Benefits of simulation
Four key drivers for the widespread introduction of simulation are:
- Public expectation and patient safety. The public not only expect health professionals to engage in appropriate skills and simulator training, but they often believe that professions already do.
- Changes in working practice. The development of new professional roles, the growth of large and complex working environments, the move to more integrated service models and the rapid pace of modern healthcare require health (and other) professionals to develop effective leadership, teamworking and communication skills. Simulation has been at the forefront of the development (and assessment) of these skills.
- Technological developments and opportunities. The technology available to support simulator training has progressed rapidly in recent years. Evidence exists that the educational value of simulators depends on learner engagement rather than the cost of the equipment.
- Service pressures and reduced training time. The impact of service pressures, shorter hospital stays, the shift of care into community-based services and (in the EU) the European Working Time Directive have resulted in a reduction in the time available for clinical training in the workplace. To make the best possible use of available time in the clinical setting, learners must have prepared effectively away from the workplace.
The use of simulation in health professions education has been shown to have benefits for learners, for development of clinical practice and practical (technical) skills, for patients and for health systems (Riley et al., 2003). As well as facilitating the acquisition of routine skills, simulation also allows safe (for the learner and the patient) exposure to rare diseases/conditions, critical incidents, near misses and crisis situations. Reflecting the experience of the airline, nuclear and other high risk industries, evidence is accumulating that patient safety standards and non-technical skills (communication, leadership, etc.) improve following simulator training (McGaghie et al., 2010).
Østergaard and Rosenberg (2013) give the rationale, pedagogical and safety advantages of using simulation-based training as follows:
The simulation setting:
- provides a safe environment
- for learners without risk of harming the patient
- that is fully attentive to learners’ needs
- for training individuals and multi-professional teams
- can be adjusted according to learners’ needs
- enables exposure to
- gradually more complex clinical challenges
- rare emergency situations where time is an important factor
- provides an opportunity for
- experiential learning
- repetitive training, deliberate practice
- individualised, tailored learning
- formative assessment, debriefing and feedback
- stimulating reflection
- learning how to learn
- summative assessment.