Datta Rashmi, Upadhyay Kk, Jaideep Cn
Senior Advisor (Anaesthesiology & Critical Care), Army Hospital (R&R), Delhi Cantt. - 10.
Brig Med (CC), Lucknow.
Med J Armed Forces India. 2012 Apr;68(2):167-72. doi: 10.1016/S0377-1237(12)60040-9. Epub 2012 Apr 21.
Medical education is increasingly laying emphasis on a curriculum based on cognitive, psychomotor, and affective domains of learning which were originally proposed nearly 50 years ago. These reforms are framed around best standards of care, error management and patient safety, patient autonomy, and resource allocation. There is a worldwide shift in the method of medical education towards experiential ('hands-on') medical learning; however, applying this concept to real patients is less acceptable to society and is subject to legal and ethical issues. Simulation is the artificial representation of a complex real-world process with sufficient fidelity with the aim to facilitate learning through immersion, reflection, feedback, and practice minus the risks inherent in a similar real-life experience. Medical simulation offers numerous potential strategies for comprehensive and practical training, and safer patient care. It is a technique, rather than just a technology that promotes experiential and reflective learning. It is also a key strategy to teach crisis resource management skills. Simulation can benefit the individual learner, the multidisciplinary team, and the hospital as a whole. In this review, the authors discuss the role of simulation in five situations namely undergraduate teaching, postgraduate training, continuing medical education, disaster management, and military trauma management and dwell upon the experience of medical simulation in the Armed Forces.
医学教育越来越强调基于认知、心理运动和情感学习领域的课程,这些领域最初是在近50年前提出的。这些改革围绕最佳护理标准、错误管理与患者安全、患者自主权以及资源分配展开。医学教育方法在全球范围内正朝着体验式(“动手实践”)医学学习转变;然而,将这一概念应用于真实患者在社会上较难被接受,且会引发法律和伦理问题。模拟是对复杂现实世界过程的人工呈现,具有足够的逼真度,旨在通过沉浸、反思、反馈和实践促进学习,同时规避类似现实生活经历中固有的风险。医学模拟为全面且实用的培训以及更安全的患者护理提供了众多潜在策略。它是一种促进体验式和反思性学习的技术,而非仅仅是一种技术。它也是教授危机资源管理技能的关键策略。模拟可使个体学习者、多学科团队以及整个医院受益。在本综述中,作者讨论了模拟在本科教学、研究生培训、继续医学教育、灾难管理和军事创伤管理这五种情况下的作用,并详述了武装部队中的医学模拟经验。