Faculty Development

The 2008 Annual report of the Chief Medical Officer, Safer Medical Practice (Donaldson, 2009) spelled out the importance of simulator training to improve patient safety and clinicians’ performance and to enable experience to be gained without practice on patients.

Four key drivers for the widespread introduction of simulation are:

1. Public expectation.  The public not only expect professionals to engage in appropriate skills and simulator training, they often believe that the profession already does.  Patient groups are shocked to learn that doctors frequently perform a skill for the first time on a real patient.
2. Changes in working practice.  The development of new professional roles, the growth of large and complex working environments, the widespread adoption of shift systems and the rapid pace of modern healthcare requires clinicians to develop high order leadership, team-working  and communication skills. Simulation has been at the forefront of the development (and assessment) of these skills.
3. Technological developments and opportunities.  The technology available to support high fidelity and simulator training has progressed rapidly in recent years.  Evidence exists that the educational value from low fidelity simulators can outweigh that of high fidelity simulators as long as they are embedded within an educationally sound training programme.
4. Reduced training time.  A number of changes including the European Working Time Directive have resulted in a reduction in the time available for clinical training; to make the best possible use of available work based time, trainees must have prepared effectively away from the work place.

The use of simulation in health professions’ education has been shown to have benefits for learners, for development of clinical practice and skills, for patients and for health systems (Riley et al, 2003).  There is now a significant and growing body of evidence that simulator training is educationally effective in developing technical skills (Ziv 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, critical incidents, near misses and crisis situations that learners may not be exposed to during clinical training. Reflecting the experience of the airline, nuclear and other high risk industries, evidence is slowly accumulating in medicine that patient safety standards and non-technical skills improve following simulator training (Beyea, 2004; McGaghie et al, 2010).