"Practicing" medicine without risk: students' and educators' responses to high-fidelity patient simulation.
OBJECTIVE
To understand the responses of medical students and educators to high-fidelity patient simulation, a new technology allowing "practice without risk."


METHODS
Pilot groups of students (n = 27) and educators (n = 33) were exposed to a simulator session, then surveyed with multiple-choice and open-ended questions. Open-ended comments were transcribed and coded. They were analyzed for recurring themes and tested for inter-rater agreement. An independent focus group subsequently performed higher-level thematic analysis.


RESULTS
Overall, 85% of the students rated the session excellent and 85% of the educators rated it excellent or very good. Over 80% of both groups thought that simulator-based training should be required for all medical students. Analytic categories derived from written comments were: Overall Assessment (i.e., "generally good experience"); Process Descriptors (i.e., "very realistic"); Teaching Utility (i.e., "broad educational tool"); Pedagogic Efficacy (i.e., "promotes critical thinking"); and Goals for Future Use (i.e., "more practice sessions"). Thirty percent of students and 38% of educators were impressed by the realism of the simulator, and they (37% and 25%, respectively) identified the ability to "practice" medicine as the primary advantage of simulation. The focus group rated cost as the major current disadvantage (66%).


CONCLUSIONS
Students' and educators' responses to high-fidelity patient simulation were very positive. The ability to practice without risk must be weighed against the cost of this new technology.
Gordon
J A
JA
Division of Emergency Medicine, Harvard Medical School, Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, CLN 115, Boston, MA 02114-2696, USA. jgordon3@partners.org
Wilkerson
W M
WM
Shaffer
D W
DW
Armstrong
E G
EG
D001291:Attitude of Health Personnel; D002982:Clinical Clerkship / Q000191:economics / Q000379:methods* / Q000592:standards*; D004635:Emergency Medicine / Q000193:education*; D005180:Faculty, Medical; D017144:Focus Groups; D006801:Humans; D008824:Michigan; D009937:Organizational Objectives; D010043:Outcome and Process Assessment, Health Care; D016544:Patient Simulation; D010865:Pilot Projects; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods / Q000592:standards