Simulation in Medical Education: A Review

Simulation is used widely in medical education. The simulation methodologies used at the present time range from low technology to high technology. This article describes how role play, standardized patients, computer, videotape, and mannequin simulations are integrated into the educational curricula for medical students and physicians. Advantages and disadvantages of simulation and barriers to the use of simulation are discussed.

[1]  M. Costanza,et al.  Can practicing physicians improve their counseling and physical examination skills in breast cancer screening? A feasibility study. , 1995, Journal of cancer education : the official journal of the American Association for Cancer Education.

[2]  R Poss,et al.  Development of a virtual reality arthroscopic knee simulator. , 2000, The Journal of bone and joint surgery. American volume.

[3]  A Ziv,et al.  A pediatric clinical skills assessment using children as standardized patients. , 1999, Archives of pediatrics & adolescent medicine.

[4]  R. Harden,et al.  Assessment of clinical competence using an objective structured clinical examination (OSCE). , 1979, Medical education.

[5]  A. Darzi,et al.  An objective assessment of laparoscopic psychomotor skills: The effect of a training course on performance , 1998 .

[6]  M. Pollack,et al.  Teaching physicians how to break bad news: a 1-day workshop using standardized parents. , 1999, Archives of pediatrics & adolescent medicine.

[7]  G. Dunnington,et al.  Comprehensive needs assessment of clinical breast evaluation skills of primary care residents , 1998, Annals of Surgical Oncology.

[8]  Physicians for the twenty-first century. Report of the Project Panel on the General Professional Education of the Physician and College Preparation for Medicine. , 1984, Journal of medical education.

[9]  A. Dietrich,et al.  A standardized‐patient assessment of a continuing medical education program to improve physicians' cancer‐control clinical skills , 1995, Academic medicine : journal of the Association of American Medical Colleges.

[10]  J. Wendlandt,et al.  ICTS, an interventional cardiology training system. , 2000, Studies in health technology and informatics.

[11]  R. Trelstad,et al.  Replacing lectures with reading, small‐group discussion, and computer‐assisted learning , 1996, Academic medicine : journal of the Association of American Medical Colleges.

[12]  S. Lizer,et al.  Using WWW-based instruction modules and E-mail for a remote neurology course. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[13]  R. Reznick,et al.  Who should rate candidates in an objective structured clinical examination? , 1996, Academic medicine : journal of the Association of American Medical Colleges.

[14]  S. Mennin,et al.  University of New Mexico School of Medicine. , 2000, Academic medicine : journal of the Association of American Medical Colleges.

[15]  J. Gordon,et al.  Integration of self‐directed computerized patient simulations into the internal medicine ambulatory clerkship , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[16]  Glyn Elwyn,et al.  General practice registrar responses to the use of different risk communication tools in simulated consultations: a focus group study , 1999, BMJ.

[17]  L. Kasten,et al.  Nonmedical influences on medical decision making: an experimental technique using videotapes, factorial design, and survey sampling. , 1997, Health services research.

[18]  G. Regehr,et al.  OSCE performance evaluations made by standardized patients: comparing checklist and global rating scores. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[19]  Functions and structure of a Medical School. , 1974, Connecticut medicine.

[20]  L. Kasten,et al.  Patient, physician and presentational influences on clinical decision making for breast cancer: results from a factorial experiment. , 1997, Journal of evaluation in clinical practice.

[21]  S. Hilton,et al.  An evaluation of the Team Objective Structured Clinical Examination (TOSCE) , 1999, Medical education.

[22]  H. Delaney,et al.  Videotaped training in alcohol counseling for obstetric care practitioners: a randomized controlled trial. , 1999, Obstetrics and gynecology.

[23]  M. Abrahamowicz,et al.  Use of standardized patients to assess between-physician variations in resource utilization. , 1997, JAMA.

[24]  A Boxwala,et al.  Multimedia medical case authorship and simulator program. , 1995, Medinfo. MEDINFO.

[25]  G. Cohen,et al.  Communicating Bad News: A Pediatric Department's Evaluation of a Simulated Intervention , 1999, Pediatrics.

