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Marianne and Marcus Wallenberg Foundation

Simulator centre

Real patients have been used for many years as guinea pigs in the training of medical personnel, but now advanced medical simulators are starting to make an appearance on a massive scale. These apparatus enable trainees to practise everything from routine operations to major surgery in realistic environments. Sweden’s leading simulation activities are based at the Simulator Centre in Huddinge, where it is hoped that they will reduce the number of mistakes made by the healthcare services.

It is a normal afternoon at Karolinska University Hospital’s Simulator Centre in Huddinge. The large picture windows let daylight filter in through the dense leaves of the rhododendron bushes. In front of the window, a row of apparatus stand like fruit machines in a casino, but instead of bouncing pinballs or racing cars, the screens show adventures of a completely different kind.

Medical student Lottie Malmström is on the term-eight surgery course and is practising surgically removing a gall bladder. With forceps in her hands instead of a joystick and her foot on a pedal, she carefully tries to remove the organ. A green mark on the realistic graphic shows here where to make the incision, but still there is unintentional bleeding and burns. But for this she can be forgiven given that it is her first go on the simulator.

“It’s great fun, and actually feels as if you’re performing a real operation,” she says.

Performing similar exercises on a living patient would be ethically indefensible. Thanks to the medical simulators, however, it is now possible for trainee doctors and nurses, as well as practitioners, to hone their skills before they encounter real patients.

Li Felländer Tsai is head of the Simulator Centre, and discovered no less than ten years ago that medical simulators were on their way. A donation from the Marianne and Marcus Wallenberg Foundation made possible the purchase of the first advanced simulator for Huddinge in 2002, since when thousands of BSc and CPD students from Stockholm and around the country have attended courses at the centre.

“Studies show that the simulators will reduce the number of mistakes made in hospitals, and probably even save lives,” says Professor Felländer Tsai.

“Traditionally, medical students practised on patients, who put their bodies in the hands of doctors to become experimental objects, but that’s no longer acceptable,” she adds.

The Simulator Centre has several simulators for keyhole surgery, in which students can practise gallbladder surgery and carry out vascular surgery and endoscopic examinations of inner organs. There is also an advanced patient simulator, a lifelike doll that can breathe and has pupil reflexes and a pulse, on which users can give anaesthesia, test drugs and perform emergency surgery.

The simulators not only help to improve the students’ and practitioners’ medical proficiency, but also give them an opportunity to practise working in teams with unknown colleagues and under time pressure.

“It’s very educational and gives people a chance to train completely different situations,” says Professor Felländer Tsai. “Another advantage is that you get immediate feedback and can monitor your progress on a chart.”

Now that some of the equipment has served its time, the centre is being updated through a new donation from the Marianne and Marcus Wallenberg Foundation. According to Professor Felländer Tsai, this is a significant investment that can help properly integrate simulators into the study programmes. After all, she reasons, no one would want to fly with a pilot who hasn’t trained in a simulator, so why shouldn’t the same also apply to hospitals?

“It’s extremely important for this field to be legislated if hospitals are to maintain a high level of safety,” says Professor Felländer Tsai. “Studies show that the simulators will reduce the number of mistakes made, and probably even save lives.”