So simulation, that is all about manikins - right?

So first blog!

I'm hoping to do a series of blogs on Healthcare Simulation, Patient Safety and Ergonomics and all things in between - I want this to be a place to share thoughts, ideas and learn (me learn as well!). I also don't want these to become overly academic - I will share and mention others peoples work but will not formally reference these.

I wanted to start with What is Simulation as this seems an important starting point to allow further exploration later - without a common mental model or reference point it becomes more difficult.

So the aim of this blog is to challenge and expand what people consider healthcare simulation to be (or what it isn't), David Gaba has pointed out that Simulation is a technique not a technology - indeed it is an educational modality.

For me healthcare simulation is all encompassing it is any patient focussed learning event where we simulated the process, patient, system, event for the acquisition of skills, knowledge and or behaviours ultimately to make patients safer. I realise that is a very broad definition so lets make it even more broader ! - for me the learner doesn't only have to be the individual or individuals but can be the organisation or systems. Further more it can do this to an extent pro-actively - we wouldn't wait for staff to make an error before we train them and the same applies to organisations with the opportunity to learn before harm occurs.

So simulation is all encompassing which actually is part of the issue - it becomes difficult to pigeon hole and explain the term simulation, or even describe best practice and set standards as it is very contextual to what the learning outcomes and delivery methods are. Consider clinical skills training, resuscitation training, emergency drills, simulations run in a formal simulation area, simulations run in a clinical area, simulations run across clinical areas and simulations run across organisations. Then add in role play, virtual reality, augmented reality, gamification, virtual worlds, simulated persons (some of the content of future blogs!).  What becomes apparent is not only the breadth of applications of this educational modality but of course also the range of different educational process, theories and pedagogical underpinnings. So some of these process will be very competency and behaviouristically (reward or punishment) focussed - often sessions that refer to being a training session and instructor led. Where as a lot of the events that we would more typically think of being simulation are more constructivist (where we want to understand the learners view of the world) in nature and have facilitators.

So how else can we distinguish behaviouristic and constructivist sessions? for me it is in the questions and discussions that occur after in the debrief event - if the discussion is focussed more on what occurred, that points towards behaviouristic models whereas if the facilitators try to understand why things happened - from the participants point of view often this suggests a more constructivist approach.

So which method is better? neither ! - both have a role and a place in developing participants but also one should not be confused with the other, both from the perspective of faculty competence but also form the tick box mentality where managers feel this group has had their "simulation" experience.