Simulation first became popular during the 1930s when flight simulators taught new pilots how to fly by responding to pilot controls and providing accurate instrument readings. During World War II, almost every battling nation used flight simulators to train combatant pilots.

Beyond flight and military applications, other complex and high-risk industries, like nuclear power production and the space program, have attempted to adapt simulation to meet specific training and risk-management needs. Due to limitations in technology and overall medical knowledge at the time, healthcare simulation didn’t take off as an acceptable training method until many years later.

While some healthcare professionals say patient care is too complex to simulate accurately, technological advances in the past two decades have made it possible to replicate everything from routine doctor visits to complex surgeries. Today, healthcare professionals use modern simulation technology to practice necessary skills in an environment that allows for errors without risking patient safety.

Types of Simulation and Simulators

A technique to replace or amplify real situations, healthcare educational simulation uses replicated experiences to mimic real-world scenarios, some guided and some for exploratory purposes. Alternately, a simulator is a device that mimics a real patient or part of the human body. In some cases, simulators can actually interact with learners. Below are various simulation techniques and devices used to educate healthcare professionals.

Role-playing
Role-playing involves learners acting out a situation to create fidelity, a close replication of a real-life situation. Despite relatively low fidelity, role-playing is a low-cost way to allow learners to react how they would in a real-life scenario without an elaborate setting or props. Role-playing offers substantial benefits to learners training as a team and helps challenge any pre-existing notions.

Live Simulated Patients
Like role-playing, live simulated patients replicate real-life scenarios with the use of actors instead of fellow learners. Simulated patients can teach learners to conduct a physical assessment, take a patient’s history, communicate bad news and even perform certain types of physical examinations. While somewhat costly and difficult to coordinate, using live simulated patients helps learners suspend disbelief, as well as become aware of communication skills, clinical strengths and weaknesses, and reactions to stressful situations.

Partial Task Trainers
Partial task trainers replicate a part of a system or process. Designed to be task specific, partial task trainers can be used to teach intubation, IV placement or how to use surgical devices. For example, learners can practice giving injections on oranges or providing life support with airway management trainers. While partial task trainers don’t do much to overcome disbelief, these types of simulators are standard and portable ways to increase skill proficiency.

Complex Task Trainers
Complex task trainers use computer-based training to create virtual-reality scenarios that allow learners to perceive stimuli while practicing skills like intravenous and central line catheterization. Sensors placed within a partial task trainer can detect pressure during learner activities to respond to interventions. While high-fidelity trainers lend an added dimension to simulations, they also increase the simulator cost.

Virtual Environment Simulation
Virtual environment simulation is used to create interactive educational experiences, similar to the community health simulation Sentinel City™, which help learners train and assess clinical knowledge and decision-making skills safely in diverse settings. Typically accessible online 24/7, virtual environment simulations are convenient and generally less expensive than other types of simulators. Physical skills and tasks cannot be taught using virtual environment simulation, however, this type of teaching tool is well suited for exploratory learning.

High-Fidelity Human Patient Simulators
Human patient simulators are high-fidelity, whole-body mannequins that can respond to certain medications, chest compressions, needle decompression, chest tube placement and other physiologic interventions. Human patient simulators contribute high degrees of realism to a learning situation as mannequins can respond to specific care interventions and treatments in real time. For example, BabySIM is an infant-sized simulator that helps teach pediatric critical care.

Full-Mission Simulation
Full-mission simulation brings learners into complex tasks or situations that usually involve a team, such as emergency scenarios carried out in a replicated emergency room. Only the simulation resources available to the educator limit full-mission training. Scenarios usually start with a briefing, are followed by task execution and conclude with an instructor-led review of the event.

Regardless of type, healthcare educational simulation is an effective and powerful tool to increase knowledge of best practices, appropriate use of instruments and procedural competence in a healthcare education setting.