The Human Face of Simulation: Patient-Focused Simulation Training

Kneebone, Roger PhD, FRCS; Nestel, Debra PhD; Wetzel, Cordula Dipl Psych; Black, Steven MRCS, Ed; Jacklin, Ros MA, MRCS; Aggarwal, Raj MA, MRCS; Yadollahi, Faranak MSc; Wolfe, John MS, FRCS; Vincent, Charles MPhil, PhD; Darzi, Ara MD, FRCS

Academic Medicine:
doi: 10.1097/01.ACM.0000238323.73623.c2
Simulation
Abstract

Simulation is firmly established within health care training but often focuses on training for technical tasks and can overlook crucial skills such as professionalism and physician–patient communication. The authors locate this paper within current developments in health care and relate it to the literature on simulation. They make the case for placing real human “patients” (played by actors) within simulation environments, thereby ensuring that the training experience remains rooted in actual practice. By practicing repeatedly within a safe environment, technical skills, communication with patients and team members, decision making, and clinical judgment may all be practiced and mastered while preserving patient safety.

In elaborating this concept of patient-focused simulation (PFS), the authors draw on work already published by their group and several recent studies that are in review. These explore PFS in low, medium, and high complexity settings. Important or rare situations can be recreated and practiced, as well as key procedures required across a range of experience levels and clinical specialties. Finally, the case is made for curriculum redesign to ensure that simulator-based technical skills training and assessment take place within an authentic context that reflects the wider elements of clinical practice.

Author Information

Dr. Kneebone is senior lecturer in surgical education, Department of Biosurgery and Surgical Technology, Imperial College London.

Dr. Nestel is senior lecturer in communication, Department of Biosurgery and Surgical Technology, Imperial College London.

Ms. Wetzel is research associate, Department of Biosurgery and Surgical Technology, Imperial College London.

Dr. Black is registrar, St Mary’s Hospital Regional Vascular Unit, London; and Department of Biosurgery and Surgical Technology, Imperial College London.

Dr. Jacklin is clinical research fellow, Department of Biosurgery and Surgical Technology, Imperial College London.

Dr. Aggarwal is clinical research fellow, Department of Biosurgery and Surgical Technology, Imperial College London.

Ms. Yadohalli is research associate, Department of Biosurgery and Surgical Technology, Imperial College London.

Dr. Wolfe is Consultant surgeon. St Mary’s Hospital Regional Vascular Unit, London.

Dr. Vincent is Professor of Patient Safety Department of Biosurgery and Surgical Technology, Imperial College London.

Dr. Darzi is Professor of Surgery and Head of Department of Biosurgery and Surgical Technology, Imperial College London.

Please see the end of this article for information about the authors.

Correspondence should be addressed to Dr. Roger Kneebone, Senior Lecturer in Surgical Education, Department of Biosurgery & Surgical Technology, Division of Surgery, Oncology, Reproduction and Anaesthetics Faculty of Medicine Imperial College London, Chancellor’s Teaching Centre, second Floor QEQM Wing, St Mary’s Hospital, Praed Street, London W2 1NY; telephone: 020 7886 7930; fax: 020 7886 1810; e-mail: (r.kneebone@imperial.ac.uk)

© 2006 Association of American Medical Colleges