Early Use of Simulation in Medical Education

Abstract

An oft-cited belief that, until recently, simulators used in education of health care professionals were simple models is wrong. Hundreds of years ago and, in one instance, thousands of years ago, intricate models were used to help teach anatomy and physiology and in training in obstetrics and many surgical disciplines. Simulators were used to learn skills before performing them on patients and in high-stakes assessment.The newest technologies were often used in simulators to improve fidelity. In the 18th century, obstetric simulators could leak amniotic fluid, and blood were used to train midwives and obstetricians to recognize and manage complications of childbirth. Italy was the major source of simulators early in the 18th century, but in the 19th century, dominance in clinical simulation moved to France, Britain, and then Germany. In comparison, much of the 20th century was a "dark age" for simulation.

História da simulação cirúrgica e sua aplicação em Neurocirurgia

“…Ludovico Cardi (1559-1613), um pintor italiano conhecido como Cigoli, desenvolveu em 1598 o primeiro modelo anatômico de cera, o "Lo Scorticato", exibido até hoje em uma cópia de bronze no Museu Nacional de Bargello, em Florença (Figura 1) [7]. Ambroise Paré (1510-1590) considerado um dos pais da cirurgia, era conhecido por levar para casa cadáveres embalsamados para praticar novas técnicas cirúrgicas [8].…”

“…Em meados do século XVIII, modelos obstétricos foram criados para treinar cirurgiões e parteiras, diminuindo as complicações nos partos. Em Bolonha, Itália, Giovanni Galli projetou um parto simulado a partir de um útero de vidro com uma pelve e um feto flexível [7]. Na Grã-Bretanha, um modelo ginecológico foi desenvolvido por Richard Manningham em 1739.…”

“…Entre os modelos históricos de maior repercussão incluem-se os fetos construídos por William Smellie (1697-1763), que tinham grande semelhança com a realidade. Considerando esses fatos na história da simulação na educação médica, percebe-se que os modelos obstétricos foram a base para a simulação cirúrgica [7].…”

Innovations in surgery simulation: a review of past, current and future techniques

“…to conceptualize nasal reconstruction with a forehead flap (8,9). Other examples of early simulator use for surgical training involved the use of wooden benchtop models, live animals and human cadavers (10). Ambroise Paré , considered one of the fathers of surgery, was known to take embalmed cadavers home to practice new surgical techniques (11).…”

Articulation Work in Subsea Operations: Taking Teamwork Seriously in Assessment of Subsea Operations

“…The simulator was first used many years ago in aviation- [17]- [19], medical and surgery- [20], and driving [21]- [23] studies to increase confidence and reduce possible errors in operations. It is a relatively new method for maritime navigation training [24].…”