UNIT 1 – The role and history of simulation in healthcare education

Summary

Traditional teaching methods like lectures and bedside teaching, although used for millennia, do have their limitations, where learners may not get sufficient exposure or hands-on experience. Simulation can help overcome these limitations by providing a safe learning environment without risk to real patients.

Simulation has in fact a long history in training, going back to ancient times with devices like acupuncture models in China and birthing simulators used by midwives in 18th century France. Aviation has extensively used simulators for pilot training for decades.

In healthcare, early computer-based simulators emerged in the 1960s for teaching anesthesia procedures. Modern simulation centers now use high-fidelity manikins, virtual reality, augmented reality and sophisticated scenarios to teach everything from basic skills to complex team coordination and crisis management.

Simulation can be used in two different modalities: one is the skill training focused on teaching specific procedures/techniques and the second is team training which emphasizes cognitive skills like communication, situational awareness and decision making within an interprofessional team environment. These two different modalities of simulation can be used to tailor the teaching to different levels of learners – from beginners learning basic maneuvers to advanced specialists practicing crisis management.

To design an effective simulation-based training the key principles to keep in mind are:

• Ensuring a psychologically safe learning environment
• Defining clear learning objectives based on needs analysis
• Employing the right simulator fidelity for the learning goals
• Following a structured approach with pre-briefing, theoretical input, skills demonstration, scenario, debriefing
• Video recording for self-reflection 
• Trained facilitators skilled at debriefing

Of course it is important to acknowledge that simulation too has its limitations: it cannot fully replicate the complexity and unpredictability of real clinical situations. Simulation augments but does not replace the need for actual clinical experience.