Realism and the Art of Simulation

Patient simulation offers clinical educators a new type of “canvas” where they can apply the principles of realism. While having the latest high-tech robotic patient simulators emplaced within fully functional clinical spaces is great, that alone does not provide enough realism. Naïve people are generally impressed by the mannequin and its capabilities, but the “patient” is the most artificial thing about simulation. It's more important to use the technology as a lens to focus on the human aspect of interactions. In the quest for realism, clinical educators create context by placing the mannequin in a simulated or real environment, breathe life into it with human interaction, and take advantage of the learner's imagination. To facilitate learners being more receptive to the educators, the Patient Simulation Center located at St. Michael's Hospital in downtown Toronto, Canada, always presents a supportive and nonthreatening atmosphere. It aims to provide experiential acquisition of skills and judgment, allowing lessons to be learned from errors made. Before starting, learners are familiarized to the environment and the mannequin, and provided with a set of ground rules. This is done on a need-to-know basis, being careful not to cognitively overload the learners with too many rules. There is no need to share all the capabilities and limitations of simulation or to explain how the props work. Keep it simple and user friendly. The rules will vary with the different levels of learners and with how they utilize simulation.