Perspective: Simulation and transformational change: the paradox of expertise

Area of Science:

• Medical Education
• Healthcare Simulation

Background:

• Simulation is a safe space for practicing procedural skills, often simplified for learning.
• The definition of simplicity in simulation is expert-driven and may not align with novice perspectives.

Purpose of the Study:

• To challenge the philosophy of oversimplification in procedural skills simulation.
• To propose an alternative simulation model that incorporates complexity and clinical context.

Main Methods:

• Utilizes the metaphor of the 'ha-ha' to illustrate expert-novice perspective differences.
• Draws on threshold concepts and troublesome knowledge theory.
• Incorporates experience with patient-focused simulation.

Main Results:

• Oversimplification can hinder deep understanding of complex procedural skills.
• Differing expert-novice perspectives contribute to simulation challenges.
• Simulation should reflect clinical uncertainties and real-world learning conditions.

Conclusions:

• Procedural skills should not be divorced from their clinical context.
• Reintroducing complexity and unpredictability in simulation fosters transformational learning.
• Effective simulation aids the development of competent clinicians by mirroring real-world challenges.