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...
