Simulation Research: The TeleSIM project

As with all reliable educational modalities, simulation has been validated as an effective tool for teaching in medical education.  Many articles have shown that through the use of procedural task trainers, high-fidelity human simulators, and standardized patients, it has been shown to improve patient safety, the number of clinical errors made, and interdisciplinary teamwork and communication.^{1, 3, 6-7}

But what about locations who can't afford to run a simulation center or purchase the costly simulation mannequins?  Are they doomed to be left without being able to practice their skills prior to caring for patients?

To address this question, a group of surgeons at the University of Toronto came up with the idea of using low-cost multimedia resources, such as Skype, to provide simulation education and training to remote areas of around world.  This novel concept was given the name "Telesimulation," and has been shown in several studies to be an effective alternative to traditional self-practice and lectures alone.^{2, 4-5}  These studies, however, mainly use laparoscopic surgical trainers as the educational medium provided.  Please watch the video to the left to get a better understanding of telesimulation and how it is currently being used.


As even in the US, cost is a big factor in determining funding for medical education, we are attempting to prove the effectiveness of telesimulation to standard high-fidelity simulation.  This study is innovative because there have only been a few small studies using telesimulation, and are based mostly on training laparoscopic surgery.  We are using our medical students that rotate through the emergency department as our subjects.  If we are able to prove that there is no difference in learning between telesimulation and standard high-fidelity simulation, we can bring telesimulation to large and remote audiences who would not have access otherwise!  Wish us luck!

To download a Skype account for your program, click this link!


References: 

1.  Aggarwal, R., Mytton, O. T., Derbrew, M., Hananel, D., Heydenburg, M., Issenberg, B., … Reznick, R. (2010). Training and simulation for patient safety. Quality and Safety in Health Care, 19(Suppl 2), i34–i43. http://doi.org/10.1136/qshc.2009.038562
2.  Henao, Ó., Escallón, J., Green, J., Farcas, M., Sierra, J. M., Sánchez, W., & Okrainec, A. (2013). [Fundamentals of laparoscopic surgery in Colombia using telesimulation: an effective educational tool for distance learning]. Biomédica: Revista Del Instituto Nacional De Salud, 33(1), 107–114. http://doi.org/10.1590/S0120-41572013000100013
3. Issenberg S, McGaghie WC, Hart IR, & et al. (1999). SImulation technology for health care professional skills training and assessment. JAMA, 282(9), 861–866. http://doi.org/10.1001/jama.282.9.861
4.  Mikrogianakis, A., Kam, A., Silver, S., Bakanisi, B., Henao, O., Okrainec, A., & Azzie, G. (2011). Telesimulation: an innovative and effective tool for teaching novel intraosseous insertion techniques in developing countries. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine, 18(4), 420–427. http://doi.org/10.1111/j.1553-2712.2011.01038.x
5. Okrainec, A., Vassiliou, M., Kapoor, A., Pitzul, K., Henao, O., Kaneva, P., … Ritter, E. M. (2013). Feasibility of remote administration of the Fundamentals of Laparoscopic Surgery (FLS) skills test. Surgical Endoscopy, 27(11), 4033–4037. http://doi.org/10.1007/s00464-013-3048-7
6. Okuda, Y., Bryson, E. O., DeMaria, S., Jacobson, L., Quinones, J., Shen, B., & Levine, A. I. (2009). The Utility of Simulation in Medical Education: What Is the Evidence? Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 76(4), 330–343. http://doi.org/10.1002/msj.20127
7.  Satava, R. M. (2010). Emerging Trends that Herald the Future of Surgical Simulation. Surgical Clinics of North America, 90(3), 623–633. http://doi.org/10.1016/j.suc.2010.02.002
8. UHN Toronto. 2010, April 26.  UHN pioneers telesimulation training worldwide.  Retrieved from https://www.youtube.com/watch?v=wwx1BUzwGNA