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Virtual reality simulations in the medical profession

WBUR ran a story yesterday morning on the use of virtual reality software/hardware to train surgeons. See Simulating Surgery (RealMedia format). The story describes various efforts to institute practical, hands-on, but simulated training for operations that would otherwise be possible only in actual, life-threatening situations. Because surgery is a kinetic skill, the simulations necessarily involve a combination of software and hardware, although more and more of it is moving into the software side with virtual reality technology.

A couple of observations from this report could be valuable when thinking about legal education:

  1. First is the fact that, because of the cutting-edge hardware/software requirements of simulation, these training modules are expensive. A comparable simulation for lawyers would be an order of magnitude cheaper. Yet the medical profession utilizes far more simulations than the legal profession. Why is that? Is it that medical skills are much more “trainable” than legal skills? That the consequences of error (financial and moral) much higher in medicine? Or just different histories or attitudes about education?
  2. Attaching institutional consequences to training is helpful. At Beth Israel, surgeons must prove their skills in simulation before working on real patients. In Massachusetts, doctors get a discount on their malpractice insurance if they train through simulations, just as drivers get discounts on car insurance for driver’s ed courses.
  3. The trainings don’t just focus on the kinetic, “hard” skills but also on such factors as decision-making, communication, teamwork, and even ethics. The learning doesn’t just happen on one dimension.

Point one notwithstanding, as Jeff Cooper, Co-Director of the Center for Medical Simulation noted: “We still have just scratched the surface — the penetration is still on the order of just a few percent becuase the educational model is based on apprenticeship so people now learn while they [are] actually performing work.” The legal profession is in a very similar place, and I think there is great promise to show managing attorneys that apprenticeship needn’t be the only way to train their younger associates.

Simulation Group, Center for Integrative Medicine & Technology
Center for Medical Simulation, Harvard Medical School

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