Simulation in Medical Education: Focus on Anesthesiology

Simulation refers to the artificial representation of a complex real-world process with sufficient fidelity to achieve a particular objective, usually for the purposes of training or performance testing. While simulation has been important from early times (as in the rehearsal of animal hunting activities or preparing for warfare), the needs of World War II greatly accelerated simulation technology for use in flight training. With the available of inexpensive computer technology in recent years, simulation technology has blossomed again, especially in the field of medicine, where applications range from scientific modeling to clinical performance appraisal in the setting of crisis management. This article presents an overview of the application of computer-based simulation to medicine, focusing on anesthesiology and critical care medicine, including discussions on physiological and pharmacological simulation, virtual experiments, software only clinical simulators, and specialized hardware/software simulators for specialty teaching, as in airway management and in regional anesthesia. While many successes in using simulation in medical education can be identified, because the field is quite young, much remains to be done to demonstrate the scientific and clinical utility of simulation technology, especially in the context of the Fitzpatrick model of program evaluation.