Article

Distributed simulation - Accessible immersive training

Imperial College London, UK.
Medical Teacher (Impact Factor: 2.05). 01/2010; 32(1):65-70. DOI: 10.3109/01421590903419749
Source: PubMed

ABSTRACT Distributed simulation (DS) is the concept of high-fidelity immersive simulation on-demand, made widely available wherever and whenever it is required. DS provides an easily transportable, self-contained 'set' for creating simulated environments within an inflatable enclosure, at a small fraction of the cost of dedicated, static simulation facilities. High-fidelity simulation is currently confined to a relatively small number of specialised centres. This is largely because full-immersion simulation is perceived to require static, dedicated and sophisticated equipment, supported by expert faculty. Alternatives are needed for healthcare professionals who cannot access such centres. We propose that elements of immersive simulations can be provided within a lightweight, low-cost and self-contained setting which is portable and can therefore be accessed by a wide range of clinicians. We will argue that mobile simulated environments can be taken to where they are needed, making simulation more widely available. We develop the notion that a simulation environment need not be a fixed, static resource, but rather a 'container' for a range of activities and performances, designed around the needs of individual users. We critically examine the potential of DS to widen access to an otherwise limited resource, putting flexible, 'just in time' training within reach of all clinicians. Finally, we frame DS as a 'disruptive innovation' with potential to radically alter the landscape of simulation-based training.

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    • "Distributed Simulation (DS) is a validated, low-cost and portable concept, devised to widen access to contextualised simulation. It comprises an inflatable shell containing the minimum necessary cues to provide a sense of realism and inbuilt recording facilities (Kneebone et al. 2010). Such inflatable simulation facilities have been promoted in educational policy (Temple 2010). "
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    ABSTRACT: Background: Simulation offers recognised training benefits, but the cost of high-fidelity contextualised simulation is prohibitive and its accessibility limited to specialised Distributed Simulation centres. Distributed simulation (DS) is an innovative concept of low-cost, portable and high-fidelity contextualised simulation. However, it has previously only been trialled at a central London teaching hospital. Aims: (1) To explore the off-site feasibility of DS. (2) To determine the response of end-users to DS. Methods: A DS naive researcher recreated a standardised porcine laparoscopic cholecystectomy scenario at a District General Hospital using DS. A research diary detailed the logistical feasibility of the project, whilst mixed methods were used to determine the response of the 10 surgeons who completed the full-team simulation. Results: DS is feasible off-site with end-users comparing it favourably to their previous simulation experiences. Surgeons perceived DS as being most useful for building the operative confidence of juniors between learning the basics on a bench top model and before entering the operating theatre. Conclusions: DS has the potential to provide high-fidelity contextualised simulation as an adjunct to, and not a replacement for, surgical training. Unlike other modalities, it is low cost and portable, thereby addressing concerns over affordability and accessibility.
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    • "Crisis events can also be modeled, allowing healthcare teams to be evaluated in realistic environment including rare but important clinical events essential for teaching patient-safety (Sica et al. 1999; Wong et al. 2002). Distributed simulation using portable, low-cost, and highly immersive environment offers a new avenue of testing clinical skills in authentic setting (Kneebone et al. 2010). Onscreen simulations, such as virtual patients, are another growing form and one that has been found to have utility in assessment as well as learning (Fischer et al. 2005; Round et al. 2009). "
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