Simulation FAQs

Broadly, simulation involves pretending, imitating or modeling something to look like something else.  Medical simulation uses multiple techniques to improve outcomes for instance: teach and assess physical, communication and problem-solving skills; model and perfect new processes and procedures before implementing with patients; study and identify solutions to errors; test new products.  Skills learned through simulation have been proven to improve actual practice in a real-setting. 

• Standardized patients – people trained to portray or act as patients 
• High-fidelity human-patient simulators -- computerized manikins that look like full-sized people and have various functions 
• Virtual reality – goggle and joystick or computer-based ‘smart games’ that mimic patient care scenarios and in which learners participate as they would in role-play games.
• Task trainers – full or partial body ‘dolls’ on which learners can practice specific procedures 
• Computerized simulation – programs and applications that allow learners to interact with medical images on a tablet or computer  
• Versatile simulation space – rooms that can be configured to look like home, public, business or healthcare environments (clinic office, ER, OR, ICU) with real, usable equipment; can be modified to include challenges to mobility, communication, etc. 

How is this related to the problem of ‘improving physical access to care?’  

While sophisticated equipment can be involved in medical simulation it is important to note that simulation is a method to enhance learning and is not related to any specific technology.  The method focuses on the guided and deliberate practice of skills, procedures and communication in a safe environment that includes feedback to allow learning.  Simulation is a proven method to improve outcomes.  Some examples in relation to the WooHealth Hackathon could include: 

• Standardized patients teaching how to communicate compassionately and effectively about sensitive topics that impact patient access to care (physical, emotional, cultural, economic…) 
• Videos (2D or 3D) that help patients who may be uncomfortable in public transit or healthcare environments to gain familiarity 
• Rooms set up to look like anything that might help address a particular area of concern e.g.  living room, exam room, hospital room, bus waiting room! 
• A board game approach to promote problem-solving or learning about resources. 
• Virtual reality tools to help people navigate spaces and interact without physically moving. 
• Standardized patients helping train real patients or providers to use telemedicine 
• High-fidelity manikins that can be structured with physical disabilities to help clinical settings improve spaces and access to care  

Any task -- from making a phone call, to crossing a street, to registering for an appointment, to having a procedure can be simulated. 

How can simulation be used to solve problems? 

Some examples of how health care organizations use simulation to improve safety and communication: 

• Interdisciplinary training: When an activity or procedure requires more than one area of expertise, simulation can be used to practice how to interact and optimize communication as a team.  For example, it may be helpful for all offices/staff engaged is patient scheduling to fully understand the process from the perspective of the patient, which can be simulated by using standardized patients for training, assessment or data collection (e.g. “secret shopper” method) 
• Practicing infrequent events that may have large impact: In situ simulation in the setting where the event might occur can help staff identify vulnerabilities in their systems or infrastructure. For example, by simulating a multi-day power outage due to a blizzard, staff may find that physical access to care is hampered in a variety of ways that can be addressed by forward planning and team practice.  
• Protocol or procedure testing:  Simulation is a very flexible method for learning and problem-solving.  It could be used at the design stage for a new office, clinic, waiting room to be sure plans are useable by the intended users.  This could avoid costly design areas (e.g. a gurney can’t move around that corner) or prevent impediments (e.g. information windows at standing height are less approachable for those requiring wheelchairs for mobility).  New processes can also be simulated to be sure team members are in sync prior to launch.  
• Quality improvement: When issues are uncovered, simulation can be useful in helping to determine the root cause, develop a plan to solve the issue and then practice the revised process (could be communication, could be changing the way a procedure is accomplished, etc.)

What are the common terms used in simulation and what do they mean?