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Professor

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Simulation in medical education

Summary

Simulation dates back centuries when clay and stone models were used to teach disease states.

Over the years there has been technological changes and complexity in teaching methods which

had led to the tendency of adopting simulation techniques in various fields. These include:

medical, nursing and allied healthcare personal education.

Simulation is a verbal technique which puts the tasks to the trainees, simulated patients and the

use of advanced simulations. Simulations are enhanced in order to enhance higher leaning of

cognitive, psycho-motion and affective skills especially in isolation technologies.

There are various reasons as to why simulation has been adopted. These include: cognitive

psychology has proven that information and its applications are best done when taught and

rehearsed in the real life and especially in the work places. It has also been established that

there is a link between education and realistic clinical content.

Noteworthy is that many training institutions have not adopted this strategy due to the risk

which is posed to patients. The risk posed to patients is still a problem in adoption of

simulation techniques and even when practicing on an animal which is still considered

unacceptable. In order to avoid all these problems there has been a trend towards adoption of

specialised simulation techniques. The two have several advantages: first is that there are no

risks which are posed to patients hence safer and second is that the students are able to practice
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and rehearse. There have been calls therefore of the incorporation of simulation on patients

safety in the curriculum.

Other advantages of simulation related to the clinical environment are that it improves the

patients outcome by reducing the central venous line of infection and also improves effective

learning capabilities. There are various uses that simulation has been subjected to since being

developed. Amongst them include its use in crisis resource management where it has been

noted to increase the patients safety. The crisis management system has also been adopted in

various industries such as the Aviation industry and in the post graduate training programs.

Despite the adoption of simulation in the various industries and training institutions, it has been

difficult to measure its impact. Clinical attempts have been adopted in order to measure the

various impacts of simulation techniques in higher education. An attempt has been made by

creation of a multidisciplinary and multi-professional environment for both undergraduate and

post graduate students. An example of this has been in summative assessments where there has

been an adoption of computer enhanced manikin simulation. The assessments that have been

adopted have been those recommended by Schuwirth which are: the use of Bayesian model and

the psychometric models. The former gives a fair and defensible assessment of simulation. It

also gives probability of future decisions about future performance to trainers. The latter entails

the collection of portfolio of simulated experience with record feedback and assessment scores.

The benefits of using a hybrid model between the psychometric model and the Bayesian model

are that they give feedback to learners based on variance rather than standardisation. This is

because the former represents the outside world unlike the latter which is presumptive. The

other advantage is that it reduces the use of checklists scoring and also enables the users to

sample large universe of learning areas. All in all simulation help in bridging classrooms with

the clinical environment.