Simulation Curriculum
From WickedSim
Contents |
Creating a Curriculum for Simulation
Closely associated with the idea of creating Simulation Standards is the concept of a 'simulation curriculum'. In medical simulation the problem of creating a curriculum is particularly vexing, as time is often limited, different educators have different emphases, and most important of all, there's such a variety of possible scenarios that it's extraordinarily difficult to decide whether to emphasise rare but important problems, or common but mundane tasks we often don't do very well.
We can nevertheless learn from the aviation community, and the concepts of a Training System and a Blueprint.
A Training System
A training system is composed of numerous elements, or training media, plus the supporting processes. Some elements are books and articles that the trainee is to read. Some are web-based lessons. Some are classroom experiences with a live instructor. Some are simulations, whether these include benchtop models, live patient actors, or mannequins. All of these elements are organized into a training system by the curriculum. Without curriculum, all you have is a loose, ad hoc collection of personality-driven simulations and events.
The curriculum for a training system contains carefully worded definitions for all tasks required "in the field". Each task has its own set of defined conditions and training standards. The simulation industry watches these definitions, and their conditions and standards, in order to know how to design their simulators. It is by meeting the training standards that objective evaluations can occur. The results of objective evaluations are fed back into the curriculum design in order to keep it current with trainee performance trends. The curriculum also needs a process by which it is updated to keep pace with new developments in the field, such as new drugs, new technology, and new techniques. When all of these processes are running strong, the result is a training system. --Lacree 11:24, 8 March 2007 (EST)
A Blueprint
Simulations can be developed in a variety of ways, but the aviation training community has learned that the best and least costly way is to systematically develop curriculum that then drives the entire training system. A training system is composed of many elements: books, classroom experience, on-line training, simulations, and actual experience. But it's easy to spend money on individual elements, and miss the big picture. In other words, investing effort and resources in developing curriculum prevents spending scarce resources on items and events that are less effective in achieving the required performance. It is easy to get focused on training devices like mannequins and miss the most important part of the training system--the curriculum.
Unfortunately, curriculum for training clinicians currently looks like a shopping list. Suppose the shopping list has an entry we'll call "Condition XYZ". "Let's go out on the floor now, because I want you to see this patient with Condition XYZ." But if by chance that patient had gone to another hospital, or never came in, there is nothing to drive realistic training in condition XYZ. In other words, the random patient distribution determines the actual curriculum, no matter what is on the shopping list.
In aviation, the curriculum specifies training in fog, blowing snow, icing, turbulence, crosswind, etc., because all of these are conditions defined in a documented performance requirement. Because these conditions can be replicated reliably only with simulation, and because a simulation hour is much cheaper than a flight hour, the simulation industry has responded to the curriculum specifications by building better simulations that actually match the training requirement.
This logic works the same in a hospital; a simulation hour is much cheaper than an OR hour, and if the cost of mistakes and the value of performance gains are included, it may also be cheaper than an hour out on the floor. Taking time to develop this blueprint properly pays off in the long run in the coins of the realm: reduced actual (and costly) errors, proper training device investments, individual and collective (team) performance gains, efficiency out on the floor and in the operating room, and reduced turnover. The complete process for developing the blueprint is contained in the Systems Approach to Training.
--Lacree 11:08, 8 March 2007 (EST)
Pre-packaged Curriculums
Currently, the only offering for a pre-packaged curriculum fully integrating simulation is PNCI from METI. In a partnership with Texas Woman's University-Dallas, METI has created a four semester 'integration roadmap' for undergraduate nursing education. It revolves around Simulated Clinical Experiences, each designed to promote a certain teaching point. The curriculum can be adopted as a whole, or specific SCEs can be used to augment an existing nursing curriculum.
