Karl Willmann, M.D., completed his undergraduate studies, medical education, and training at the University of Wisconsin. He is currently an Assistant Professor at the University School of Medicine and Public health, Department of Anesthesiology. Karl utilizes the Department of Anesthesiology’s METI Human Patient Simulator as a training mechanism for medical students and anesthesiology residents. He works closely with Eric Bauman in the Department of Anesthesiology’s Simulation Laboratory developing curricula utilizing high fidelity simulation as a mechanism for education and evaluation in the health sciences.
Karl is an avid gamer who cut his teeth in the arcades, and predates the infamous Commodore 64. He has been an avid online gamer ever since being allowed online. He has played the entire Diablo series and EverQuest, as well as a plethora of other online and console games. He is currently playing World of Warcraft. It is Karl’s understanding of gaming that helps him to appreciate the need to engage learners of all levels throughout the educational process.
High Fidelity Simulation in the Health Sciences
High fidelity simulation is gaining popularity as a tool for adult education in circumstances in which student performance in clinical and professional environments involves high human stakes. High fidelity simulation is a term that appears to evolve as technology improves. Simulation today, especially in the health sciences such as nursing and medicine, represents a far cry and vast improvement over static CPR manikins with which many are familiar. In its current context, high fidelity simulation provides realistic opportunities to assess, diagnose, treat and or intervene on the behalf of a simulated patient (manikin), replicating a human condition by utilizing complex mathematical algorithms managed by computers to a large extent that are either programmed by or operated by a human operator. These complicated technological manikins and their simulated computer physiology are generally known as human patient simulators.
Advocates of high fidelity simulation argue that simulation influences later outcomes associated with students’ and/or professionals’ clinical performance by providing exponential increases in experiential learning (Gordon, Oriol & Cooper, 2004). High fidelity simulation provides learners with routine and critical experiential learning scenarios that may not be readily available or ethically available in clinical practice (Institute for Medical Simulation, 2005).
An often-overlooked component of high-fidelity simulation is the environment in which the simulation takes place. Dropping an expensive piece of electronic equipment into the classroom often leads to disappointing experiences for both teachers and students. Using technology to create environments and virtual realities in which students can be inserted offers entirely different possibilities. Through the use of high fidelity simulation, environments and content can be designed and situated to meet learners’ needs across numerous disciplines. Providing learning environments consistent with actual practice settings, whether they are in the emergency room, the cockpit of an airplane, an accident scene or an operating room is thought to enhance the generalization and transfer of training to real life clinical practice (Pratt & Nesbit).
The use of simulation, particularly high fidelity simulation in the health sciences is often used in two-distinct modes. The first, the tutorial mode, provides students with diagnostic and treatment walkthroughs of various patient presentations. This provides students with an interactive learn-as-you-go approach, where learning is rather immediate. In the case of tutorial instruction an instructor is usually present in the room with students talking them through various assessments and treatment options. Alternatively, high fidelity simulation can be used to encourage reflective learning. In this mode of simulation, students are placed into an evolving simulation, which will develop according to their actions. In this style of simulation, students participate in a debriefing led by the instructor to assist them to come to conclusions through reflection about their strengths and weaknesses, whether technical or behavioral.
Through the use of a METI human-patient-simulator and a hands on created environment, participants will be inserted into basic and advanced crises situated in an interactive health care simulation. Participants need not be health care clinicians in order to engage these simulations and learn about how the art of simulation is blurring the boundaries between entertainment and education.
Engaging a debriefing process often associated with simulation will provide participants with the opportunity for discussion about how the academic setting is learning from the success of the gaming industry, emphasizing the need to engage the learner/player in the scene, while setting the stage for further reflection. Complex high fidelity simulation is not successful because it utilizes complex mathematical algorithms, but rather because it goes to great lengths to situate the player with a sense of familiarity while pushing the boundaries of their comfort levels.
Simulation as a tool for education is as much or more about behavioral interaction in response to realistic stimuli, as it is a mechanism for psychomotor skill development. Creating an environment that addresses both of these variables provides for realistic and meaningful experiences that may be applied to real world practice.