[26]  W J Costello,et al.  Computer case simulations for student evaluation in a PBL track , 1997, Academic medicine : journal of the Association of American Medical Colleges.

[27]  G. Regehr,et al.  Using videotaped benchmarks to improve the self‐assessment ability of family practice residents , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[28]  P. Getson,et al.  Teaching telephone management skills to pediatric residents in a pilot program using a standardized patient. , 1999, Southern medical journal (Birmingham, Ala. Print).

[29]  H. Barrows,et al.  Developing consortia for clinical practice examinations: The Macy project , 1994 .

[30]  W. McGaghie,et al.  Implementation of a four-year multimedia computer curriculum in cardiology at six medical schools. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[31]  G. Norman,et al.  Evaluating communication skills in the OSCE format: reliability and generalizability. , 1996, Medical education.

[32]  V. Kowlowitz,et al.  Pelvic examination instruction and experience: a comparison of laywoman‐trained and physician‐trained students , 1996, Academic medicine : journal of the Association of American Medical Colleges.

[33]  A. Ziv,et al.  Using standardized patients to assess the interpersonal skills of physicians. , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[34]  L. Perkowski,et al.  The relationship between preceptor expectations and student performance on 2 pediatric objective structured clinical examination stations. , 1998, Archives of pediatrics & adolescent medicine.

[35]  Proceedings of the AAMC'S Consensus Conference on the Use of Standardized Patients in the Teaching and Evaluation of Clinical Skills. Washington, D.C., December 3-4, 1992. , 1993, Academic medicine : journal of the Association of American Medical Colleges.

[36]  R. A. Melker,et al.  Simulated patients in assessing consultation skills of trainees in general practice vocational training: a validity study , 1994, Medical education.

[37]  A. Ziv,et al.  High-stakes Examinations: What Do We Know About Measurement? , 1998 .

[38]  Geoff Norman,et al.  Evaluating communication skills in the objective structured clinical examination format: reliability and generalizability , 1996 .

[39]  A. Jones,et al.  Evaluation of a breaking bad news course for medical students , 1995, Medical education.

[40]  A. Swanson,et al.  Educating medical students. Assessing change in medical education–the road to implementation , 1993, Academic medicine : journal of the Association of American Medical Colleges.

[41]  J. Gravenstein,et al.  ANESTHESIA SIMULATORS AND TRAINING DEVICES , 1993, International anesthesiology clinics.

[42]  J. Bauer,et al.  Checklist self-evaluation in a standardized patient exercise. , 1995, American journal of surgery.

[43]  J. Colliver,et al.  Relationship between clinical competence and interpersonal and communication skills in standardized-patient assessment. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[44]  P. Maurette.  [To err is human: building a safer health system]. , 2002, Annales francaises d'anesthesie et de reanimation.

[45]  R. Sanson-Fisher,et al.  Training medical students in HIV/AIDS test counselling: results of a randomized trial , 1996, Medical education.

[46]  S. Dubovsky,et al.  Evaluating medical school graduates of a reduced course program: a preliminary report. , 1984, Journal of medical education.

[47]  D. Kassebaum,et al.  Shortcomings in the evaluation of students' clinical skills and behaviors in medical school. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[48]  H. Schwid,et al.  The Anesthesia Simulator-Recorder: a device to train and evaluate anesthesiologists' responses to critical incidents. , 1990, Anesthesiology.

[49]  M. A. Simpson,et al.  How to use role-play in medical teaching. , 1985, Medical teacher.

[50]  J. Rethans,et al.  Assessment of practicing family physicians: comparison of observation in a multiple-station examination using standardized patients with observation of consultations in daily practice. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[51]  M. Mira,et al.  Who should assess medical students' communication skills: their academic teachers or their patients? , 1998, Medical education.

[52]  C. Woodward,et al.  What factors influence primary care physicians' charges for their services? An exploratory study using standardized patients. , 1998, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[53]  J. S. Denson,et al.  A computer-controlled patient simulator. , 1969, JAMA.

