Simulation in Health Professions Education
Patient simulation in all its forms is widely used to help prepare health professionals for working with patients and colleagues with the key aims of improving learners’ competence and confidence, improving patient safety and reducing errors. Understanding its benefits, range of uses and limitations can help teachers improve the learning experience.
This module discusses how simulation can be used in health professions education to develop and improve practical and team resource management skills and introduces the most common uses of simulation in clinical education settings.
Simulations are used as a dress rehearsal to a real event where mistakes can be made and lessons learned, but no one comes to harm. Simulations include activities such as role play or teamworking tasks, use of manikins for life support training and the use of computer-based simulators, e.g. anaesthetics or birthing simulators. People from many occupations (including athletes, actors and pilots) routinely use simulation as part of their training. In these professions, in common with healthcare, people have to perform skills in what are often high pressure situations. The first recorded use of a medical simulator is that of a manikin created in the 17th century by a Dr Gregoire of Paris (Buck, 1991). He used a pelvis with skin stretched across it to simulate an abdomen, and with the help of a dead foetus explained assisted and complicated deliveries to midwives.
In spite of this early start, simulators did not gain widespread use in the following centuries, principally for reasons of cost, reluctance to adopt new teaching methods, and scepticism that what was learned from a simulator could be transferred to the actual practice. All these reasons are still relevant today, but the combination of increased awareness of patient safety, improved technology and increased pressures on educators have promoted simulation as one option to address problems with traditional clinical skills teaching. Simulation has moved from the province of a few enthusiasts to a mainstream learning modality. As the American anaesthetist, Gaba comments:
‘No industry in which human lives depend on the skilled performance of responsible operators has waited for unequivocal proof of the benefit of simulation before embracing it.’ (1992).
Most students and practitioners will be trained and assessed using some form of simulation, and the use of clinical skills and simulation is now seen as routine in health professions education. Advances in technology have led to very lifelike simulators for patients, surgery procedures and full-scale mock-ups of wards, theatres, delivery suites, ambulances and emergency departments. Many include software so that the simulator’s reactions depend on learners’ actions. There are many advantages to simulator training. The most obvious is that learners can practise as often as they like and whenever they want (within reason) without harming a patient.
Before you start
Before you start the module, we recommend that you spend a few minutes thinking about the following points and noting down some of your thoughts. If you are registered on the site, you can do this in the ‘reflections area’. Click on the ‘my area’ link at the top of the page to access your personal pages. Please note that you must be logged in to do this. Please also note that you will need to contribute to the ‘reflections area’ in order to complete and print out your certificate.
In your own role as a teacher, how do you use simulation?