State-of-the-art usage of simulation in anesthesia: skills and teamwork.
OBJECTIVE
This review describes the level of evidence for the use of medical simulation in anesthesia. It also discusses the topic of realism in simulation and its use for assessment.


RESULTS
Medical simulation in anesthesia covers a variety of techniques used for training and assessment. The current level of evidence for the use of medical simulation strongly supports a shift from learning on patients to learning on simulators. Skill and multidisciplinary team training are effective modalities and improve (team) performance and patient outcome.Well defined learning objectives, not a high level of realism should be the main focus of a simulation activity. Simulation centers should focus on faculty development as emphasis on simulation facilities and simulator fidelity alone does not guarantee effective training.Formative and summative assessment can help identify the omissions in knowledge, skills, and the ability to work in a team for both residents and anesthesiologists. Not only does it help to obtain competence, it also helps to maintain it.


CONCLUSIONS
Simulation for skill and team training should be a mandatory component for anesthesia residency programs and continuous medical education. The 'see one, do one, teach one' approach is obsolete and should be abandoned.
Department of Anesthesiology, ADAM SimLab, VU University Medical Center, Amsterdam, the Netherlands.
Ralf
R
Krage
Micha
M
Erwteman
D000776:Anesthesiology / Q000193:education*; D002983:Clinical Competence; D006801:Humans; D007396:Internship and Residency; D008348:Manikins; D010348:Patient Care Team