Clinical simulation provides compelling experiential learning programs and effective assessments of clinical skills.
Real-life challenges are presented in a safe and supportive environment through the use of standardized patients, procedural task trainers (bench models), high-fidelity mannequins, virtual reality, and screen-based simulations. Experiential workshops combine lively interactivity with immediate debriefing, feedback and coaching.
Simulations allow valid and reliable assessments of key clinical competencies such as diagnostic interviewing, physical examination, communication and interpersonal skills, decision-making, procedural skills, teamwork and professionalism. Digital video recordings document simulated encounters and can be reviewed, annotated and scored online.
Patient Safety and Quality Improvement
Simulations provide a safe venue for practicing new and error-prone procedures and investigating near misses. Unannounced standardized patients (“mystery shoppers”) provide a powerful tool for exploring the patient experience in hospitals and clinics.
Research and Innovation
Clinical simulation experiences serve as highly effective research interventions, outcome probes, and evaluation tools for research studies in health professions education and patient safety. The development and validation of new and innovative simulations is an additional area of scholarly activity.
Programs are grouped under their primary learning or assessment objectives, although programs for advanced learners frequently address multiple objectives within a given simulated scenario. All programs can be modified for learners of different backgrounds and levels of training.
Program objectives include:
- Communication Skills
- Interviewing and History-Taking Skills
- Physical Exam Skills
- Procedural Skills
- Team Training
- Patient Safety and Quality Improvement
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Simulated encounters present communication challenges that elicit learners’ ability to communicate effectively with patients, families and colleagues.
Professional actors provide realistic reactions such as grief and anger so that learners are able to experience first hand some of the more difficult communication tasks they will encounter in practice.
Sample projects focusing on communication skills include:
Groups of up to 15 students and a faculty preceptor interact with an SP portraying a difficult communication challenge, allowing students to practice interviewing skills such as taking a sexual history or addressing domestic violence.
Communication Skills Assessment
Residents in family medicine, internal medicine, neurology, OB/GYN, pediatrics and surgery encounter SPs in six one-on-one communication scenarios such as giving bad news, obtaining informed consent and discussing a medical error. An individual debriefing with the patient takes place immediately after each encounter.
Interviewing and History-Taking Skills
History-Taking and interviewing skills are needed to successfully gather essential and accurate information from patients.
Learners practice effective listening skills and elicit information using nonverbal, explanatory, questioning and writing skills.
Sample projects focusing on history taking include:
M1 History/Interview Assessment
First-year medical students are assessed on their ability to interview three different patients with disparate chief complaints.
M3 Psychiatry Clerkship Assessment
At the conclusion of the Psychiatry Clerkship rotation each student interviews three simulated psychiatric patients and documents their findings.
Physical Exam Skills
The ability to perform a physical exam (PE) and interpret physical findings is critical to patient care.
Trained practical instructors supplement faculty teaching and facilitating practice.
Sample projects focusing on physical examinations include:
Physical Exam Workshops
Provide instruction ranging from basic PE maneuvers to more invasive exams. Gynecologic Teaching Associates, trained instructors who teach students to perform pelvic and breast exams on the GTA’s own body, provide feedback from the patient’s perspective.
Learning to recognize abnormal findings: Clinical Findings Simulators
Allow students to practice recognizing abnormal findings that cannot be simulated by an SP.
Head to Toe PE Assessment
Students are tested on a 143-item checklist of PE maneuvers that comprise a full Head To Toe physical exam. Practical instructors provide students with immediate feedback and teach them how to perform the maneuvers correctly.
A large variety of simulation equipment facilitate the instruction and assessment of procedural skills.
Sample projects focusing on procedural skills include:
Basic procedural skills:
Small groups of students rotate through a series of stations, each focused on a particular procedural skill such as lumbar puncture, IV insertion and suturing.
Central Venous Catheter Workshop
Physicians and nurses practice safe insertion and removal of Internal Jugular and Subclavian central lines in this interprofessional workshop. Removal is practiced using lines “inserted” in standardized patients, who can simulate complications and adverse events.
High-fidelity mannequin simulations provide interprofessional teams with practice in critical decision-making, teamwork, team leadership, and team communication skills.
Facilitated debriefings help participants increase their repertoire of effective team behaviors.
Sample projects focusing on team training include:
Rapid Response Team Training
Residents, nurses and respiratory therapists practice responding to hospital “patient” crises simulated by mannequins in-situ at the University of Illinois Hospital.
Pre-Critical Care Rotation Workshop
Internal Medicine residents, Pharmacy residents and Nurse Practitioner students practice effective responses to critical care emergencies and ACLS scenarios.
Patient Safety and Quality Improvement
Patient Safety projects focus on preventing, responding to and appropriately disclosing medical errors.
Quality Improvement projects address other quality issues such as patient satisfaction.
Moderate Sedation Workshop
Physicians and nurses who administer moderate sedation for medical, surgical or dental procedures practice recognizing and responding to potential problems.
Outpatient Quality Assurance Project
Unannounced standardized patients (USP’s) serve as “mystery shoppers” in the outpatient clinic, allowing administrators to identify priority areas for intervention to improve patient satisfaction. Staff development workshops include SP interactions and video vignettes based on USP experiences, facilitating the rehearsal of effective patient-centered interactions.