HEAPHY 1 & 2 PLENARY Billie MUDIE

1. Fri 30th Aug 2013 Session 3 / Talk 1 13:05 – 13:50 HEAPHY 1 & 2 PLENARY Billie MUDIE ABSTRACT "VERT™ is a virtual environment of a radiotherapy treatment room. Through captivating 3D views and life size visualizations, VERT offers an excellent platform for supplying radiation therapy training to students, nurses and multidisciplinary team members. From illustration of theoretical concepts through to acquisition of clinical skills in a safe environment VERT delivers benefits for the student, tutor, clinic staff and the patient.“ In Jan 2013 the Radiation Therapy Department at the University of Otago, Wellington had New Zealand's first and only VERT system installed. This presentation will demonstrate this virtual environment using a portable version of vert. The session will be interactive with case studies presented and an opportunity for feedback and ideas from delegates

2. education and simulation Where have we been; where are we going

3. education and simulationANCIENT EGYPTIANS • Edward Smith Papyrus • Imhotep 2600BC • Learnt medicine by working with other physicians Edward Smith PapyrusAncient Egyptian word for brain

4. education and simulationAncient greeks • First Medical School at Cnidus in 700BC • Learning through apprenticeship • Hippocrates (460BC – 370BC) • The Father of Modern Medicine • The Hippocratic Oath • Four Humours

5. education and simulationAncient romans • Galen – (129 – c200/216AD) • Accomplished surgeon (cataract surgeries similar to modern techniques) • Aged 16 learnt medicine at the local Asclepeion • Due to religious restrictions anatomy/physiology learnt through vivisection and dissection on pigs and Barbary monkeys

6. education and simulationup to 14oo Ad • Galen’s and Hippocrates theories dominated Western medicine for 1300 years • Large medical schools throughout Europe • Mostly lectures and readings – very little training

7. education and simulationmiddle ages • Universities established – Padua 1222 • Dissection for anatomical training allowed • Often criminals • First public dissection recorded in 1315 • Dissection in England not permitted until 16th Century • Anatomists

8. education and simulationeighteenth century • Teaching is still lecture and reading based • Final year medical students clinical experience limited to following professors through the wards

9. education and simulation19th and 20th centuries • Rise of modern medicine • Apprenticeship model incorporated into medical training

10. education and simulation • Radiation Therapy and Medical Imaging • Apprenticeship model of training • DCR – degrees, masters and PhDs

11. education and simulationwhat is simulation? • “ The technique of imitating the behaviour of some situation or process (whether economic, military, mechanical, etc) by means of a suitably analogous situation or apparatus, especially for the purpose of study or personnel training” • Medical EducationVolume 40, Issue 3, pages 254-262, 17 FEB 2006 DOI: 10.1111/j.1365-2929.2006.02394.xhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-2929.2006.02394.x/full#f2

12. education and simulationsimulators

13. education and simulationsimulation types

14. education and simulationhistory • Military • Chess • Jousting • Aviation • Flight Simulators • Space Programmes • Zero gravity • Flight simulators • Nuclear Power Industry

15. education and simulationMedicalhistory • Anatomical models • 17th Century obstetric mannequin • Early 1960s • Resusci-Anne

16. education and simulationMedicalhistory • Mid 1960s • Sim One • First computer controlled mannequin simulating the entire body • Originated through “Aerojet needing to develop peacetime applications of its capabilities in the face of diminishing military funding, before the escalation of the Vietnam conflict” • High fidelity features • Only one created

17. education and simulationMedicalhistory • Harvey – cardiology simulator • 1987 CASE • GAS

18. education and simulationnursing • Nursing • Entire simulated wards

19. education and simulationnursing

20. education and simulationwhy use simulation? • Provides a safe, supportive educational environment • Duty of care to the patient • Minimise risk of harm • Patient autonomy • Cost effective

21. education and simulation Medical EducationVolume 40, Issue 3, pages 254-262, 17 FEB 2006 DOI: 10.1111/j.1365-2929.2006.02394.xhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-2929.2006.02394.x/full#f2

22. education and simulationadvantages • Feedback • Identify gap • Provide feedback on the ap • Investigate the basis for the gap • Help close the gap – discussion and targeted instruction • Risk to patient is avoided • Skill acquisition and maintenance • repetition • Transfer to practice • Team work training • Mastery learning • A critical review of simulation-based medical education research: 2003-2009. McGaghie, W et al • Medical Education 2010; 44: 50-63

23. education and simulationRadiation therapy • VERT - Virtual Linear Accelerator and Environment • Released in UK in 200 • Australia 2011 • New Zealand 2013

24. education and simulationvert

25. education and simulationsimulationvs clinical experience • Can simulation replace clinical experience? • Does it replace clinical experience? • Should it replace clinical experience?