Faculty Development

Simulation is increasingly used at all levels of medical education and training to complement learning and assessment using real patients. Although simulation can never replace the authentic learning experiences of the clinic or bedside, it can prepare clinicians for the real world, providing an environment for the practice of technical and non-technical skills, clinical reasoning and professional judgement.

Simulation replicates an environment or situation through the use of technologies, interaction with people, computers or models. It can range from low-fidelity activities such as paper-based exercises, case studies, problem-based learning or role play; to medium-fidelity teambuilding exercises; through to the use of manikins and complex high-fidelity integrated simulators.

Simulated patients (SPs) were first used in the 1960s, with their use in medical undergraduate and postgraduate education expanding rapidly since the 1980s (Barrows, 1993). Simulated patients are role players (often actors) who are trained to work with healthcare professionals in communication and diagnostic skills. They are used in clinical simulation, particularly in the teaching of communication skills and OSCE-style assessments.

Training is essential to making simulated encounters as real and as standardised as possible, particularly in high-stakes summative assessments. There is wide international experience of using simulated patients in most clinical specialties, although children, the very elderly and some mental health problems are difficult to simulate in this medium and are therefore perhaps under-represented in assessment and training. Alternatives such as videoing clinical encounters for teaching and assessment are described shortly.