Integrating Low-Fidelity Desktop Scenarios into the High- Fidelity Simulation Curriculum in Medicine and Aviation

The pursuit of efficiency in training systems design whilst simultaneously maximising transfer of training and the depth of training outcome presents a number of challenges for the curriculum designer. The recent developments in low-cost desktop simulation and training have the potential to offer much to the simulation-based curriculum. There exists considerable research evidence suggesting that low-fidelity simulation can achieve high levels of transfer of training, without the organisational burden of costs associated with the use of high-fidelity simulators. Similarly, research has suggested that there is not a simple direct relationship between fidelity and learning outcome in the simulation-based training environment. Within both the medical and aviation training settings, the learner’s experience of high-fidelity simulation is typically through complete immersion in brief, stressful and complex scenarios. These sporadic forays into the simulation-based training environment frequently require a level of cognitive engagement with the simulated task that can impact on the potential for learning to take place. Indeed, it could be suggested that high-fidelity simulation provides only the experiential component for a learning process that actually begins well prior to the simulation and the majority of learning actually takes place during the post-simulation debrief and subsequent reflection on action. This paper explores the potential of low-fidelity desktop simulation as an integrated element of the overall simulation-based curriculum, and as a ‘wrap-around” for high-fidelity simulation. The paper provides a series of examples to illustrate an integrated curriculum, and highlights areas in which both efficiencies and enhancements might be achieved.