Abstract
Simulation education is used in a variety of health professions for training and continuing education. To accomplish this, instructors must identify learning objectives and suitable equipment and locations for simulation training. In addition, simulation educators may develop or adapt simulation scenarios to meet these objectives. Manikin-based simulation is the use of dolls or humanoid figures called manikins (mannequins) to practice procedures that would typically be performed on a human patient. This chapter describes the types of manikin-based simulation—low-fidelity and high-fidelity manikins—and explores various use-cases for manikin-based simulation in healthcare. Finally, this chapter outlines the approach to basic simulation scenario development for manikin-based simulation.
TopBackground
Manikins come in various sizes with varying features to represent adult, juvenile and even newborn patients. The manikin’s appearance can be customized by the manufacturer with different skin colors and tones which are then matched to the appropriate patient characteristics in the scenario. In addition, the manikin must be dressed appropriately for the case to create a sense of realism for the learner. For example, the manikin is dressed in a hospital gown and placed on a hospital bed for a hospital-based scenario or in street attire on a stretcher for a trauma or emergency room scenario.
Manikins are equipped with a range of features that include the ability to portray realistic vital signs and physiologic responses and to allow learners to perform procedures such as obtaining vascular access or performing chest tube placement. Ultrasound simulators have been used for training in ultrasound techniques (Tolsgaard et al., 2015). Birthing simulators have the appearance of female pregnant manikins and can be used to conduct obstetrical procedures and delivery of newborns. Surgical manikins are used to perform various types of surgical and trauma procedures (C. H. Evans & Schenarts, 2016; Naur, Nilsson, Pietersen, Clementsen, & Konge, 2017; See, Chui, Chan, Wong, & Chan, 2016; Valdis, Chu, Schlachta, & Kiaii, 2016).
In the context of a simulation scenario, manikins can be broadly arranged into two categories: low-fidelity simulators and high-fidelity simulators. The distinction between the two types of simulators is based on the degree to which they can represent vital signs and clinical features like heart and lung sounds. High-fidelity simulators typically have considerable technological components, such as physiology engines, in addition to other features, such as Bluetooth wireless communication to vital sign monitors and control devices (Hunziker et al., 2010; Wetzel, Lang, Pendergrass, Taylor, & Geis, 2013). However, the presence of technology is not necessary in order for the learner to have a high-fidelity experience (L. Evans & Taubert, 2019).
Key Terms in this Chapter
Teledebriefing: Teledebriefing describes a process in which learners who are participating in a simulation scenario undergo debriefing with a facilitator located at an off-site location.
Video-Assisted Debriefing: The practice of using video captured during simulation sessions for reflective discussions on learner and team performance.
High-Fidelity Manikin: This term refers to a technology-enabled manikin with features such as mechanical respiration and heart rate.
Simulation Technician/Specialist: An individual who supports the practice of simulation through setting up and managing simulation manikins and supplies.
Simulation Debriefer: A simulation instructor who leads the learners through a reflective analysis of simulation events.
Telefacilitation: The conduct of a telesimulation by a remote facilitator.
Low-Fidelity Manikin: This is typically a low cost, low technology manikin with minimal features.
Virtual Environment: 3D computer generated objects that can be viewed on a screen or in a head-mounted display.
Telesimulation: Telesimulation is a process by which telecommunication and simulation resources are utilized to provide education, training, and/or assessment to learners at an off-site location.
Simulation Facilitator: A simulation instructor who guides the learners through the scenario with the goal of meeting learning objectives.
Augmented Reality: Computer generated holographic images can be viewed by the learner in the physical environment using a mobile device or specially designed headset.
Virtual Reality: Computer generated 3D images viewed by a learner in a virtual environment using a low-cost or high-end head mounted display.
Objective Structured Clinical Examination (OSCE): An approach to assessment that involves defined objectives and anticipated actions, often with an accompanying checklist for assessment.