Simulation is a set of techniques that replace or amplify real experiences with planned experiences, often immersive in nature, that evoke or replicate substantial aspects of the real world in a fully interactive fashion.
“Immersive” conveys the sense that participants have of being immersed in a task or setting as they would if it were the real world. While seamless immersion is not currently achievable, experience shows that participants in our current types of immersive simulations easily suspend disbelief and speak and act much as they do in their real world positions.
Why Use ISL?
We do this ultimately for the purpose of improving the quality and safety of patient care both for today’s clinicians and for those who will be the next generation. We are committed not only to improve the education of those just starting, but to making a difference now.
There is a saying so good that it exists in various forms in both the Hebrew Talmud and the Muslim Quran: “Whoever saves a life (or a heart, or a brain), it is as if he has saved all of mankind”. This is the spirit that drives CISL as it drives our clinical learner populations.
Our Long-term Vision for ISL
Our long-term vision is to embed ISL into the fabric of healthcare, not just for novices and not just an extra and rare event. Clinicians should cycle through ISL activities of many different sorts, sometimes as individuals and sometimes in teams or whole work units. Our vision is that if someone is a healthcare professional the only way they get to stop being in simulations is to either retire or die. That’s exactly the way it is in other industries – like aviation – where the public places its faith in highly trained professionals.
Applications of simulation relate the intended goals of the activity to specific target populations of participants and to specific types of simulation and curricula. ISL techniques address many gaps in the current system of training and assessment, providing focused learning experiences that cannot be readily obtained using traditional techniques or in real patient care situations.
For novices, immersive and simulation learning serves as a bridge between classroom learning and real-life clinical experience. Using simulation technologies in true-to-life medical settings, early medical students are free to build on their current knowledge base and develop important clinical skills before they work with real patients. More experienced clinicians can hone their skills as individuals and teams to be “at the top of their game.”
Where We are Now
At present, both at Stanford through our historical pioneering efforts dating back 30 years as well as our ongoing innovation, ISL is widely used for all learner populations: lay public/school children; undergraduate university students; medical students and bioscience graduate students; interns, residents, fellows; experienced clinicians from Stanford Medicine; experienced clinicians from outside institutions. We use nearly all modalities of ISL, especially Standardized Patient actors; computerized mannequins; and task trainers. Much of ISL is devoted not only to the “medical & technical” skills of diagnosis, therapy, and manual procedures but also to “non-technical” skills such as dynamic decision making; teamwork; communication; ethics; and professionalism.
For relatively experienced personnel (i.e. interns & residents and above for physicians; new staff nurses and above for nurses) we have activities that are conducted for “single disciplines” (e.g. just for anesthesiologists) or for combined teams (e.g. the whole OR team of surgeon(s), nurses, anesthesiologist(s), technician(s), etc.)
CISL has accomplished a great deal in the last 12 years but there is so much more to do. We guarantee that we will never stop trying to make healthcare better for patients and families using all the tools at our disposal.