“Simulation is a technique, not a technology, to replace or amplify real experiences with guided experiences, often immersive in nature, that evoke or replicate substantial aspects of the real world in a fully safe, instructive, and interactive fashion.” 1
The limitations of standard classroom didactics and “on-the-job-training” for the initial training of residents and fellows in their procedural skills are well recognized and have helped fuel the growing emphasis on simulation training for medical students, residents, and support staff by the governing bodies of medical education such as the ACGME. For residents and fellows at Penn State Milton S. Hershey Medical Center, simulation training in gastrointestinal (GI) procedures has just taken a large leap forward. A recent multimillion dollar investment in renovating simulation facilities and technology has resulted in the nationally recognized Penn State Hershey Simulation Center, now under the direction of Elizabeth Sinz, M.D., professor of anesthesiology and associate dean for simulation. New generation simulators for diagnostic and therapeutic upper endoscopy, colonoscopy, and ERCP are available and are light-years ahead of what was available just a few years ago. For fellows in the GI-hepatology training program, Matthew T. Moyer, M.D., M.S., the new director of endoscopic education, is incorporating these technologies and training techniques to increase the depth of the curriculum. Moyer explains, “Simulation is becoming important, perhaps even mandatory, in the early instruction of our residents and fellows. This process allows them to have initial exposure to certain high-risk procedures (such as ERCP), or crisis situations (such as ACLS), during simulated sessions, prior to practicing on actual patients. This gives new trainees an opportunity to achieve a certain level of comfort and technical proficiency in a safe environment with continual feedback prior to entering the busy workflow of patient care.”
Integration of simulation training into the fellowship program is a challenge for Moyer, but allows repeated exposures to standardized cases which trainees encounter in clinical practice, such as the patient with an upper GI hemorrhage. Moyer says, “The student thinks through, talks through, and finally works through a standardized scenario.” The process allows for immediate feedback and learning and offers initial experience in a safe environment in performing procedures that are new, high-risk, or uncommon. In addition, simulation training of ancillary staff, so vital for successful therapeutic endoscopy, is available. Simulation training will enhance and refine the skills of new and experienced physicians, nurses, and technicians, and promises to improve patient care and outcomes. Six GI fellows and thirty-seven general surgery residents will receive their introduction to the fundamentals of endoscopy under this program in 2012. Moyer’s work in education is supported in part by the Margot E. Walrath Career Professorship. The Penn State Hershey Simulation Center is located on the second floor of the George Harrell Library at Penn State Milton S. Hershey Medical Center, Hershey, Pa.
1. Gaba DM: The Future Vision of Simulation in Healthcare. Quality and Safety in Health Care 2004; 13 (Supp 1).
Assistant Professor of Medicine, Penn State Hershey Gastroenterology and Hepatology and Penn State Hershey Cancer Institute
- Phone: 717-531-3694
- Fellowship: Gastroenterology, Penn State Milton S. Hershey Medical Center
- Residency: Internal Medicine, Penn State Milton S. Hershey Medical Center
- Medical School: Penn State College of Medicine