Supporting transitions in medical career pathways: the role of simulation-based education

Abstract

Transitions, or periods of change, in medical career pathways can be challenging episodes, requiring the transitioning clinician to take on new roles and responsibilities, adapt to new cultural dynamics, change behaviour patterns, and successfully manage uncertainty. These intensive learning periods present risks to patient safety. Simulation-based education (SBE) is a pedagogic approach that allows clinicians to practise their technical and non-technical skills in a safe environment to increase preparedness for practice. In this commentary, we present the potential uses, strengths, and limitations of SBE for supporting transitions across medical career pathways, discussing educational utility, outcome and process evaluation, and cost and value, and introduce a new perspective on considering the gains from SBE. We provide case-study examples of the application of SBE to illustrate these points and stimulate discussion.

Multiple patient encounter simulations in emergency medicine

“…Indeed, the role of the ED trainee often involves managing the whole department as well as being involved in the individual management of clinical cases. This role, particularly for more junior trainees, is daunting and it may be that simulation-based education aids in the transition from novice (managing one patient) to expert (can manage a team managing multiple patients) 4. Furthermore, the MPES enables particular elements of non-technical skills to be practised.…”

Contextually balanced medical education: realigning with global health care delivery

“…Medicine is best learned experientially in the clinical environment. Simulation alone cannot replace it . A doctor works in a stressful uncertain environment where risk and patient safety are of utmost importance.…”

Early clinical exposure requires facilitated access to support learning

“…It is assumed that when they are allocated a clinical placement, students will access learning opportunities and develop on the wards. The current reality is that students frequently fail to achieve the potential learning from the clinical environment that is expected and new medical graduates lack preparedness in technical and non‐technical skills …”

“…However, all members of a team in which a new professional works, including nurses and allied health professionals, play a part in student education. In order to help students navigate and understand the new learning environment, the team should provide both formal and informal support . When students do not feel attached to a person or team, they can feel disconnected and isolated …”

“…The current reality is that students frequently fail to achieve the potential learning from the clinical environment that is expected and new medical graduates lack preparedness in technical and non-technical skills. 3,4 The current reality is that students frequently fail to achieve the potential learning from the clinical environment that is expected…”