Editor Discusses Current State of Simulation in the Medical Field

In 1980 I attended an airline training symposium at which it was stated that if the current rate of accidents per thousand take offs was extrapolated in line with expected growth over the next twenty years, with no improvements to safety, the global industry could expect an accident a week by the early 2000’s.

What that would have done to the growth of the airline industry was easily understood and as we had just been approached by a group of airlines and existing clients to produce an airline training magazine (now CAT) I also ‘got it’. That scenario did not play out and in recent years the airline industry has been able to claim the lowest ever incident rates. Broadly, the reasons for this major success were two fold, first massive improvements in aircraft and airline technologies. Second a transformation in training, specifically moving from training on the aircraft to training on devices like the full flight simulator. Today a pilot’s first flight in any commercial aircraft  is with a full load of passengers aboard. The quality of flight simulation is hyper realistic.

Healthcare simulation and more specifically, surgical simulation is not yet at that happy state. It should be there in under a decade, at which point the surgeon’s first experience with a human patient should be as a fully trained ‘proficient or expert’ practitioner. The practice portion of the career will have been completed in training.

There are further similarities between the healthcare professions and the airlines. Both face the same demographic problems, both face restrictions on work hours, both enjoy continually changing technologies, and sadly, both face a lack of interest in the job from the ‘brightest and best’ whose attention, up until now, they have enjoyed. Both are also driven by dedicated teams who must work together to achieve full success.   Therefore leadership and communication skills are key abilities that must be taught and practiced, until deeply ingrained.

On the bright side, perhaps, both expect tremendous growth rates in the next twenty years, indeed for the Healthcare sector that is unavoidable. The population pyramid is top heavy and will become more so in the next twenty years providing many more ‘customers’.

In 1990 I was the subject of a laparoscopic procedure and already being involved in simulation I was curious to find out how training was performed using this new and different technique. I was not impressed by what I found and saw over later years at various conferences. Launching this magazine became a ( long term) passion.

Thankfully there does now appear to be a real widespread desire and intent to transform healthcare education and training. It is much needed and there is no doubt that simulation will play a key role. Surgical technologies, or ‘disruptive surgical technologies’ such as laparoscopy and robotics will also change the way in which care is given. Perhaps these practices will be a part of a technology contribution similar to that from which the airlines benefited. These ‘man machine interfaces’ in surgery readily lend themselves to simulation, in fact they demand it, as do the new breed of physicians who will deploy them.

I very much hope that you find this first edition of MEdSim a valuable read and I hope that we can help the healthcare industry transform its training as it strives to improve patient safety. We are not a simulation company though we are all convinced of its ability to improve training but as a simulation company colleague recently said, “it’s not the simulation, it’s the curriculum”.

Buying a simulator or two will not help you much unless it is fully integrated into a new curriculum. MEdSim, as its strap line states, will look at education, simulation and training.  We hope to hear from you as we continue to develop the publication.

My editorial colleague on CAT magazine uses the salutation ‘safe travels! Perhaps our salutation should be,

Safe caring!

Andy Smith Publisher, MEdSim