Judicious Use of Simulation Technology in Continuing Medical Education

Abstract

Use of simulation-based training is fast becoming a vital source of experiential learning in medical education. Although simulation is a common tool for undergraduate and graduate medical education curricula, the utilization of simulation in continuing medical education (CME) is still an area of growth. As more CME programs turn to simulation to address their training needs, it is important to highlight concepts of simulation technology that can help to optimize learning outcomes. This article discusses the role of fidelity in medical simulation. It provides support from a cross section of simulation training domains for determining the appropriate levels of fidelity, and it offers guidelines for creating an optimal balance of skill practice and realism for efficient training outcomes. After defining fidelity, 3 dimensions of fidelity, drawn from the human factors literature, are discussed in terms of their relevance to medical simulation. From this, research-based guidelines are provided to inform CME providers regarding the use of simulation in CME training.

Creating new realities in healthcare: the status of simulation-based training as a patient safety improvement strategy

“…The relationship is complex, but at least two findings are apparent: simulator fidelity has multiple dimensions, and higher simulator fidelity does not always translate into improved learning outcomes. First, at least two main types of simulator fidelity exist: physical fidelity (ie, the degree to which the simulator looks and feels like the thing it simulates) and cognitive or functional fidelity (ie, the degree to which the simulator requires the learner to think and act as they would in real life) 25. Physical and cognitive fidelity are not entirely independent but the distinction is critical.…”

Improving Quality in Systems of Care: Solving Complicated Challenges with Simulation-Based Continuing Professional Development

“…19 Cost in simulation increases as the simulation achieves greater fidelity with clinical practice, but simulation fidelity may have little to do with overall quality of the educational experience; lower-fidelity simulations actually lead to better end results in select situations. 20 Curtis et al 21 describe the multidimensional underpinnings of fidelity by dividing it into the domains of physical fidelity, functional fidelity, and psychological fidelity. Similarly, Seagull 22 uses task abstraction, dual-task technique, and bandwidth feedback-concepts derived from human factors studies-to examine planning decisions and develop expertise sensitive to organizations and learning environments.…”

The Value of Simulation in Interventional Radiology

“…28 Curtis et al refer specifically to how well a simulation recreates the physical properties of an operational task as its "physical fidelity," and they caution that "overtraining" on simulators with high but imperfect physical fidelity may lead to "simulation specific" techniques that do not transfer well to actual clinical performance. 29 Research findings on the validity of high-fidelity endovascular simulation reveal somewhat mixed but nevertheless promising results. For example, repeated measurements of efficiency in simulated renal artery stenting on the Mentice VIST correlated with increased levels of experience over the course of IR fellowship training.…”