4 Anaesthesia simulators

Abstract

The practice of anaesthesia involves routine activities which have the potential to develop into critical incidents. Moreover, many life-threatening complications in anaesthesia are so rare that practitioners seldom, if ever, come across them in routine practice. In this respect, anaesthesia is comparable to industries such as aviation and the nuclear power industry. Simulators and training devices are regularly used in these industries to maintain the efficiency and proficiency of operators. Within the past few years, there has been an increasing interest in the use of simulators in anaesthesia. Many computer screen-based and full-scale anaesthesia simulators have been developed and evaluated. The computer screen-based simulators are less expensive and more widely available. However, they lack the ability to simulate reality and certain other aspects of anaesthesia such as the human-machine and interpersonal interactions. Full-scale simulators recreate the whole anaesthesia work environment, but the disadvantage of these simulators is their high acquisition and running cost. The major purpose of anaesthesia simulators is to rehearse the management of both frequently occurring and rare events during anaesthesia. Full-scale anaesthesia simulators are ideal for training anaesthetists about the concepts of human-machine interactions and the complications of working in a complex environment. Many simulator-based training courses, which involve these concepts, have been developed and are being conducted in many training centres (e.g. the Anaesthesia Crisis Resource Management course and, the Rational Anaesthesia course). Simulators are also useful for continuing education of practising anaesthetists. Routine in-training examinations, assessment of trainees with questionable competence and periodic re-examination of practitioners could be conducted on simulators. As research tools, simulators can be used to study the responses of anaesthesia personnel to critical incidents, the utility of different displays and alarm modalities, the effects of artifacts or false alarms on problem-solving performance, and the effect of fatigue and other stresses on anaesthetists' performance. In addition, anaesthesia simulators can be used to evaluate the ergonomics and performance of equipment, especially during the development phase. Interest in anaesthesia simulators is increasing rapidly and the devices are constantly being improved. However, the full potential of these devices in the practice of anaesthesia needs to be explored further.