High-fidelity patient simulation in physiotherapy education.

Over the last 30 years, the medical profession has been following in the foot steps of the aviation industry by developing equipment and teaching styles to recreate, or simulate, patient scenarios for educational purposes. One of the first mannequins in simulation education was the cardiopulmonary resuscitation mannequin, used with nurses and medical professionals for basic life support training since the 1970s. The popularity and positive learning outcomes noted from the use of such an education tool stimulated the medical profession to develop a vast assortment of simulators, ranging from simple part task trainers through to technologically advanced medium-to high-fidelity human patient simulators. ‘Part task trainers’ refers to modelled segments of the body, eg, the pelvis or knee, designed to teach specific skills such as intra-articular injection, scopic surgical procedures, or pelvic examinations. ‘Mediumto high-fidelity human patient simulators’ are full body mannequins that mimic precisely physiological responses to medical intervention such as drug administration or invasive procedures. The high-fidelity mannequin is linked to a computer system that drives physical changes in the mannequin such as respiratory rate, and opening of eyes, as well as physiological responses displayed on the ‘patient’ monitor such as heart rate, blood pressure, and oxygenation. This technology allows medical educators to simulate patient cases and provide students with the opportunity to refine practice away from real patients, in a safe and supportive learning environment. Integration of simulation education into medical curricula has been shown to facilitate the acquisition of technical skills such as resuscitation and invasive procedures (Gaba et al 1998, Issenberg et al 2003, Pittini et al 2002) as well as development of higher level processes such as cognitive analysis, clinical decision making, self efficacy, and communication skills in medical students (Blum et al 2005, Gaba et al 1998, McMahon et al 2005, Steadman et al 2006, Weller et al 2004, Zirkle et al 2005).