UNIT 2 – The different simulation modalities

Welcome to Unit 2 about the different simulation modalities. In this unit you will learn how simulation in healthcare can be declined in many different ways and will get to know about procedural training, high and low fidelity simulations and the use of new technologies such as the VR.

In an influential article by Chiniara et al [1], the authors propose a conceptual framework to assists educators in selecting characteristics for the best design of simulation training interventions; this framework describes an educational activity using healthcare simulation by using of four progressive levels, that are: 

  • the instructional medium
  • the simulation modality
  • the instructional method
  • the presentation

In their work, the authors stress that the selection of the appropriate media and simulation modalities should be based on the learning outcomes: the decision to use simulation as an instructional medium should be based on the analysis of the characteristics of acuity (severity) and opportunity (frequency) of the specific events that are the desired focus of training and propose a matrix of zone of simulation to guide the instructors in the selection of the appropriate training method.

The framework identifies four different simulation modalities: procedural simulation, computer-based simulation, simulated clinical immersion, and SP, with the added methodology of hybrid simulations. Each is best suited for specific competency domains or learning outcomes.

In this unit we will learn about:

  • Procedural Training and Task Trainers (called Procedural Simulation in the framework)
  • Screen-based and VR simulations (called Computer-based Simulation in the framework)
  • High (or not so high) fidelity simulation, that will be discussed in
    • how much technology is good for simulation
    • how much fidelity is good for simulation

 

Contents

The contents of this unit will be presented as follows:

Presentation:

  • How much fidelity is good for simulation (23 min)
  • How much technology is good for simulation (20 min)
  • Procedural training and task trainers (45 min) (with summary)
  • Screen-based and VR simulations (40 min) (with summary)

Articles:

  1. Taxonomy and conceptual framework (Chiniara 2013) (Mandatory)
  2. How low can you go (Beaubien 2004) (Mandatory)
  3. other optional references: see bibliography

 

Bibliography

1 Gilles Chiniara, Gary Cole, Ken Brisbin, Dan Huffman, Betty Cragg, Mike Lamacchia, Dianne Norman & Canadian Network For Simulation In Healthcare, Guidelines Working Group (2013) Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection, Medical Teacher, 35:8, e1380-e1395, DOI: 10.3109/0142159X.2012.733451

2 Beaubien JM, Baker DP. The use of simulation for training teamwork skills in health care: how low can you go? Qual Saf Health Care. 2004 Oct;13 Suppl 1(Suppl 1):i51-6. doi: 10.1136/qhc.13.suppl_1.i51. PMID: 15465956; PMCID: PMC1765794.

 

Other references used in the videos

Rudolph JW, Simon R, Raemer DB. Which reality matters? Questions on the path to high engagement in healthcare simulation. Simul Healthc. 2007 Fall;2(3):161-3. doi: 10.1097/SIH.0b013e31813d1035. PMID: 19088618. 

Dieckmann, P. (2005). “Ein bisschen wirkliche Echtheit simulieren” Über Simulatorsettings in der Anästhesiologie. [Online: http://docserver.bis.uni-oldenburg.de/publikationen/dissertation /2005/diebis05/diebis05.html ] Oldenburg: Universität, Dissertation. 

Chang, Todd & Gerard, James & Pusic, Martin. (2016). Screen-Based Simulation, Virtual Reality, and Haptic Simulators. 10.1007/978-3-319-24187-6_9. 

Gaba, DM (2004). The future vision of simulation in health care. Qual Saf Health Care 2004;13 (Suppl 1):i2–i10. doi: 10.1136/qshc.2004.009878

Gupta S, Wilcocks K, Matava C, Wiegelmann J, Kaustov L, Alam F. Creating a Successful Virtual Reality-Based Medical Simulation Environment: Tutorial. JMIR Med Educ. 2023 Feb 14;9:e41090. doi: 10.2196/41090. PMID: 36787169; PMCID: PMC9975916.

