Introduction
Practicum Lund/Malmö Clinical Skills Centre at Skåne University Hospital, is responsible for coordinating development, pedagogical and curriculum issues, information gathering, research activities, marketing, etc within the field of clinical skills training.
The centre offers courses and training opportunities for different categories of health professionals: nursing students, registered nurses, medical students, interns, licensed physicians, paramedics and rescue services.
We work with advanced full-scale simulation (adult, paediatric and neonatal mannequins). These trainings are best for team training. We have also some simulators for individual skills training, like interventional vascular procedures, laparoscopic surgery, endoscopies and eye surgery.
Development of CMS, 2003-2008
Our first simulator, a Human Patient Simulator (HPS from Meti, Florida) was installed in august 2003. it was at that time in a section of education within the Department of Anaesthesiology. In 2006, with the chairman of Anaesthesiology stepping down from his position, the CMS was formed as an independent organisation within the hospital Planning Department. From that time the CMS was not included in any clinical department but stood free and could develop courses within several fields and not only anaesthesiology.
At the same time CMS could grow from the single simulator to today seven simulators, as described above.
The organisation around all simulators is a small staff with three people functioning together with training staff from anaesthesiology, surgery, gastroenterology, neonatal and ophthalmology. The administrative team is then supporting training with all simulators in an economical way instead of having a large staff on site.
Educational philosophy
Medicine is undergoing a change in increasing specialization together with shorter hospital stays for patients. This calls for more training situations, often with very focused questions. Simulators have become the new part for such training and it has shown to be of great value since no patient is at risk during the training, the training can be repetitive, groups could train team function and training could in fact take place in delivery room, car accidents etc.
Very often are training filmed and the film used after the training in a situation of reflective discussions (debriefing) together with the students from the training. Such a session has shown to be the most valuable part of simulator education. The team can see themselves and discus treatment and technique as shown on the film.
We have found that simulator pedagogic has some corner stones:
- Orientation towards the training group. The training must relate to the students knowledge and training level.
- Experiential learning. Students learn more from textbooks if they can apply their knowledge on a “real situation”
- Multiprofessional training. It is of value if different professional groups train together and understand each others competence.
- Evidence based knowledge. Education must have a scientific background.
Types of courses on the full-scale simulator e.g.
- Trauma teams training for the Emergency room.
- Professional team functions for departments of Cardiology and Internal Medicine.
- Team training for paramedic teams.
- Malign hyperthermia training for anaesthesia personnel.
- Airway problems for paramedics.
- Patient safety courses.
Training volume
The full-scale simulator is used for courses about four days/week during student semesters. The vascular simulator, the laparoscopic simulator, the endoscopic simulator and the eye simulator are less often in use and they require a different type of course curricula to be useful. We are today able to train almost 1000 students/practitioners each year in our current four day/week program.
Future
Simulation has proven valuable and there is a growing number of requests, why we are constantly looking for expansion both when it comes to space, simulators and new teaching staff.
On the 10th of October Anders Bergenfelz takes office as director of Practicum – Lund/Malmö Clinical Skills Centre when the two skills centres in Lund and Malmö, respectively, are merging. Anders Bergenfelzis a Lund-based surgeon and he has also been appointed professor of practical medical training at Lund University.
Dr Bergenfelz is a nationally and internationally leading endocrine surgeon, who currently is editor of British Journal of Surgery and who has served as chairman of the endocrine surgical section of UEMS (European Union of Medical Specialists). He is also founder and chairman of the Scandinavian Registry of Neck Surgery.
During his career Dr Bergenfelz has been active in teaching on undergraduate, graduate as well as postgraduate levels and he has been convener of multiple clinical educational courses and activities nationally and internationally.