SIMULATION IN UNDERGRADUATE MEDICAL TRAINING

1. SIMULATION IN UNDERGRADUATE MEDICAL TRAINING BY ERNEST TEIKO LARMIE MBBS, PhD, MSC (Elec. Eng.) Diploma Nuclear Reactor Eng.

2. THE GREAT DEBATE ●BULDING ABRIDGE BETWEEN BASIC SCIENCES AND WARD CLINICAL TEACHING

3. THE VISION FOR USINGSIMULATION IN UNDERGRADUATE MEDICAL EDUCATION? ٭Provision of a Facility for deliberate practice (Clinical skills Center for UG & students) ٭Consolidation of Basic Clinical Skills (undergraduate) using: Standardized skill training methods, Patients, Human simulators, Video technology, CDs, IT etc. ٭Enhancement of Skills at PG level – through Specialty training- Advance simulators ٭Synchronizingwith the objectives of the National Health Delivery System of Malaysia

4. AIMST’SMISSION ٭To train students using medical and surgical simulation ٭To use simulation to ensure a high degree of patient’s safety ٭To utilize simulation tools to support individualized learning both cognitive and procedural skills to attain competence

5. ●AIMST’SMISSION ٭To use simulation to ensure a high degree of patient’s safety with i)continuous assessment ii)constructive feedback and iii)more opportunities for deliberate practice

6. AIMST’S MISSION ٭Must promote interdisciplinary teaching, team training, communication skills and professionalism ٭Must enable learners to achieve skills, knowledge and behaviours necessary for independent, life- long professional growth ٭Must provide opportunities to improve physical coordination and cognitive reasoning

7. ● OBJECTIVES OF THE AIMST PROGRAMME DESIGNED TO: ٭Improve the clinical skills of students prior to their clerkship ٭Standardize the clinical skill procedures ٭Encourage students to learn as individuals and at their own pace

8. ● OBJECTIVES OF THE AIMST PROGRAMME ٭Encourage students to formulate their own learning goals ٭Inculcate in students a habit of continuous learning ٭Motivate students to acquire more knowledge about the skills that are being taught

9. THE AIMST APPROACH – THE CURRICULUM cs

10. CNS SUTURING BASIC AND ADVANCED CLINICAL SKILLS TRAINING

11. ●INTERACTION WITH DEPARTMENTS / UNITS SUPPORTING CLINICAL DEPARTMENTS /UNITS (Clinical Consultants) Medicine Surgery Obstetrics & gynecology Otorhinolaryngology (ORL) Orthopedics Anesthesia Family Medicine Ophthalmology Radiology INPUT OUTPUT LABORATORY CLINICAL SKILLS TRAINING(1st & 3rd years Medical Students) Using Human Simulators Mannequins DEPARTMENT OF MEDICAL EDUCATION WARD CLINICAL SKILLS TRAINING(using Patients in the 4TH & 5TH years) LABORATORY UNDERGRADUATE CLINICAL SKILLS TRAINING CLINICAL SKILLS CENTER STAFFCoordinator Tutor Nurses Assistant SUPPORTING UNITS AUDIO VISUAL GRAPHICS SUPPORTING BASIC SCIENCE DEPARTMENTS (Resource staff with MD degrees) Physiology Anatomy Chemical Pathology

12.  TOOLS NEEDED • 1.LOG BOOK • CHARACTER -LOG BOOK. It should: • mirror the five year program of AIMST • be integrated / holistic in character • be spiral • define the dimensions of the skills to be taught Must know Good to know Mirror Cognitive knowledge & Basic generic skills Nice to know

13. ● SPIRALFUSION OF BASIC AND ADVANCED CLINICAL SKILLS TRAINING

14.  TOOLS NEEDED HANDOUTS – ORGAN-BASED CONTENTS OF THE HANDOUTS Reflects: Skills Objectives Outcomes Anatomy Physiology *Pathophysiology ٭Indications ٭Procedure ٭Complication ORGAN-BASED SYSTEM HANDOUTS Cardiovascular, Respiratory, Genitourinary, Reproductive, Musculoskeletal, Endocrine,Central Nervous System and gastrointestinal systems

15.  TOOLS NEEDED VIDEO CLIPS / CDs / CAI STANDARDIZED PATIENTS

16. ● THE TEACHING PROCESS • ELEMENTS • Procedural skills training-2nd and 3rd years • Communication skills -2nd and 3rd years • Clinical judgment - 3rd 4th years • Team work – 3rd and 5th years • v)Use of standardized, validated educational tools – for all years

17. THE TEACHING PROCESS – ‘SODO’ Next level Hand outs Assessment of Each system - OSCE Feedback Post-assessment questionnaire PASS RESULTS • Facilitators: • Consultants • CSC Staff Students SELF DIRECTED LEARNING FAIL counseling Pre-assessment questionnaire • MATERIALS • AT CSC • Mannequins • CDs • Video clips • X-ray Films • CSC Staff CLINICAL SKILLS TRAINING Complementary To PBL Evaluation of the Clinical skills programme

18. “SODO” TEACHING SESSIONS

19. ٭It allows skills to be mastered through repeated practice ٭It allows mistakes to be made and immediate feedback possible ٭It allows non-dependence on patients

20. ٭It allows chronic medical or complex problems to be acted out in a short period of time using Human Simulators and Computer Aided Instructional (CAI) programmes

21. OSCE - CONTENTS • Clinical scenario - Patient presentation, Examination, Investigation • Skill / Procedures - Check list • Investigation - Radiograph, Interpretation of Lab results • History Taking (Simulated patient interviews)

22. ٭Askills laboratory is an expensive facility to establish and run, yet ٭ there is enough evidence that lab clinical simulation has an impact on students performance during clerkship ٭skills taught on manikins are transferable ٭the learning environment is safe and informal

23. STUDENT’S VACTIVITIES

25. CLINICAL SKILLS CENTRE

26. IT IS FUN WORKING WITH ME . I AM REAL BELIEVE ME ! THANK YOU