Simulation in Graduate Medical Education 2008: A Review for Emergency Medicine

Authors

  • Steve McLaughlin MD,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • Michael T. Fitch MD, PhD,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • Deepi G. Goyal MD,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • Emily Hayden MD,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • Christine Yang Kauh MD,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • Torrey A. Laack MD,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • Thomas Nowicki MD,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • Yasuharu Okuda MD,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • Ken Palm MD,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • Charles N. Pozner MD,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • John Vozenilek MD,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • Ernest Wang MD,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • James A. Gordon MD, MPA,

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author
  • on behalf of the SAEM Technology in Medical Education Committee and the Simulation Interest Group

    1. From the Department of Emergency Medicine, University of New Mexico (SM), Albuquerque, NM; the Department of Emergency Medicine, Wake Forest University (MTF), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic Rochester (DGG, TAL), Rochester, MN; Gilbert Program in Medical Simulation, Harvard Medical School and the Department of Emergency Medicine, Massachusetts General Hospital (EH, JAG), Boston, MA; New York Methodist Hospital (CYK), Brooklyn, NY; the Integrated Residency in Emergency Medicine at the University of Connecticut (TN), Farmington, CT; the Department of Emergency Medicine, Mount Sinai School of Medicine (YO), New York, NY; the Department of Emergency Medicine, Vanderbilt University Medical Center (KP), Nashville, TN; the STRATUS Center for Medical Simulation, Brigham and Women’s Hospital (Emergency Medicine), Harvard Medical School (CNP), Boston, MA; the Northwestern McGaw Simulation Network, Medical Education, Feinberg School of Medicine, Northwestern University, Division of Emergency Medicine, Evanston Northwestern Healthcare (JV), Evanston, IL; and the Division of Emergency Medicine, McGaw Medical Center of Northwestern University, Evanston Hospital (EW), Evanston, IL.
    Search for more papers by this author

Address for correspondence and reprints: Steve McLaughlin, MD; e-mail: smclaughlin@salud.unm.edu.

Abstract

Health care simulation includes a variety of educational techniques used to complement actual patient experiences with realistic yet artificial exercises. This field is rapidly growing and is widely used in emergency medicine (EM) graduate medical education (GME) programs. We describe the state of simulation in EM resident education, including its role in learning and assessment. The use of medical simulation in GME is increasing for a number of reasons, including the limitations of the 80-hour resident work week, patient dissatisfaction with being “practiced on,” a greater emphasis on patient safety, and the importance of early acquisition of complex clinical skills. Simulation-based assessment (SBA) is advancing to the point where it can revolutionize the way clinical competence is assessed in residency training programs. This article also discusses the design of simulation centers and the resources available for developing simulation programs in graduate EM education. The level of interest in these resources is evident by the numerous national EM organizations with internal working groups focusing on simulation. In the future, the health care system will likely follow the example of the airline industry, nuclear power plants, and the military, making rigorous simulation-based training and evaluation a routine part of education and practice.

Ancillary