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"We have trodden new paths" - interview with Dr. Szilárd Rendeki, director of the Medical Simulation Education Center

11 May 2020

Although the coronavirus epidemic has undoubtedly made practical medical training difficult, the Medical Simulation Education Center, which enables the development and practice of manual skills, continues to play an important role in the training. The successful digital transition has been greatly facilitated by the audio-visual teaching materials produced by the MediSkills Lab, and the Center has a critical role in teaching and practicing the procedures needed to safely treat the coronavirus. We have reviewed the role of the MediSkills Lab in this extraordinary situation with the director of the Center, dr. Szilárd Rendeki.

 

Written by Miklós Stemler

 

The UP Medical School Medical Simulation Education Center has a long history, and as far as I know, the tools and methods used here are considered very modern in international comparison as well. Let us talk briefly about the MediSkillsLab itself!

In 2012, the implementation of the Medical Simulation Education Center started with the support of the School and students, and then we managed to create a facility with truly modern equipment through the cooperation of the three rural medical faculties and the efficient use of available tender resources. MediSkillsLab is in a special position because we do not to perform educational tasks as an independent discipline, but we provide state-of-the-art tools and background for the acquisition of manual activities and skills in different clinical disciplines, which meet the needs of a simulation education system in international comparison as well. The instructor colleagues are delegated by the parent institutes, the educational topics follow the curriculum of the institutes.

In the middle of March, the entire School had to switch very quickly to digital education, which was facilitated by years of large-scale digital curriculum development at the School, and the epidemiological situation essentially accelerated this. What is the role of the MediSkills Lab, which is based on practical education and more precisely which makes practical education more effective, in this situation?

All this has undoubtedly created a special situation because this part of medicine is quite difficult to teach online. In addition, previously we also placed emphasis on creating a variety of illustrative materials, we had large raw video and photo documentation. These have come in very handy in the development of digital learning materials, our online video teaching materials showing important manual interventions in health emergencies only needed to be refined, and we could immediately use these to conduct professional trainings, which were shortened due to the epidemic, making it easier to prepare our colleagues participating in the courses. The center was up to date with the production of visual and video materials needed for online education in order for the introduction of the new educational order. We continue to develop and update our previous online teaching materials, and, using the equipment available to us, we prepare professional materials that also present complex multidisciplinary care protocols.

How can the Medical Simulation Education Center work in this situation?

Education continues in the current epidemiological situation as well. This now mainly covers postgraduate trainings, which on the one hand means task-oriented education of young colleagues in acute care. In accordance with the epidemiological regulations and the national procedure on health policy, we perform the demonstration and implementation of airway securement and basic intensive therapy tasks in the prescribed protective equipment and the implementation of invasive interventions in difficult working conditions with adequate patient and healthcare worker safety. All these require different protocols, and in recent months a lot of international experience has been gathered in this area. At our center, it is possible to practice working in different types of protective equipment, the use of which is not easy even for experienced professionals.

Due to the state of emergency, there was suddenly a particularly high demand for certain medical professions, such as anaesthesiologists and intensive therapy specialists. Of course, the training of specialists is not a short process, but through the MediSkills Lab and the available simulation tools and visual learning materials, we are able to help young colleagues sent to us from other professions to change their professional perspectives. In addition, while the need for doctors in the fields of anaesthesiology and intensive therapy has suddenly increased, in other medical professions this need has not decreased either, and because of the colleagues temporarily away, there are more tasks to be performed manually for those who are still working in their original jobs, and in order to practice and revive these, small group trainings are continuous.

We are well aware based on examples from abroad that the work of healthcare workers has special risks at the moment, and the sudden overload of the system has caused enormous problems in developed countries as well. Can these trainings help with this?

Fortunately, we had enough time to learn from the international events, and we also gained valuable professional experience right at the beginning of the epidemic from our colleagues working abroad. This way, we were able to prepare and provide a “Covid-hazardous” environment for the practices, both organizationally and on the asset level. In more than one case, this required the learning of the use of completely new protective equipment. An example is the "plexiglass box", which can be used to secure the airways while reducing the risk of infection. Although I also do regular airway securement during my daily work, the task was not easy to complete. But I could also mention the protective clothing, we had to learn how to move in these, not to mention such details that by using protective goggles, our own glasses and the face shield, the fields of vision can become completely different. In short, we had plenty of work in recent months, perhaps even more than we had expected.

Did only doctors from Pécs participate in these trainings?

Personally yes, but we also have an extremely good professional relationship with several teaching hospitals and they also used the materials we have developed. The national network of simulation centers is working well in this field, a very fruitful collaboration has developed, everyone was happy to share and use these materials willingly, i.e. the online cooperation was especially successful. One could say everything was in the right place at the right time.

Due to the extraordinary situation, older colleagues also had to attend these trainings, how did they respond to these modern solutions and methods?

Although we do rely on state-of-the-art methods and possibilities in simulation education, this has always been an integral part of medical education – it is based on when the old master shows the young apprentice what to do. Taking advantage of and acquiring the rapidly changing digital possibilities requires technical staff who operate these devices so that physicians practicing on them only have to focus on using them. Older colleagues enjoy this a lot as well, they are very receptive, for example, to the fact that newer tools are able to track the development of individual users, and this also encourages them to move forward.

In the short term, we certainly need to live with the limitations caused by the coronavirus and the current situation is also a good example of how quickly such an extraordinary situation can arise. To what extent will current experience be used in the long run in either education or health care?

Through one of our tenders, we are planning a huge simulation education center with a floor area of ​​1600 square meters, which will be able to increase patient safety and improve medical and specialist training in all practicing medical professions through the knowledge and manual skills that can be acquired here. We can now embark on this development with a lot of new experience, we will already have our trodden roads and paths. There have always been and will always be pandemics, even if there has not been such a strong pandemic like the coronavirus for some time. We are also much ahead in preparing for these, as we have developed the necessary procedures and we have the necessary tools and teaching materials to learn how to use them.

We have gained a lot of international experience and practice, and to that we have added our own as well, we have developed, improved these tools and their use further. Now we are in the licensing and standardization phase so that we can be more prepared to similar emergencies, which are not epidemics only, but any kind of crisis. In addition to the many adverse effects of the epidemic, the up-to-datedness and standardization of online curriculum is a particularly beneficial thing, and I am confident that students have also welcomed the changes. Overall, I expect an increase in the effectiveness of medical education. No one wished for this current situation but due to the work of the past years, we were able to receive it with preparedness and learn a lot from it.