SIMULATION CENTRE PROJECT

The Tasmanian Ambulance Service Clinical Practice & Education Unit in association with the Southern Region Ambulance Service Medical Officer, Dr Andrew Climie, have submitted a detailed proposal to establish a medical training simulation centre primarily for ambulance use.Important extracts from the submission are:

Project Description - We plan to establish the Tasmanian Ambulance Simulation and Skills Centre, a dedicated training space where clinical situations and specific skills can be realistically replicated through the use of computer simulation, actors, anatomical models, and low and medium fidelity mannequins. Learning will be made more structured than can real life clinical events, to meet specific learning needs. An expert debriefing utilising audiovisual recordings of performance will be an essential component of the scenario training. We will employ dedicated instructors and train them to use simulation effectively, initially at the Southern Health Simulation and Skills Centre in Melbourne.

Complex and realistic incidents which require teamwork and leadership as well as individual clinical competencies can be readily created in a Centre such as we are planning. We will also be able to present different practitioners with identical scenarios to assess performance against the acceptable standard, identifying the need for additional targeted training or other intervention as appropriate.

Much of our worst road trauma occurs on rural roads, as crashes are often at highway speed and delays to hospital can be considerable. First ambulance responders are usually Volunteer Ambulance Officers (VAOs) who are the least trained ambulance personnel and the least able to properly manage these patients. Often the rural GP and Health Centre nurses are also involved. Teamwork is often poor. Once the Simulation Centre is functioning well we will address this by delivering multi-disciplinary pre-hospital trauma training developed at the Centre to these groups, in their towns, utilising our best mannequins, a specially fitted training ambulance and Clinical Instructors trained to do this.

The Tasmanian Ambulance Service (TAS) has an excellent relationship with the Emergency Department (ED) at the Royal Hobart Hospital. We plan to offer them the use of the Centre facilities when not required by the TAS, and to combine training at times to replicate the initial phase of hospital trauma resuscitation. The Tasmanian Medical Retrieval Service and the rescue helicopter crews will also train at the Centre. Once the is proven and programmes are developed we will offer training to a number of interested 'outside' groups (GP Training Tasmania, Early Management of Severe Trauma course, and others) on a fee-for-service basis to make the Centre at least partially self-funding.

Project Aims:

Provide the Clinical Practice & Education Unit with the wherewithal to:

• Develop innovative training methods for use at the Simulation and Skills Centre (the Centre), by the Regional Training Units, and by Clinical Instructors conducting courses for doctors, nurses and VAOs at rural health facilities.

• Train ambulance personnel of all levels to the standard necessary, emphasising excellence in clinical skills, teamwork, leadership and decision making.

• Train ambulance personnel to manage uncommon but critical conditions rapidly and well.

• Introduce advanced procedures and protocols, such as drug assisted intubation and chest drain insertion. These are the essential procedures that currently differentiate what a doctor and a paramedic can do for major trauma pre-hospital.

• Ensure uniformity of training and clinical standards across TAS regions.

• Assess the performance of problem practitioners.

Provide an appropriate environment for other groups to train in procedural skills, crisis management, teamwork and leadership;

• RHH trauma team

• Tasmanian Medical Retrieval Service

• Crew of the Rescue Helicopter (pilot, paramedic & police crewman)

• TAS Southern Region Regional Training Unit

• Other interested parties

Source: "MAIB Injury Prevention and Management Foundation, Application for Funding", Tasmanian Ambulance Service, April 2005.

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