Jessica M. Phillips, Mary G. Harper, Holli A. DeVon, Virtual Reality and Screen-Based Simulation Learner Outcomes Using Kirkpatrick’s Evaluation Levels: An Integrative Review,Clinical Simulation in Nursing, Volume 79, 2023, Pages 49-60, ISSN 1876-1399, https://doi.org/10.1016/j.ecns.2023.02.008 

Sayed Azher, Amanda Cervantes, Caroline Marchionni, Keerat Grewal, Hugo Marchand, Jason M. Harley, Virtual Simulation in Nursing Education: Headset Virtual Reality and Screen-based Virtual Simulation Offer A Comparable Experience, Clinical Simulation in Nursing,Volume 79, 2023, Pages 61-74,ISSN 1876-1399, https://doi.org/10.1016/j.ecns.2023.02.009 

Jones, J.; Wilkins, M.; Caird, J.; Kaba, A.; Cheng, A. & Ma. I.W.Y. (2017). An experimental study on the impact of clinical interruptions on simulated trainee performances of central venous catheterization. Advances in Simulation,2 (5), DOI 10.1186/s41077-017-0038-1

Weaver, S.J.; Dy, S.M.; Rosen, M.A. (2014). Team training in healthcare: a narrative synthesis of the literature. BMJ Quality & Safety, 23, 359-372. 

Wang Z, Liu Q, Wang H. Medical simulation-based education improves medicos’ clinical skills. J Biomed Res. 2013; 27(2):81–84.

McClelland, D. C. (1973). Testing for competence rather than for “intelligence.” American Psychologist, 28(1), 1–14. https://doi.org/10.1037/h0034092 

Nasir ANB, Ali DF, et al. Technical skills and non-technical skills: predefinition concept. Presentation at the IETEC’11 Conference, Kuala Lumpur, Malaysia. 2011.

Prineas, S., Mosier, K., Mirko, C., Guicciardi, S. (2021). Non-technical Skills in Healthcare. In: Donaldson, L., Ricciardi, W., Sheridan, S., Tartaglia, R. (eds) Textbook of Patient Safety and Clinical Risk Management . Springer, Cham. https://doi.org/10.1007/978-3-030-59403-9_30

Engel N, Patey R E, Ross S, Wisely L. Non-technical skills BMJ 2008; 337 :0812454 doi:10.1136/sbmj.0812454

Helyar V. Flight school:learning lessons from aviation BMJ 2006; 332 :0606252 doi:10.1136/sbmj.0606252

Rosendal AA, Sloth SB, Rölfing JD, Bie M, Jensen RD. Technical, Non-Technical, or Both? A Scoping Review of Skills in Simulation-Based Surgical Training. J Surg Educ. 2023 May;80(5):731-749. doi: 10.1016/j.jsurg.2023.02.011. Epub 2023 Mar 9. PMID: 36906398.

Gilles Chiniara, Gary Cole, Ken Brisbin, Dan Huffman, Betty Cragg, Mike Lamacchia, Dianne Norman & Canadian Network For Simulation In Healthcare, Guidelines Working Group (2013) Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection, Medical Teacher, 35:8, e1380-e1395, DOI: 10.3109/0142159X.2012.733451

https://bemedskilled.com/gp 

Ellinas H, Denson K, Simpson D. Low-Cost Simulation: How-To Guide. J Grad Med Educ. 2015 Jun;7(2):257-8. doi: 10.4300/JGME-D-15-00082.1. PMID: 26221446; PMCID: PMC4512801

May BJ, Khoury JK, Winokur RS. Tools for Simulation; Low Budget and No Budget. Tech Vasc Interv Radiol. 2019 Mar;22(1):3-6. doi: 10.1053/j.tvir.2018.10.002. Epub 2018 Nov 2. PMID: 30765073

Nachshon A, Mitchell JD, Mueller A, Banner-Goodspeed VM, McSparron JI. Expert Evaluation of a Chicken Tissue-based Model for Teaching Ultrasound-guided Central Venous Catheter Insertion. J Educ Perioper Med. 2017 Jul 1;19(1):E503. PMID: 28377943; PMCID: PMC5327868

https://lowcostsim.wordpress.com/ 

https://simghosts.org/ 

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