The paper by Ker et al. (Citation2005) fills an important gap in the literature on simulated patients. The paper reviews the relatively limited literature and draws on the authors’ experiences of the Dundee Simulated Patient Bank.
Readers may be interested in an additional role to which we put our simulated patients––the development and assessment of procedural skills (Kneebone et al., Citation2002a; Kneebone et al., Citation2003; Nestel et al., Citation2003a, Citationb). By linking simple (e.g. suture pad, urinary catheterisation, venepuncture) or more complex (e.g. carotid endarterectomy, virtual reality endoscopy) models with actors we aim to create an authentic simulation that uses all relevant senses (e.g. audio, visual, tactile) in realistic settings (Kneebone et al., Citation2002b; Kneebone & Nestel, Citation2005; Kneebone et al., Citation2005). These simulations provide learners with an opportunity to integrate technical, communication and other professional skills essential for effective practice with real patients.
Depending on the nature of the procedural skill, simulated patients undergo various levels of training. Performance depends on characterization of role as well as knowledge of key aspects of the procedure so that the simulated patient can respond appropriately (e.g. time taken for local anaesthetic to work, relief from successful urinary catheterization). In some procedures, the simulated patient cannot see the clinician conducting the procedure so performance cues for the simulated patient are provided by a concealed audiolink from an observer.
Like Ker et al. (Citation2005) we are committed to sharing experiences in order to develop simulated patient programmes that provide learners with the best opportunities in which to develop a whole range of professional skills. We believe the success of our simulated patient programme is based on adherence to principles of adult learning (Knowles, Citation1990), thinking creatively about ways to support health care professional training and a team approach that whenever possible includes students, actors, clinicians, psychologists and educationalists at all stages of programme development, implementation and evaluation.
Debra Nestel, Senior Lecturer in Clinical Communication
Department of Biosurgery and Technology, Imperial College London, Paterson Centre
Charing Cross Hospital, St Dunstan's Road, Room 9L04
London W6 8RF, UK.
Email: [email protected]
Roger Kneebone,
Senior Lecturer in Surgical Education
Steve Black,
Clinical Research Fellow
Norma Jones, Simulated Patient
Emma Horrocks, Medical Student
Rachael Harrison, Medical Student
Cordula Wetzel, PhD Student
References
- Ker JS, Dowie A, Dowell J, et al. Twelve tips for developing and maintaining a simulated patient bank. Medical Teacher 2005; 27: 4–9
- Kneebone RL, Kidd J, Nestel D, et al. An innovative model for teaching and learning clinical procedures. Medical Education 2002a; 36: 628–634
- Kneebone R, Nestel D, Darzi A. Taking the skills lab onto the wards. Medical Education 2002b; 36: 1093–1094
- Kneebone R, Taylor P, Nestel D, et al. Learning the skills of flexible sigmoidoscopy––the wider perspective. Medical Education 2003; 37: 1–9, (Suppl. 1)
- Kneebone RL, Nestel D. Learning clinical skills––the place of simulation. Clinical Teacher 2006, in press
- Kneebone RL, Kidd J, Nestel D, et al. Blurring the boundaries: Scenario-based simulation in a clinical setting. Medical Education 2005; 39: 580–587
- Knowles M. The Adult Learner: A Neglected Species. Gulf Publishing, Houston, TX 1990
- Nestel D, Kneebone R, Taylor P. Communication for gastro-intestinal endoscopy: experiences of a course for nurse practitioners. Gastrointestinal Nursing 2003a; 1: 18–25
- Nestel D, Kneebone RL, Kidd J. Teaching and learning about skills in minor surgery—–an innovative course for nurses. Journal of Clinical Nursing 2003b; 12: 291–296