Simulation Technology for Health Care Professional Skills Training and Assessment

Abstract

Changes in medical practice that limit instruction time and patient availability, the expanding options for diagnosis and management, and advances in technology are contributing to greater use of simulation technology in medical education. Four areas of high-technology simulations currently being used are laparoscopic techniques, which provide surgeons with an opportunity to enhance their motor skills without risk to patients; a cardiovascular disease simulator, which can be used to simulate cardiac conditions; multimedia computer systems, which includes patient-centered, case-based programs that constitute a generalist curriculum in cardiology; and anesthesia simulators, which have controlled responses that vary according to numerous possible scenarios. Some benefits of simulation technology include improvements in certain surgical technical skills, in cardiovascular examination skills, and in acquisition and retention of knowledge compared with traditional lectures. These systems help to address the problem of poor skills training and proficiency and may provide a method for physicians to become self-directed lifelong learners.

Use of simulation‐based mastery learning to improve the quality of central venous catheter placement in a medical intensive care unit

“…4 Simulation-based training has been used in medical education to increase knowledge, provide opportunities for deliberate and safe practice, and shape the development of clinical skills. 9,10 We previously used simulation-based mastery learning to improve the thoracentesis and advanced cardiac life support (ACLS) skills of internal medicine residents. 11,12 Although a few small studies have linked simulation-based interventions to improved quality of care, [13][14][15][16][17][18][19] more work is needed to show that results from a simulated environment transfer to actual patient care.…”

Review article: Simulation in anesthesia: state of the science and looking forward

“…11 The growing acceptance of simulation in healthcare training has been attributed to the decreased availability and acceptance of practising skills on patients, the growth in technology, which has fuelled the development of increasingly sophisticated simulation modalities, as well as the development of a culture of safety, which has resulted in decreased tolerance for errors. 3,5,[12][13][14][15] Together, these forces have led to greater interest and expertise in the development of simulation-based training modalities to re-create teaching and assessment opportunities where practice or assessment on real patients is either not feasible or undesirable.…”

“…The development of the fullbody mannequins that are currently used for training and assessment date back to the mid-1980s with the CAE-Link simulator developed at Stanford University by Gaba et al 16 and the Gainesville Anesthesia Simulator developed by Good and Gravenstein at the University of Florida in Gainesville. 5,14,17 Although the two groups had different approaches for simulation-based training, they both targeted the recognition of anesthetic critical events and their management. 5,18 Gaba's work on team training, Simulation-Based Training in Anesthesia Crisis Resource Management (ACRM), has had a marked impact on simulation-based training in anesthesia.…”

“…95,100 Strong performance in one aspect of competency does not imply that a candidate will perform equally well in other aspects of competency. 86 As such, multiple stations (8)(9)(10)(11)(12)(13)(14)(15) were recommended in order to ensure that the scores obtained are reliably precise enough for an examiner to make decisions regarding an examinee's level of competence. 99,[101][102][103][104] Boulet and Murray 99 also discussed research into the validity of simulation-based assessments.…”

“…For example, one of the central tenets attributed to simulation is that it allows for deliberate practice. 14,117 Deliberate practice is defined as practice undertaken over an extended period of time to attain excellence, and it entails the ongoing efforts required to maintain it. [118][119][120] It consists of practising a well-defined task at an appropriate level of difficulty for the individual, informative feedback, and opportunities for repetition and correction of errors.…”