date with new technology, simulation and multimedia systems are becoming essential component of medical curricula. Recent advances in simulation technology have improved student’s understanding of disease pathophysiology and enhanced the opportunity for clinical skills training. SimMan is a portable and advanced patient simulator for team training. SimMan has realistic anatomy and clinical functionality. It provides simulation-based education to challenge and test students' clinical and decision-making skills during realistic patient care scenarios. On the other hand, Harvey simulator is Cardiopulmonary Patient Simulator. It is a proven system to teach bedside cardiovascular medical skills that transfer to real patients. Harvey simulator realistically simulates nearly any cardiac disease by varying blood pressure, pulses, heart sounds and murmurs.

To evaluate and compare the effectiveness of simulation technology in medical education, 280 medical students from Yong Loo Lin School of Medicine - National University of Singapore, were asked to give a feedback on SimMan and Harvey simulator sessions. A structured questionnaire was designed to reflect study goals. The participants were first year medical students who had passed their theoretical course in cardiovascular and respiratory physiology. In Harvey simulation session, the first year students practiced general cardiovascular examination, identifying the main cardiovascular signs (e.g., central venous pressure, carotid artery pulsation and apex beat) followed by auscultation of normal and pathological cardiac sounds and murmurs. In SimMan simulation session, medical student were tested by two cardiovascular scenarios (Hemorrhagic shock and cardiogenic shock) and two respiratory scenarios (tension pneumothorax and pulmonary embolism).

A highly positive outcome was derived from the student and interviews. The majority find ‘Harvey’ simulator interesting and facilitating learning (98%) and most of the participants wish for more simulation sessions (87%). However, the feedback from SimMan session was more critical than Harvey simulator. This could be attributed to the suboptimal simulation of heart and respiratory sounds and other clinical signs by SimMan simulator. On the other hand, the main advantage of SimMan simulator is the possibility to perform several clinical procedures such as endotrachial intubation and decompressing of tension pneumothorax.

In our presentation we will compare and contrast the advantage and disadvantage of using SimMan, Harvey and other simulators in the medical curriculum as well as describe some methods that could be used to overcome these disadvantages by careful and proper designing of the practical sessions.

Keywords:

High-fidelity patient simulation, undergraduate medical curriculum, Harvey simulator, SimMan simulator.