Overview for First-time Developers

The CISL faculty have had a very strong pioneering presence using ISL to teach various aspects of the specialty practice of medicine to: advanced trainees, interns, residents, and fellows (collectively known as “housestaff”).

Traditionally, most of their training has been apprenticeship-style: taking care of patients under the supervision of experienced faculty specialists. In many departments, ISL now provides a substantial addition to traditional training, filling gaps that are otherwise hard to address. ISL is particularly important in fields that involve invasive and hazardous work, including surgery, anesthesia, intensive care, neonatology, emergency medicine, and obstetrics and gynecology.

Simulation is a set of techniques to 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 of participant being immersed in a task or setting as they if they were the real world. While seamless immersion is not currently achievable, experience shows that participants in immersive simulations easily suspend disbelief, speak and act, much as they do in their own jobs. Applications of simulation relate the intended goals of an activity to a specific target populations of participants and to specific types of simulation and curricula.

Immersive and simulation-based learning (ISL) techniques provide a safe environment for the learning of appropriate diagnostic, therapeutic, and interpersonal responses to clinical situations. Our programs are effective for teaching clinical knowledge and technical ability, while providing an opportunity for participants to develop teamwork, communication, and dynamic decision-making skills in a realistic but controlled setting.

Serving as a bridge between classroom learning and real-life clinical experience learners are free to build on their current knowledge base and develop important clinical skills before they work with real patients, addressing the 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.

Using simulation technologies in true-to-life medical settings, combined with moderated debriefing and formative assessment, immersive learning programs can produce substantial improvements in clinical performance and patient safety.


Wide Range of Repeatable Learning Opportunities

Immersive and simulation learning offers intense experiences where learners can address multiple different aspects of cognitive and psychomotor skills including knowledge, tasks, decision-making, and teamwork. Training is available for a variety of patient care activities ranging from prevention to surgery and, because situations can be portrayed at will, events can be scheduled when convenient and repeated as often as necessary.

Freedom to Make Mistakes and Learn from Them

The experience of working in an artificial environment allows learners to make mistakes without the need for expert intervention and, by seeing the outcome of their mistakes, students gain a powerful learning experience not available in the real world.

Scaled in Complexity to Match the Learner's Experience

Programmable to any level of expertise an immersive learning event can accommodate a range of learners, from first-year medical students to seasoned clinicians, looking to learn new techniques or review a rare scenario.

Detailed Feedback and Evaluation

Immersive learning allows participants to obtain extensive feedback on their performances. Simulated clinical scenarios are video recorded and played back during debriefing sessions, so learners and instructors review participant performance together, serving as an effective trigger for discussion.

Types of Learning


Comprising of facts, concepts, and the relationships between them, knowledge can be the fundamental description of human biology and physiology such as anatomy or molecular genetics or the applied description of the human body in health and disease such as pathology and pathophysiology. However, it also encompasses the conceptual and practical basis of therapy such as pharmacology, surgery, or radiation oncology, as well as the evidence-based protocols that guide optimum therapy. Immersive learning provides the means to make knowledge “come alive”, facilitating comprehension and interest.

Tasks and Skills

Real patient care requires clinicians to lay hands on patients and perform important procedures. How to perform these procedures involves aspects of psychomotor skills that cannot be acquired with mere knowledge. Simulation through part-task trainers and other systems allows hands-on learning without discomfort or risk to patients. The skills acquired range from physical examinations and blood drawing, to more invasive procedures such as spinal tap or chest drainage, as well as complex surgical procedures such as laparoscopic surgery, cardiac surgery and catheter-based interventions such as “cath-lab” procedures treating aortic aneurysm or carotid artery blockage.


Treatment and diagnosis of patients requires making many decisions, both in real-time and over a longer periods of time. Simulations provide structured and supervised practice in both kinds of decision-making, and is uniquely able to probe and challenge decision-making in very time-critical hazardous settings like operating rooms, intensive care units, or emergency departments.


Teamwork comprises all the information, attitudes, and practical skills that must be learned and practiced. Immersive and simulation sessions allow personnel to train and practice these skills together in a structured environment partaking in role-reversals, such as a physician being the nurse and vice versa. Whether the teams interact in person or through computer-generated virtual worlds, collaboration is a keystone of improving teamwork and the quality and safety of patient care.