‘Simulation is the imitation or representation of one act or system by another. Simulations can be said to have four main purposes – education, assessment, research, and health system integration in facilitating patient safety.’ [Society for Simulation in Healthcare, 2011].
For many years now, simulators have been used for training and practice in aviation and other high-risk industries.
In the mid1990s similar principles were applied to the training of medical, nursing and allied health professionals. Medical simulation training ultimately aims to increase patient safety, manages errors in a safe environment, and improve clinical and team management skills. Even in sophisticated healthcare systems many patients are harmed (NHS England, 2014), not as a result of illness but as a result of preventable human error. Errors arise due to communication breakdown, loss of skills with time and failure to update knowledge.
Simulation adds value by providing a realistic experience in a safe environment with no adverse consequences, developing team communication, and increasing retention of knowledge and skills.
It has been demonstrated that when learning occurs in a realistic work-related environment, knowledge and skills are retained more effectively.
Accidents and incidents are usually caused by a combination of organizational and operational factors. Investigations into ‘human errors’ have shown that as many as 80 per cent of them are the result of human factors breakdown, such as poor communication, inadequate monitoring, failure to cross-check drugs and equipment, rather than the lack of technical knowledge. Non-technical skills are generic skills that underpin and enhance technical tasks, improving safety by helping people to anticipate, identify and mitigate errors.
To guarantee successful simulation training, we have to ensure that our learners believe they are in their familiar, real environment and interact with the simulators as though they are real patients.
In our simulation training these skills are used and developed with medical knowledge and clinical techniques.
As well as the training of medical and nursing postgraduates, undergraduate students can also benefit from demonstrations of physiology of the cardiovascular and respiratory systems, some pharmacological effects of cardiovascular and respiratory drugs and pathological changes to human physiology, which we are able to replicate in the simulators.
Our team has developed curricula, and is able to offer customized curricula to meet the specific needs of healthcare professionals. Simulation allows experiential learning, critical thinking and reflection during debriefing afterwards.
Simulation training includes:
Cognitive training: The development of problem solving skills.
Team dynamics: Developing communication skills.
Procedural training: For example, the difficult airway, advanced resuscitation or surgical skills training.
Competency assessments: In both technical and non-technical skills to assist in identifying areas in need of further development.
Reflective practice: Reflection on the processes and interactions identified in the simulation allows participants to challenge their own thinking and current practice. Video recordings of the simulation are used in a facilitated debriefing session that allow candidates the opportunity to learn through reflection, mutual support and shared skills.