Using Simulation in Clinical Education
Patient simulation in all its forms is widely used in clinical education with the key aims of improving learners’ competence and confidence, improving patient safety and reducing errors. Understanding its benefits, range of uses and limitations will help clinical teachers improve the learning experience.
This module discusses how simulation can be used in medical and 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 a dress rehearsal to a real event where as many mistakes as possible can be made and lessons can be learned, but no one comes to harm. People from many occupations (including athletes, actors and pilots) use simulation as part of their training. In these professions, in common with medicine, people have to perform skills in 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, medical 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.
The American anaesthetist Gaba said:
‘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 junior clinicians will now be trained and assessed in simulators and the use of clinical skills or simulation laboratories is seen as routine in medical and health professions’ education. Advances in technology mean that there are very lifelike simulators for patients, surgery procedures and full-scale mock-ups of wards, theatre 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 trainees can practice 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’ during the course of the module in order to complete and print out your certificate
In your own role as a teacher how do you use simulation?
This may be high fidelity simulation using models or manikins or low level simulation such as role plays and team building exercises.
• What types of simulation methods are the most useful in improving the learning experience?
• What do you need to know more about in order to use simulation more effectively in your own teaching?
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