Abstract
This chapter begins with a brief history of health professional simulation which had its origins in antiquity. The types of simulation and various approaches to simulation-based education including manikin-based and virtual simulation (also known as simulation games) are described. The chapter also introduces an approach to simulation education and basic concepts such as in situ simulation, simulation fidelity, and simulation technology. The relationships between simulation and patient safety and the influence of the military and aviation industry on modern day practice of simulation are explored. Finally, the chapter concludes with an overview of the global application of simulation to learning and evaluation in health professional education.
TopIntroduction
Simulation has been utilized in various forms for centuries. However, the current approaches to simulation education date back to the 19th century with the use of obstetric simulators to train midwives and obstetricians in how to recognize and treat childbirth complications. The growth of simulation education has been fostered by an increased focus on patient safety events. While the traditional approaches to learning in the health professions have relied on observation and practice in the clinical setting, simulation allows learners to practice their skills and make mistakes without harming a patient. Manikin-based simulation involves the use of humanoid simulators by trained simulation faculty who facilitate simulation scenarios in simulation centers i.e., dedicated locations for simulation, or in clinical settings. Other simulation modalities such as telesimulation and virtual simulation are accessible by remote facilitators and learners. The “fidelity” of the simulation experience represents the degree to which it matches a clinical experience. While historically, manikins were crude representations of the human form, today’s manikins come in all sizes and portray realistic physiologic responses. The concepts of high-fidelity and low-fidelity as well as high-technology and low-technology simulation are explored in Chapter 3 titled “Scenario Development for Manikin-based Simulation” and Chapter 4 titled “Scenario Development for Virtual Simulation”.
Key Terms in this Chapter
Simulation Facilitator: A simulation instructor who guides the learners through the scenario with the goal of meeting learning objectives.
Telefacilitation: The conduct of a telesimulation by a remote facilitator.
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 Environment: 3D computer generated objects that can be viewed on a screen or in a head-mounted display.
Simulation Debriefer: A simulation instructor who leads the learners through a reflective analysis of simulation events.
Video-Assisted Debriefing: The practice of using video captured during simulation sessions for reflective discussions on learner and team performance.
Low-Fidelity Manikin: This is typically a low cost, low technology manikin with minimal features.
Virtual Reality: Computer generated 3D images viewed by a learner in a virtual environment using a low-cost or high-end 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.
Objective Structured Clinical Examination (OSCE): An approach to assessment that involves defined objectives and anticipated actions, often with an accompanying checklist for assessment.
High-Fidelity Manikin: This term refers to a technology-enabled manikin with features such as mechanical respiration and heart rate.
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.
Simulation Technician/Specialist: An individual who supports the practice of simulation through setting up and managing simulation manikins and supplies.