Distributed simulation – Accessible immersive training

Abstract

Distributed simulation (DS) is the concept of high-fidelity immersive simulation on-demand, made widely available wherever and whenever it is required. DS provides an easily transportable, self-contained ‘set’ for creating simulated environments within an inflatable enclosure, at a small fraction of the cost of dedicated, static simulation facilities. High-fidelity simulation is currently confined to a relatively small number of specialised centres. This is largely because full-immersion simulation is perceived to require static, dedicated and sophisticated equipment, supported by expert faculty. Alternatives are needed for healthcare professionals who cannot access such centres. We propose that elements of immersive simulations can be provided within a lightweight, low-cost and self-contained setting which is portable and can therefore be accessed by a wide range of clinicians. We will argue that mobile simulated environments can be taken to where they are needed, making simulation more widely available. We develop the notion that a simulation environment need not be a fixed, static resource, but rather a ‘container’ for a range of activities and performances, designed around the needs of individual users. We critically examine the potential of DS to widen access to an otherwise limited resource, putting flexible, ‘just in time’ training within reach of all clinicians. Finally, we frame DS as a ‘disruptive innovation’ with potential to radically alter the landscape of simulation-based training.

Additional information

Notes on contributors

Roger Kneebone

ROGER KNEEBONE trained first as a general surgeon and then as a general practitioner. In 2003 he joined Imperial College London, where his research focuses on simulation and the contextualisation of clinical learning, using innovative hybrids of models and simulated patients. Roger directs Imperial's Masters in Education (MEd) in Surgical Education.

Sonal Arora

SONAL ARORA is a general surgery trainee and clinical research fellow, currently completing a PhD in simulation-based training of non-technical skills for surgeons. Sonal is interested in assessing and training safety-related skills in operating theatre teams. She is currently exploring simulation as a training tool, alongside other training modules.

Dominic King

DOMINIC KING is a specialty registrar in General Surgery in London and is undertaking a PhD in Behavioural Economics and Health Policy at Imperial College London. He has a Masters in Surgical Education from Imperial College London and maintains a significant interest in undergraduate and postgraduate teaching and education research

Fernando Bello

FERNANDO BELLO is a senior lecturer in Surgical Graphics and Computing. His research interests include modelling and simulation, medical virtual environments and haptic interaction. His work spans across technology and education, including development of patient specific simulation and exploring the integration of computer-based simulation and context via patient-focused simulation.

Nick Sevdalis

NICK SEVDALIS is an experimental psychologist, currently a lecturer in patient safety in Imperial College London. Nick leads a research team that is carrying out research in real and simulated clinical settings, with a focus on non-technical skills (communication, team working, leadership) in surgical teams, and decision-making in physicians and patients.

Eva Kassab

EVA KASSAB holds an MSc in Cognitive and Decision Sciences and is currently a research psychologist in Imperial College London. Eva is interested in assessing non-technical skills in surgical teams in real and simulated procedures. She is currently working on developing further the DS environment and assessment tools.

Raj Aggarwal

RAJ AGGARWAL is a specialist registrar in General Surgery in London and an academic clinical lecturer in Surgery at Imperial College London. His research interests include the validation of simulation training and training curriculum development for surgeons.

Ara Darzi

ARA DARZI holds the Chair of Surgery at Imperial College London and is an honorary consultant surgeon at St Mary's Hospital, London. His main clinical and academic interests lie in minimally invasive therapy and educational research. His teams were awarded the 2001 Queen's Anniversary Prize for Excellence in Higher and Further Education.

Debra Nestel

DEBRA NESTEL is a professor of Medical Education at Gippsland Medical School, Monash University and consultant to Imperial College London. Her research interests are in clinical communication, simulated based education, especially simulated patient methodology and programme evaluation.