[54]  R. Yagel,et al.  Functional endoscopic sinus surgery training simulator , 1998, The Laryngoscope.

[55]  T. Moberg,et al.  Educational technology to facilitate medical students' learning: background paper 2 of the medical school objectives project. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[56]  G. Dallabetta,et al.  Quality of case management of sexually transmitted diseases: comparison of the methods for assessing the performance of providers. , 1997, Bulletin of the World Health Organization.

[57]  J L Tasto,et al.  PreOp endoscopic simulator: a PC-based immersive training system for bronchoscopy. , 1999, Studies in health technology and informatics.

[58]  J W Mayer,et al.  A cardiology patient simulator for continuing education of family physicians. , 1981, The Journal of family practice.

[59]  A. Rashid,et al.  What determines competence within a general practice consultation? Assessment of consultation skills using simulated surgeries. , 1998, The British journal of general practice : the journal of the Royal College of General Practitioners.

[60]  H. Barrows.  An overview of the uses of standardized patients for teaching and evaluating clinical skills. AAMC , 1993, Academic medicine : journal of the Association of American Medical Colleges.

[61]  M. Wilkes,et al.  Doctoring: a longitudinal generalist curriculum , 1994, Academic medicine : journal of the Association of American Medical Colleges.

[62]  B. Blatt,et al.  "Teach 1, do 1 ... better": superior communication skills in senior medical students serving as standardized patient--examiners for their junior peers. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[63]  J. Ali,et al.  Effect of the Advanced Trauma Life Support program on medical students' performance in simulated trauma patient management. , 1998, The Journal of trauma.

[64]  J Chalabian,et al.  Standardized patients: a new method to assess the clinical skills of physicians. , 1997, Best practices and benchmarking in healthcare : a practical journal for clinical and management application.

[65]  M. Quirk,et al.  Evaluation of primary care futures: a faculty development program for community health center preceptors , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[66]  J. DeVries,et al.  Evaluation of clinical competence: the gap between expectation and performance. , 1996, Pediatrics.

[67]  John O. Andes.  In-Basket Simulation , 1977 .

[68]  S L Kanter,et al.  Integrated case studies and medical decision making: a novel, computer-assisted bridge from the basic sciences to the clinics. , 1995, Academic medicine : journal of the Association of American Medical Colleges.

[69]  R. Gottlieb,et al.  Structured clinical observations: a method to teach clinical skills with limited time and financial resources. , 2000, Pediatrics.

[70]  C. Woodward,et al.  Provision of preventive care to unannounced standardized patients. , 1998, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[71]  A pilot study of faculty development for basic science teachers , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[72]  M. Wilkes,et al.  Doctoring: University of California, Los Angeles , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[73]  S. van der Geest,et al.  The fake patient: a research experiment in a Ghanaian hospital. , 1998, Social science & medicine.

[74]  A. Gallagher,et al.  Virtual Reality Training in Laparoscopic Surgery: A Preliminary Assessment of Minimally Invasive Surgical Trainer Virtual Reality (MIST VR) , 1999, Endoscopy.

[75]  R. Fraser,et al.  Consultation competence in general practice: testing the reliability of the Leicester assessment package. , 1994, The British journal of general practice : the journal of the Royal College of General Practitioners.

[76]  F. Mansfield.  Supervised role‐play in the teaching of the process of consultation , 1991, Medical education.

[77]  D. Gaba,et al.  Anesthesia crisis resource management training: teaching anesthesiologists to handle critical incidents. , 1992, Aviation, space, and environmental medicine.

[78]  Mba Facp Gary Meller MD.  A typology of simulators for medical education , 2009, Journal of Digital Imaging.

[79]  Jeanne M. Madden,et al.  Undercover careseekers: simulated clients in the study of health provider behavior in developing countries. , 1997, Social science & medicine.

[80]  R. Harden,et al.  Assessment of clinical competence using objective structured examination. , 1975, British medical journal.

[81]  J. Carline,et al.  History-taking and preventive medicine skills among primary care physicians: an assessment using standardized patients. , 1998, The American journal of medicine.