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Low-Fidelity Simulation in Global and Distributed Settings

Published online by Cambridge University Press:  30 December 2015

Tia Renouf*
Affiliation:
Associate Professor and Chair, Discipline of Emergency Medicine Health Sciences Centre St. John’s NL, Memorial University of Newfoundland, St. John’s, Newfoundland A1A1A6, Canada.

Abstract

Type
Letters
Copyright
Copyright © Canadian Association of Emergency Physicians 2015 

To the editor:

I enjoyed the CJEM June 2015 article about the International Federation of Emergency Medicine (IFEM) and continuing professional development.Reference Hobgood, Mulligan and Bodiwala 1 Hobgood et al. note that there is “at least modest evidence for the use of high-fidelity medical simulation, particularly for use in teamwork training and critical incident communication, two essential EM competencies.”Reference Hobgood, Mulligan and Bodiwala 1 They also note that “there are core principles that IFEM endorses: every EP should evolve in the multiple domains that are required for practice advancement; patient care should evolve according to the best available evidence; and there is a set of basic core EM knowledge, skills, and attitudes that define the discipline regardless of the location of practice.”Reference Hobgood, Mulligan and Bodiwala 1

Low-fidelity simulation, used with sound pedagogy, also has a positive effect on learningReference Maran and Glavin 2 - Reference Norman, Muzzin and Williams 6 and may be a more effective tool than high-fidelity simulation in global low-resource settings. Simulation feasibility, or required cost and value attained, relates to affordability and logistic implementation.Reference Munshi, Lababidi and Alyousef 5 High-fidelity simulation is expensive, challenging to maintain and operate, and may lack contextual validity in low-resource or distributed settings. High-fidelity simulation is not always superior to lower-fidelity; it depends on the type of task involved and the learner’s level.

IFEM represents emergency medicine (EM) learning in global contexts. These contexts exist on a spectrum with rural and remote EM in distributed settings closer to home, where low-fidelity simulation is sustainable and contextually relevant. Moreover, the use of local materials to make low-fidelity trainers can provide insight for learners into the social determinants of health when, for example, local and visiting learners attend village markets together to buy simulation materials. Low-fidelity simulation should be included as a learning tool for core EM knowledge, skills, and attitudes.

References

1. Hobgood, C, Mulligan, T, Bodiwala, G, et al. International Federation for Emergency Medicine model curriculum for continuing professional development. CJEM 2015;17(3):295-309, doi:10.1017/cem.2014.79.Google Scholar
2. Maran, NJ, Glavin, RJ. Low‐ to high‐fidelity simulation—a continuum of medical education? Med Educ 2003;37(s1):22-28.CrossRefGoogle ScholarPubMed
3. Priest, HA. Using simulation-based training to improve patient safety: what does it take? Jt Comm J Qual Patient Saf 2005;31(7):363-371.Google Scholar
4. Wiseman, J, Snell, L. The deteriorating patient: a realistic but “low‐tech” simulation of emergency decision‐making. Clin Teach 2008;5(2):93-97.Google Scholar
5. Munshi, F, Lababidi, H, Alyousef, S. Low vs. high fidelity simulation in teaching and assessing clinical skills. J Taibah Univ Med Sci 2015;10(1):12-15, doi:10.1016/j.jtumed.201#85CBAB.Google Scholar
6. Norman, G, Muzzin, L, Williams, R, et al. Simulation in health sciences education. J Instr Dev 1985;8(1):11-17.Google Scholar