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BEEP BEEP BEEEEEEEEEEEEEEEEP – a potentially disastrous sound in real life for a doctor, but not for this one – she is playing a game as part of her medical training.

These days, technology such as simulations and games has made it possible for medical students to practise in realistic settings, where the challenges are life-like but the environments are safe and controlled. Thanks to such technology, students can train repeatedly in simulated scenarios until they become more confident in what they do and gain mastery over their skills.

Professor Fatimah Lateef, Director of SingHealth Duke-NUS Institute of Medical Simulation (SIMS), said, “Technology can inculcate better decision-making in our practitioners, to stimulate greater clinical reasoning in a systematic manner. It also enables them to learn in a customised manner, since learning can be done anywhere, anytime and on any platform.”

There are many types of technology that SingHealth currently use in preparing the next generation of doctors and nurses. Simulations and games, in particular, are of great interest due to the immense potential of their capabilities.

Simulations are already being used rigorously in other industries. Pilots train heavily on flight simulations before doing any actual flying. Members of the Armed Forces play war games on simulation to learn about strategy.  In a similar vein, our doctors and nurses can train at the SingHealth Duke-NUS Institute of Medical Simulation (SIMS), one of Singapore’s largest simulation facilities. The institute is equipped with a comprehensive range of simulation modalities, cutting edge technology and training programmes for healthcare professionals to sharpen their clinical skills.

Simulations are a good way for medical students to establish basic techniques and broaden the breadth and depth of their experience. Students merely have to step into a simulated operating theatre, where they can practise on computerised manikins which replicate the symptoms and distress of real patients, simulating emergency situations.

Simulations can also be used to serve and nurture professional learners at all levels. It provides training support for individuals as well as teams in very basic to highly complex and specialized areas.

Fans of computer games can rejoice, since specially-designed games will now be a part of the training of doctors and nurses in SingHealth. The use of such games and their developments were discussed at the recently held Serious Games Conference 2018, which was co-organised by Serious Games Association (SGA), SIMS, the SingHealth Duke-NUS Institute for Patient Safety and Quality (IPSQ), and the Lifelong Learning Institute (LLI).

At the conference, Dr Mary Dankbaar, Chair of the Dutch Society for Simulation in Healthcare (DSSH) Commission on Serious Games, shared an example of an online simulation game that requires players to take on the role of doctors and nurses to resuscitate critically ill patients. The game is set in a virtual emergency department, and the student must make the right choices in a timely manner in order to save the patients.

In this game, medical students will learn how their choices affect the condition of the patient, as well as how to make good decisions under stressful conditions. The greatest advantage is that they can learn all these without having to deal with costly consequences that would result from their mistakes, if it were a real-life emergency.

What lies in the future?
Games and simulations will become an even bigger part of the training of medical and nursing students. So, it is more important than ever for these games to adhere to certain standards and technical requirements.

To promote a more widespread adoption of games for use in training, the Serious Games Evaluation Framework was launched at the Serious Games Conference. It was also announced that the first Serious Games Accreditation Centre will be opened in 2019 at Temasek Polytechnic. This centre, together with the Evaluation Framework, will function to provide a more standardised mode of assessment and data protection for games.

As technology progresses at hyper speed, the measure for the standards of medical excellence is being redefined by the day. After all, as Prof Lateef said, “The potential of technology is tremendous, and its possibilities are limitless. It is only up to our imagination to see how far we really want to go!”