Surgery simulation centre opened at Mater Dei

The Mater Dei Hospital simulation centre was officially opened today for trainee anaesthesiologists to be monitored whilst they perform simulated administration of anaesthesia during mock surgical procedures on a fully responsive mannequin before performing real procedures on real patients. 

Chairman of the Department of Anaesthesiology, Joseph Zarb Adami said this was the perfect way to train doctors. "Just as a pilot cannot be trained to land a plane without wheels without the use of a simulation programme, doctors now have a way to practice before attempting the real thing. This technology will help improve performance and fills the gap in teaching ability”.

Zarb Adami said that the operating theatre being used for MDH simulations is fully functional and has only ever been used once before the introduction of the new technology to see that it works.

A mannequin was laid out on the operating theatre and was connected to a computer system which controlled everything from its breathing to reactions to administered medicines all the way to eyelid flutters.

The doctor in charge of the project and control room, Stephen Sciberras, explained that the whole theatre and mannequin were hooked up to four computers, to control the mannequin, monitor what was being done by trainee anaesthesiologists and two computers to record all events audio-visually.

Health Minister Joe Cassar said Malta had to provide the same services found abroad in just one centre. Cassar said the health ministry was invested in the future of the doctors to be trained in Malta and that €140,000 was invested in the simulation mannequin and programmes for this reason.

The centre was first used in July 2011 after all the equipment was delivered in February. Each computer programme used to simulate real life events during an operation costs around €5,000. 

As part of the programme, all doctors have a yearlong attachment with a hospital abroad for further training. Funds are only available to train four people each time and these have to be chosen from 30 applicants.

“Young doctors trained in Malta are going abroad and we have found that many are exceeding their foreign counterparts. This is a double-edge sword since we do tend to lose our doctors to other countries. However, we are just as proud of these because we helped them become some of the best,” Cassar said.

Zarb Adami said training sessions in the operating theatre take place once a month, which is more often than in centres abroad but added that the theatre can be used for real operations if there were no other theatres available.

A simulation was performed by trainee anaesthesiologists and recovered the ‘patient’ who was going blue from low oxygen intake and blood pressure as a result of a reaction to antibiotics administered at the beginning of the mock surgery.

The mannequin’s actions and reactions were all controlled by Sciberras who was in the control room monitoring everything being done by the trainees.

An observation room allows junior trainees to observe their colleagues and write comments based on footage transmitted from within the operating theatre. The entire session is then reviewed and assessed by the trainers.

There are 72 anaesthesiologists currently working within the department and 30 of these are foreign doctors. Anaesthesiologists have been trained in Malta since 1982 and over the past eight years, 24 doctors were trained and 20 trainees are now in the programme.