Michael A. Ricci, MD is Clinical Director of Simulation and a vascular surgeon at the UVM Medical Center.

Would any of us get on a commercial airliner if we knew the pilots had never set foot in a flight simulator?  It seems we all know that is the way pilots train and stay current.  But what’s the big deal?  All we want them to do is fly straight and level and land on time so we don’t miss our connection – that can’t be too hard for a trained pilot.

But that is not what happens in flight simulators.  Pilots practice EPs – emergency procedures – during simulation.  That’s the kind of stuff we don’t want to happen and fortunately rarely does. However, sometimes it does.  And when it does, we want to know our pilot knows what to do.

On January 15, 2009, US Airways Flight 1549, on takeoff from LaGuardia Airport in New York, struck a flock of Canada geese shortly after takeoff and lost both engines.  (This is a great video recreation worth looking at).  The pilot ditched (landed on water) the Airbus A320 in the Hudson and all 155 passengers and crew on board survived; a remarkable achievement.  He credited part of his success to having practiced the procedure in a flight simulator.

Okay, so what does this have to do with medicine?    The first time I did an EP on a patient was, well, more likely than not, the first time I did the EP.  Maybe I had some help around to guide me.  So, as long as I had perhaps seen the EP or read and memorized it, we should be okay (to my knowledge, I did not harm anyone I cared for during training).  Having accumulated a few gray hairs, you should understand my medical training occurred at a different time.

Today’s health care trainees, thankfully, learn under different circumstances.  First, we have come to learn that working 24 hours straight without rest is not good for learner or patient.  Second, we know that adult learners do better doing rather than listening.  Okay, we haven’t given up the ubiquitous PowerPoint® presentations yet, but we do have the new Clinical Simulation Laboratory.  Here, learners of all levels and disciplines get to practice in a safe environment.  It is okay to make a mistake during an EP in the simulation laboratory because no one gets hurt and, in fact, that mistake probably won’t be repeated when it counts for real.

And here’s the fun part: “like” the UVM Medical Center on Facebook and enter to win our “Doc for a Day” event, and you might just get the chance to come and practice some EPs in our Clinical Simulation Laboratory.  But sorry, no Airbus A320 simulators – just humans.

Michael A. Ricci, MD is Clinical Director of Simulation and a vascular surgeon at the UVM Medical Center.

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