title: Review article: simulation: a means to address and improve patient safety.
abstract: OBJECTIVE
  The purpose of this article is to review the role of technical and nontechnical skills in routine and crisis situations. We discuss the role of different simulation modalities in addressing these skills and competencies to enhance patient safety.
  
  
  RESULTS
  Human and system errors are a recognized cause of significant morbidity and mortality. Technical skills encompass the medical and procedural knowledge required for patient care, while nontechnical skills are behaviour-based and include task management, situation awareness, teamwork, decision-making, and leadership. Both sets of skills are required to improve patient safety. Healthcare simulation can provide an opportunity to practice technical and nontechnical skills in a patient-safe environment. More specifically, these skills are most required in dynamic and crisis situations, which may best be practiced in a simulated patient setting.
  
  
  CONCLUSIONS
  Healthcare simulation is a valuable tool to improve patient safety. Simulation-based education can focus on the necessary technical and nontechnical skills to enhance patient safety. Simulation-based research can serve as a means to identify gaps in current practice, test different solutions, and show improved practice patterns by studying performance in a setting that does not compromise patient safety.
authors.affiliation: Department of Anesthesiology, The Ottawa Hospital, University of Ottawa Skills and Simulation Centre, 725 Parkdale Ave, Ottawa, ON, K1Y 4E9, Canada. vnaik@toh.on.ca
authors.forename: Viren N
authors.initials: VN
authors.lastname: Naik
authors.forename: Susan E
authors.initials: SE
authors.lastname: Brien
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D003657:Decision Making; D003695:Delivery of Health Care / Q000592:standards; D006801:Humans; D007857:Leadership; D019300:Medical Errors / Q000517:prevention & control*; D005791:Patient Care / Q000592:standards; D010348:Patient Care Team / Q000458:organization & administration; D061214:Patient Safety; D016544:Patient Simulation; D011361:Professional Competence