The Scope of Simulation-based Healthcare Education

Abstract

S imulation-based healthcare education has expanded tremendously over the past few years, as witnessed by the creation and growth of the Society for Simulation in Healthcare and its journal. These developments represent a turning point at which simulation is no longer seen as a novelty whose existence needs to be justified or defended by a few staunch believers. We can now move beyond reporting on the potential role of simulation or how it compares to other more traditional (yet often unproven) methods of training, and focus instead on the most effective use of simulation for healthcare education.From the perspective of the training program, the effective use of simulation may be seen as the product of three components ( Fig. 1): training resources, trained educators, and curricular institutionalization. It is important to note that if any of these components are missing or deficient, the product will become zero and effective training will not occur. For example, it is not rare for an institution to obtain a simulator only to see it collect dust because faculty members were not properly trained in its operation or did not know how to introduce it into the curriculum. These components include the following. Training ResourcesThis component refers to having appropriate simulators, task trainers, standardized patients, and computer software that meet a program's needs. In addition, it includes having the necessary physical space and associated equipment (eg, monitors, beds, cameras, microphones, recording and playback equipment) for simulation-based training. It also encompasses the associated curriculum (eg, crisis resource management, 1 advanced life support, laparoscopic surgery), outcome measures (eg, checklists, rating forms), learning strategies (eg, experiential learning, deliberate practice 2 ), and curriculum management systems (to schedule and track learners' time and performance). Trained EducatorsThis component includes healthcare professionals trained in the proper use of simulation-based medical education. It also includes individuals involved in the operation, management, and administration of simulation-based training, as well as researchers dedicated to advancing the field. Curricular InstitutionalizationThis component includes elements necessary for full adoption and integration of simulation-based medical education into an institution's mission and culture. It involves the decision of an institution to fully embrace its goal of improving patient care and patient safety through reducing and preventing medical errors, as well as more individual goals of improving a wide range of competencies (eg, acute care skills, surgical skills, crisis resource management, teamwork, and communication).During the past four decades of simulation use in healthcare, the literature has focused almost entirely on the first component of training resources. To illustrate, a recent systematic review of the literature on high-fidelity simulation identified 10 features that led to effective learning (Table 1). 3 Nine out o...

As time goes by: Stakeholder opinions on the implementation and use of a virtual patient simulation system

“…Even though, a few years ago, effective training in simulation was postulated to be ''the product of training resources, trained educators and curricular institutionalization'' (Issenberg 2006), staff development in simulation has hardly been discussed (Steinert et al 2006;Haag et al 2007;McLaughlin et al 2008). The need for resident training in simulation-based education was recently identified (McLaughlin et al 2008).…”

The TACTIC: development and validation of the Tool for Assessing Chest Tube Insertion Competency

“…13,14 Others have demonstrated that simulated experiences are useful adjuncts to fill training gaps. [6][7][8][15][16][17] More evidence is available to suggest that simulated experiences increase procedural knowledge, skill, and behaviours and may improve patient outcomes. The educational intervention, which included both screen-based learning and hands-on learning with feedback, was carefully designed to include several important instructional design features for simulation.…”

“…[5][6][7][8][9][10] Although various different chest tube insertion task trainers exist, there is no objective and validated scoring system in the literature to assess chest tube insertion competency. Such a tool could be used to assess a practitioner's skill, identify areas for improvement, or rate on a scale for high-stakes assessment (either in the simulated or real environment).…”

Twelve Tips for Utilizing Virtual Patients to Teach Professionalism

“…Virtual patient is an educational tool which should be used as part of a larger "professionalism curriculum" (Edelbring et al, 2012;Ellaway et al, 2015;Howendiuk et al, 2013;Huang et al, 2007;Issenberg, 2006). Virtual cases alone will not suffice to teach professionalism; multiple strategies and learning approaches which address Murphy S, Imam B, Whitehouse L MedEdPublish https://doi.org/10.15694/mep.2016.000107 Page | 3 different learning styles and different contextual needs should be incorporated into the professionalism curriculum, as individual learning styles can affect the efficacy of virtual patients as a learning tool (Cook & Triola, 2009).…”

“…Virtual patients are "a specific type of computer program that simulates real-life clinical scenarios; learners emulate the roles of health care providers to obtain medical history, conduct a physical exam, and make diagnostic and therapeutic decisions" (AAMC, 2007).Virtual patients are increasingly used in health professions education (Cook & Triola, 2009;Ellawayet al,2009;Poulton & Balasubramaniam, 2011).The benefits of using virtual patients appear similar to those from other forms of simulation in medical education (Ellawayet al,2015); while virtual patients may be costly and resource-intensive to produce (AAMC, 2007;Cendan & Lok, 2012;Ellawayet al,2015;Huang et al, 2007), they provide a flexible and accessible learning tool with opportunities for repetitive practice without putting actual patients at risk (AAMC, 2007;Issenberg, 2006). To be an effective educational tool, virtual patients need to be used judiciously (Edelbring et al, 2012;Ellaway et al, 2015;Huang et al,2007;Huwendiek et al, 2013;Issenberg, 2005).…”