The use of simulation for training teamwork skills in health care: how low can you go?

Abstract

High fidelity simulation has become a popular technique for training teamwork skills in high risk industries such as aviation, health care, and nuclear power production. Simulation is a powerful training tool because it allows the trainer to systematically control the schedule of practice, presentation of feedback, and introduction (or suppression) of environmental distractions within a safe, controlled learning environment. Unfortunately, many within the training community have begun to use the terms simulation and high fidelity simulation almost synonymously. This is unfortunate because doing so overemphasises the instructional technology to the detriment of more substantive issues, such as the training's goals, content, and design. It also perpetuates several myths: simulation fidelity is unidimensional, or higher levels of simulation fidelity lead to increased training effectiveness. The authors propose a typology of simulation fidelity and provide examples of how the different classes of simulation have been successfully used to train teamwork skills in high risk industries. Guidelines are also provided to maximise the usefulness of simulation for training teamwork skills in health care.

Teamwork training with nursing and medical students: does the method matter? Results of an interinstitutional, interdisciplinary collaboration

“…Beaubien and Baker15 have identified three principal-components of simulation fidelity: equipment, environment and psychological fidelity. They argue that the most applicable component of teamwork training, psychological fidelity, can be achieved in low-technology simulation environments 15 16.…”

Team Training of Inter-Professional Students (TTIPS) for improving teamwork

“…High-fidelity SBT provides a safe learning environment in which students can learn from ‘mistakes’ without repercussions 10. It draws on Kolb’s theory of experiential learning11 to allow learners to (1) undergo a concrete experience via a simulated clinical scenario, (2) reflect on that experience in the postaction debriefing, (3) draw abstract lessons as a result of the reflective debriefing and (4) apply the knowledge, skills and attitudes (KSAs) learnt to actual clinical practice.…”

Patient-actor perception of care: a comparison of obstetric emergency training using manikins and patient-actors

“…Scoring systems have previously been described measuring patient-actor perception or satisfaction during simulated medical scenarios 22 – 24. However, they were not translatable to this study, as they were developed to assess non-acute patient–staff interaction—for example, catheterisation,23 suturing23 or outpatient consultations24 25—rather than emergency situations.…”