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University medical facilities are often on the cutting-edge of training and simulation techniques and the published results are invaluable resources. However, these naturally focus upon academic training of medical students. Medical training is broader than that: from new apparatus training for seasoned professionals to various levels of training for health care assistants, nurses, and GI technicians. In this blog, we propose ways to look beyond the assumptions made in traditional university endoscopic-training literature and examine some areas that reflect the challenges of the medical world anno 2020.
I: recurrent training
Current articles focus little attention on career-long medical training, including that of endoscopy. Compare this to the aviation practices: no matter how experienced, skilled, and well-trained they are, pilots are required to follow strict guidelines for recurrent training. This means that thankfully, planes are flown by someone who 1) has mastered the newest apparatus and techniques in a controlled setting 2) has fresh knowledge of emergency protocol when something goes wrong.
Certainly, there are medical institutions where staff regularly train to master new equipment and techniques through simulation and systematically review emergency protocol rather than relying solely on—often vague recollections of— their initial training. There are many others for whom this is only an ideal-world notion. Is it time to regulate recurrent training in the medical field?
II: increased awareness of the associated costs
Hundreds of articles have been written about endoscopic training, but very few discuss financial aspects. Live and ex-vivo models require substantial investments, especially considering how briefly the tissues are viable. Computer models require a hefty initial outlay (€30,000+) and then ‘job done,’ right? Wrong. All sophisticated equipment has inevitable ‘hidden’ costs: upkeep, reprogramming, even basic operational expenses.
Considering the spiraling costs of running medical facilities, more conscious expenditure on training facilities must be a priority in 2020 and beyond.
While both wet and dry simulated methods justifiably play star role in the literature concerning training, neither meets a medical professional’s need today for speed and flexibility. Hectic careers and limited and unpredictable ‘windows of opportunity’ require a mobile, train-when-and-wherever-you-can solution for practicing with new implements. It is impossible to regularly hone one’s skills when training needs to be planned weeks, if not months, in advance and cannot easily be rescheduled.
When it comes to training to use sophisticated equipment and increasingly intricate technique, there is no ‘one-size-fits-all’ solution. What works for a nurse or novice med student is too simplistic for a specialist fellow or an advanced professional wanting to master the new procedures. That’s why it is essential to go beyond the status quo and find methods that better suit the complexity of modern medicine.
“Simulation in endoscopy: Practical educational strategies to improve learning” World Journal of Gastrointestinal Endoscopy Vol. 11, no. 3: 2019
‘Endoscopic simulation: where we have been and where we are going’ Gastrointestinal Endoscopy Vol. 61, no. 2: 2005