OPENING ADDRESS BY DR JANIL PUTHUCHEARY, SENIOR MINISTER OF STATE, MINISTRY OF HEALTH, AT THE S3 CONFERENCE 2022

Good afternoon.

1.      It is my real pleasure to join you at the third S3 Conference.

Importance of Simulation Training in Healthcare

2.       Medical simulation has been instrumental in transforming the way clinical skills training is conducted. It exposes healthcare professionals and healthcare students to real-life scenarios in a safe and supervised setting, and it develops their clinical decision-making skills and competence in performing procedures. Ultimately, this builds their confidence in managing similar scenarios in actual practice. We know this improves outcomes in patient care. This is why simulation training is now increasingly well-received, increasingly adopted and implemented in a variety of healthcare education settings, not just here in Singapore, but globally.

Recent Applications of Simulations in Healthcare Training

3.       I personally have benefitted from simulation training, both undergraduate and postgraduate. I suspect nothing like the Fidelity with the devices that you are discussing and displaying over your conference. But I subsequently as a medical educator also benefitted from the availability of these tools to have my students, my trainees, think through far more complicated scenarios than would otherwise be available. It gives me great satisfaction to see how healthcare simulation has continued to improve by leaps and bounds. The use of Augmented and Mixed Reality, broadening the application of simulation in healthcare training. The use of this technology, allowing our learners to visualise, to interact with the material to hone their clinical skills in a realistic environment.

4.       At the same time, a parallel set of technologies around 3D segmentation and printing have facilitated the simulated learning experience. This was especially helpful during the COVID-19. There was a scarcity of cadavers – the usual source of anatomical material for us to think through some of these complicated 3D relationships. To overcome this challenge and to enhance simulation training, we developed patient-specific, 3D printed anatomical models, allowing a variety of training environments, but also a simulation of procedures prior to its implementation in the real patient, having surgeons rehearsing complex and uncommon surgical procedures prior to doing it in that patient.

5.       Simulations were also particularly useful during the pandemic when physical training and overseas travel were curtailed. Many of you would be familiar with the Advanced Cardiac Life Support (ACLS) Certification workshop. We had to then increase the amount of simulation used in our ACLS procedures and processes to replace the face-to-face lectures that we previously assumed that we could not substitute. This shift to online training has allowed critical training programmes, such as  ACLS, which we know we have to maintain our certification on a regular basis, allow these critical training programmes to continue. This has benefitted healthcare professionals from across our healthcare institutions. But not just our healthcare professionals. Personnel from our Singapore Armed Forces and Singapore Civil Defence Force, will also benefit from these kind of approaches. We have been able to extend this training through virtual workshops to colleagues and participants from around the ASEAN region.

6.       As we do this, in tandem with the progress made in simulated medical training from around the world, we have to ensure that our healthcare community here in Singapore can understand those benefits, learn from the best in the world and bring those practices and skills to our healthcare community here. We have incorporated medical simulation into our local education curriculum for medical students and we have established multiple dedicated simulation centres.

7.       More recently, in January 2022, SingHealth launched the SIMS i3 Hub and has seen an encouraging uptake in the use of simulation technologies such as Augmented Reality, Mixed Reality, Virtual Reality and serious games by clinical educators. These technologies have become essential tools for enhancing the knowledge of healthcare professionals by allowing the replication of high risks situations in a risk-free environment. The SIM i3 Hub is expected to benefit more than 2,000 learners by the end of this year.

Developing the Capabilities of Educators in the Field of Healthcare Simulation

8.       We can have all the technology that companies, manufacturers, our own engineers can develop. We can have all these cutting-edge tools that we can dream up or we can programme or code. But ultimately it comes down to the training professional who is the educational professional who is using these tools. A good education professional is someone who has experienced the training, can make pieces of plastic and posters come alive in a simulated environment. Now, an unskilled educator, perhaps not so familiar, can make a very sophisticated simulation mannequin move due to the software but a very difficult learning experience for our students. It comes down to that professional having the skills in education, having the experience in training, having the approach to the learners, to then make use of the technology that is available. We have to equip our educators with the necessary knowledge and skills for them to fully harness the potential of this growing field. We’ve had a pilot run of the SIMS Fellowship Programme conducted at Sengkang General Hospital in June 2022. This programme aims to develop healthcare educators into competent simulation educators or simulation specialists who are well-versed with the operation and delivery of simulation-based education. There are plans to offer this Fellowship Programme to a wider audience, both locally and internationally, in the near future.

Closing

9.       The future will have simulation as part of healthcare education. It’s the used case. We no longer have to argue. I do remember that when I was involved in setting up of the simulation centre at KK Hospital. Now, part of the argument was, was this the right way to go? I think a combination of de-risking our patients, de-risking the exposure for our learners and more recently, we experienced through the pandemic, we now fully accept that some certain circumstances, you have to substitute with an online tool, software tool, simulated tool, to prep and to practise, to become familiar with the situation before going on into the real-world environment. So this approach for simulation training is here to stay. We don’t have to make that argument anymore. Now, we have to concentrate on how to make this set of tools work best for the outcomes that we are trying to deliver around healthcare education and ultimately translate that into patient outcomes. Conferences like today’s S3 Conference, is where we can bring together partnerships, collaborations, learn from the best in the world, develop new platforms for research and collaboration to take this exciting field of healthcare simulation training forward. I wish the organising committee a successful conference. Well done on getting this going so soon after the pandemic. I hope everyone attending will have a fruitful learning journey, productive discussions, and a lot of exciting simulations to try out over the next few days. Thank you very much.