Education Matters

Simulation in Medical Education: More than an Educational Tool

Simulation as a Research Tool

Over the last 20 years, simulation has become a tremendously popular educational tool. The increased use of simulation by medical teachers and educators has raised questions regarding its effectiveness in achieving important learning objectives and in assessing trainees’ knowledge and skills. Not surprisingly, most educational researchers have thus considered simulation as a object of research. More recently, simulation has also been used as a research tool to study other topics relevant in medical education. 

What Can Simulation Do for You!
Thus far, three types of objectives have been pursued by researchers who have used simulation as a research tool: identifying trainees’ deficiencies regarding specific clinical knowledge or skills (e.g. communication of bad news); determining the impact of a variable (e.g. sleep deprivation) on trainees’ clinical performance; and assessing the impact of a non simulation based educational intervention (e.g. change in clinical curriculum) on trainees’ performance. Simulation has thereby contributed to a greater understanding of the learning processes involved in clinical training and has created opportunities to design better educational interventions based on research findings.



Why Use Simulation as a Research Tool?

Conducting educational research in real clinical settings would be optimal, but often practically impossible. Exposing real patients to the risks posed by suboptimal clinical performance or gaps in trainees’ knowledge and skills for research purposes are not ethically acceptable. Simulation provides an environment where these studies can be safely conducted. Furthermore, the ability to control variables that may influence research outcomes and to record trainees’ behaviours and performance offers significant advantages for the researcher. However, simulation also presents some limitations as a research tool that must be considered early in the design of a study. 



A Few Caveats…

Three types of challenges must be expected when designing a simulation-based study. First, organizing simulation sessions involves significant financial and human resources. Many educational projects are completed with minimal funding, and careful planning is needed to limit unnecessary expenses. Second, the choice of outcomes and variables used to measure these outcomes is important for producing informative results (e.g. Which scale should be used to measure communication skills?). Finally, researchers have to keep in mind that simulation is not exactly like the real clinical environment. Research findings resulting from simulation-based studies may need to be confirmed (when possible) in real clinical settings. However, simulation has a lot to offer as a research tool. With a bit of work, lots of help, and sparks of creativity, simulation-based research can be a rewarding and exciting adventure!


Dr. Dominique Piquette
Staff Physician & Clinical Associate
Critical Care Medicine
Sunnybrook Health Sciences Centre

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