Historic of Simulation in Medical Education

Kids, when they are playing with dolls or little cars, are learning real life through simulation.

In the aeronautic area, pilots spend 10 % of their worktime on flying simulators, in order to learn how to fly a plane, and who to react in a critical situation. In many other industries, considered safe, simulation has been used in order to improve security, such as army or nuclear industry.

What about simulation in Medical studies? In this field, security and safeness are also crucial, especially in case of critical situation.

The word simulation in health education correspond to the use of a material (manikin or simulator), a virtual tool (mooc, serious game) or a standardized patient to reproduce situations or healthcare environments, with the objective of teaching diagnostic therapeutic procedures, or decision-making process by a professional or a team.

In 18th century, Angelique Marguerite Du Coudray, famous midwife in France, holds a substantial position in the history of simulation. She traveled to rural provinces in France where birth survival rates were incredibly low, teaching midwifery by using revolutionary techniques, including a panoply of manikins and lifelike machines to simulate childbirth. Mme du Coudray’s teaching initiative was a huge success, and resulted in an increased numbers of successful births.

In the year 1968, an American citizen from Miami, Dr. M. Gordon, created Harvey®, the Cardiopulmonary Patient Simulator. He is a full-size manikin that realistically simulates nearly any cardiac disease, including blood pressure, breathing, pulses, heart sounds and murmurs, used to train medical student, resident, and cardiologists.

With the 21st century, were born high fidelity manikins, and with them the possibility to simulate very realistic medical emergency scenarios. Manikins are able to speak, to breathe, to shout, to bleed, they can even give birth !

Somes studies have even demonstrated a positive correlation between video gaming and technical skill performance in some surgical procedures, because of the formation of psychomotor mechanisms such as ability to concentrate on the operative task via a screen without being distracted by events in the background.

What about communication with this way to learn medical skills ? Simulation is also a powerfull way to develop non technical skills as interdisciplinary communication.

Nevertheless, some questions remain answerless : does simulation training actually improve medical technical and non technical skills ? Is it able to reduce stress for professionals when they have to face a critical situation ? We need to discover it, via research in this area.