Critical events in paediatrics are infrequent, yet patients can have good outcomes if successfully managed (10
). Although many practicing health care providers will at some point be required to manage acutely ill or injured children, very few opportunities to learn and practise the necessary skills are encountered during medical training or practice. Many of these skills are taught didactically, with few opportunities for hands-on practice. Lack of opportunities to practice skills erodes health care provider confidence, adversely affects their performance, and increases the possibility of medical errors or an adverse outcome (13
). Until now, opportunities for hands-on practice have either been left to chance or have been created using static mannequins with indirect patient feedback from an instructor. Because these experiences lacked the realism of actually assessing and treating an acutely ill or injured child, there are significant limitations in terms of the knowledge, clinical skills and confidence these sessions have imparted to learners. By comparison, the immersive nature of simulation training allows participants to practise in an environment that closely mimics the assessment and treatment of real patients (17
). The suspension of disbelief achieved by a well-designed simulation allows learners to speak and act as if in an actual patient encounter, while receiving direct feedback from the simulation equipment.
Increasing exposure to acutely ill or injured children in this type of immersive environment is a major benefit of simulation education. According to adult learning theory, learning is enhanced when ‘real-world’ application is appreciated by the learner, when direct feedback is incorporated and when small groups with varied experiences are able to reflect together to direct their learning and generalize their experience (19
). Using David Kolb’s Experiential Learning Model (20
), simulation can provide a learning experience that incorporates these important elements to meet the adult learner’s needs. This model involves using a highly realistic experience (the simulation) with immediate ‘real-world’ relevance, followed by reflection on this experience in small groups to generalize learned concepts to new experiences. This reflective component is usually accomplished using video-assisted debriefing to stimulate a discussion with expert feedback regarding what occurred during the simulation experience. This is then followed by a discussion of how concepts can be generalized more broadly, ultimately allowing for the opportunity to try out new or different approaches the next time that same experience is encountered (20
). Given these enhanced abilities for reflection, generalization and application, the ability to provide additional and ongoing opportunities for experience and practice in the assessment and management of acutely ill or injured children is likely the greatest benefit of simulation. Experiences can be provided on an on-demand basis versus by chance alone, and scenarios with unexpected or unfortunate outcomes can be repeated and mastered (5
Other significant benefits of the simulation experience include practice in a risk-free environment, allowing errors to occur and reaching a conclusion; presentation of uncommon disease presentations or atypical presentations of common diseases; practice of complex clinical situations; and the ability to evaluate new equipment, interventions, treatment protocols and procedures (21
). Even with all of these potential benefits of simulation learning, there is an emerging body of evidence that indicates that the potentially greatest benefit of simulation may be the ability to train in a team setting with the incorporation of training in human factors that contribute to medical error. The quality of team behaviour has been shown to improve following training as a team using simulation, and this may lead to a subsequent reduction in the number of medical errors (29
). Ongoing assessment of the value and benefits of simulation is essential for integration into formal medical education. summarizes the benefits of simulation-based education.