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Bringing Good Teaching Cases "To Life": A Simulator-Based Medical Education Service. Gordon JA, Oriol NE, Cooper JB. Acad Med. 2004; 79: 23-27 Reviewed by Michael Barone, MD, Johns Hopkins University


Bringing Good Teaching Cases "To Life": A Simulator-Based Medical Education Service.

Gordon JA, Oriol NE, Cooper JB. Acad Med. 2004; 79: 23-27

Reviewed by Michael Barone, MD, Johns Hopkins University

This article provides a chronicle of a productive educational endeavor: always an enjoyable read. It is conspicuously without graphs and confidence intervals but still holds rich information. The authors detail the early, but so far successful, integration of simulator-based education into the Harvard Medical School undergraduate curriculum. They present a strong case that, given student testimonials and spreading enthusiasm, the use of simulators is a powerful and engaging means of teaching trainees, particularly in the recent climate of patient safety.

Described here is the process that led to the creation of the medical education service, a concept that takes a simulation center beyond simply a room with whiz-bang toys. After procurement of funding for one simulator, key steps in the process included creation of interdisciplinary oversight, appointment of a program director, partnering with the simulator technology companies, and promotion of the resource within the institution. The goal of the service is to make the simulator accessible to students and instructors at anytime. No use having a fancy model if it is collecting dust halfway across campus. To meet this goal, faculty have been recruited to be "on-call" for the simulator with the purpose of using the machine to recreate teaching cases whenever appropriate. I have to admit, this sounded a bit ambitious to me and I remain curious if such a model can be sustained. The authors, however, also describe an inventive model to have senior residents participate in teaching. Using these resources, sessions can often be arranged "within hours to days" of the request.

I am sure many institutions are already using simulators often. Here at Hopkins, their use is currently sporadic but a simulation center is on the horizon. What will be the perfect balance of real patient exposure, standardized patients and electronic simulators to train the next generation of physicians? It will likely vary on the training setting and the specialty. While we are still in the discovery phase, future contributions of directed research and detailed reports of experiences, such as this article, will help to create that recipe.

(Simulation centers are a new and important technology for us. However, sometimes people trot out sessions that are more about showing off the method than teaching something specific and useful. Most simulators do best in teaching resuscitation and physiology. There is little or nothing related to using it to teach diagnostic reasoning, a large source of medical errors.)

(Do you use a simulation center to teach any competencies during your clerkship?

What would you choose to teach about first, if you suddenly had access to a simulation center?

On a scale of 1-10 - with 10 being agree strongly, do you agree that simulation will be a huge enhancement for teaching third year medical students the competencies relevant for pediatrics.

Steve Miller.)

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