In part 3 of our interview with Lars Konge, the head of research at CAMES (Copenhagen Academy for Medical Education and Simulation) we talk about the successful CAMES simulation masterclasses and the problems of training during Covid-19.

Can you tell us about the CAMES simulation masterclasses?
When I set up this technical skills training center, I looked to other countries to see whether they could help. Most of the simulation centers I visited were very focused on traditional team-based simulation and I found that VR simulators for advanced technical skills training were put to one side.

So, there wasn’t a good place for guidance 10 years ago. So, I started to invent a lot of this stuff myself, making lots of mistakes, reading books and papers, and publishing a couple of hundred papers around simulation. I felt that I had started to crack the code on how to do this stuff in an evidence-based way and people started to notice.

I had more and more requests for people wanting to visit but it took up too much time. So instead of doing smaller visits, we decided to do a yearly, full week, intensive class, gathering a limited number of people. And we would invite all our experts and show all the stuff we had developed with engineers and surgeons.

I thought it was just hands-on training, but it’s more of a how-to-program in setting up a simulation center?
Yes. The target audience is for trainers not trainees. A course for people who are interested in simulation and want to improve their knowledge and skills on how to use simulation. For people who want to take their simulation center to the next level and start doing simulation-based research, add to the simulation community and share knowledge. It is a great opportunity to keep in contact with these simulation leaders from across the world.

Sounds fantastic. It does feel that simulators are not used to their full capacity, there is so much more you can do.
I have solid evidence that you need protected time and integration of simulation into the curriculum. Just putting a simulator in the corner will not give its full potential, we have evidence showing that you need to practice towards a target.

I see so many one-day courses where trainees practice for four hours, have some lectures in the morning and then practice a bit more and then everybody goes home! Even though we have so much evidence showing that not all trainees learn at the same pace and that demanding an end exam will improve retention and make training much more efficient.

Do the masterclasses lead to studies and research within different simulation groups and centers?

Before COVID we had specific plans for a world-wide PhD, where we would automate a collection of simulation-based data and set up the biggest simulator study by far in the world and we were supposed to start publishing our first studies together with researchers from China.

And instead, the study is now a needs assessment that looks into what kind of training doctors and nurses need to have to tackle the pandemic. It’s good that we can still do research together, but I would much rather do research on something else than Covid-19.

Obviously Covid-19 has had a massive impact on your surgical training, and I imagine it’s going to take a while for things to get back to normal.
In the beginning, our all training was closed. And after two days, we could open our simulation center again and do a structured training of doctors and nurses who needed to go in on Covid duty.

So after two months where we were only allowed to do Covid-19 related training our government figured out that the training of doctors practicing real life was so important that we had to open that again, that we were allowed to open our simulation center.

So now we are open, but of course still plagued by the lack of human resources that comes as a natural course of a pandemic.

Most elective surgeries in England are not happening. So, in terms of the training, it’s difficult to train on patients right now. So, a good opportunity for VR simulation training.
Yes. I talked with a famous eye doctor from Morefield Eye hospital in the UK, where they have many trainees in cataract surgery training, not having practiced for six months and they are doing a simulation-based, retraining program, where they have to go to the simulators to be retrained before they can go back into the normal training program. So yes a good time for simulation training.


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