Doctors should practise on dummies, not people, says medical chief

LONDON - Surgery in Britain's hospitals was unnecessarily risky because doctors were having to hone their skills on real patients instead of practising on plastic dummies, the British Government's Chief Medical Officer was to say today.

Sir Liam Donaldson says patients are being exposed to harm because there are too few simulators for doctors to learn on.

Airline pilots are challenged every six months in simulators on their responses to emergencies but surgeons may spend entire careers without facing an equivalent test.

Airline passengers have a one in 10 million chance of dying in an accident; a hospital patient has a one in 300 chance of dying or being seriously harmed. Donaldson planned to call for greater investment in mannequins, and establishment of a national centre for simulation techniques.

In his annual report, he was to say surgical safety had fallen a long way below airline safety because of lack of regular testing. "Medical training is often caricatured in the phrase, 'See one, do one, teach one'. How much better if, before you do a gall bladder operation, you have already done 100 in a simulator," Donaldson said.

Patient Elaine Bromley died during a minor operation in 2005 after anaesthetists were unable to place a breathing tube down her throat.

Instead of puncturing her throat through the neck in a tracheostomy, the doctors panicked and struggled for 20 minutes to insert the tube. She suffered irreversible brain damage.

Donaldson compared her death with the survival of the 155 airline passengers whose plane was successfully landed on the Hudson River this year after both engines failed.

"The captain [was] calm and collected because he had rehearsed emergency landings in simulators many, many times before."

Research shows surgeons trained on simulators are twice as fast and twice as accurate as those who have not been.

DUMMY RUNS

* 20 sophisticated simulators for 12,000 surgeons and 47,000 doctors in training.
* 14 simulators used by British Airways to train 3200 pilots.

- INDEPENDENT