Introduction to Simulation in Anesthesia Training
The past decade has seen mounting interest in translocating the interaction of anesthetist-with-patient from the operating room in the real world to a make-believe setting where factors not normally under our control can be manipulated for purposes of teaching or assessing performance. This desire to simulate the anesthetist's work has been driven by concerns that the traditional hands-on method is limited by many factors.
Due to the random nature of case opportunities, residents may not be exposed to the full spectrum of clinical problems during their residency. Facts and principles learned from texts and lectures may not get tested and properly assimilated into one's set of clinical skills. Even more important are the infrequent critical events, when more experienced anesthetists may feel obligated to assume control of the care of the patient due to legitimate concern over case outcome and the resident becomes simply an observer.
How a resident performs in clinical situations has always been difficult to assess. Verbal one-on-one sessions with staff may help delineate weaknesses but putting one's knowledge into appropriate action in a real and complicated situation may not be adequately tested in oral exams. And in recent years, there is interest in how the anesthetist performs as part of the OR personnel "team", particularly in crisis events where the anesthetist must assume a leadership role.
A simulator tries to replicate in an artificial environment enough factors of a real-world situation that certain goals can be achieved. If the simulator can replicate the workplace accurately and comprehensively then it is said to have high fidelity. How important fidelity is to the working of the simulator depends on the goals set by the instructors. As with flight simulation, the need to test anesthetists in time-critical crisis events demands an environment which allows the trainee to suspend disbelief and to become immersed in the simulation.
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