1 - The future vision of simulation in health care. Are we there yet?

You have been asked to develop a five-year strategic plan for simulation services in your hospital. Through your literature review you recall an article by David Gaba, ‘The future vision of simulation in healthcare’. All your dreams have been answered. In 2004 Gaba mapped the dimensions of organisational applications of simulation. You are thrilled to find his projection of two possible histories viewed from 2025; one optimistic – simulation integrated into the very fabric of health care; and one pessimistic – lamenting the abject failure of simulation to progress past and ad-hoc expensive education luxury. Now your challenge lies in which history rings most true in 2016 and how do we move forward for the next five years? 

 

In 2016, the term ‘simulation’ covers a wide range of activities - procedural skills, team training, quality improvement, mannequins, simulated patients, virtual reality and much more. And yet healthcare simulation remains inaccessible, badly delivered or simply failing to live up to promise in many contexts. 

To kick off our first episode of Simulcast, Jesse and I decided to tack a step back and look at the ‘state of the art’ of healthcare simulation in 2016. We used David Gaba’s landmark paper - The future vison of simulation in health care from 2004 - as a starting point.  

David Gaba is one of the grandfathers of healthcare simulation. Trained as a biomedical engineer, a pilot and then as an anaesthesiologist, he brought a unique vision to how to train better for the work we do in healthcare.  

When he wrote this paper in 2004, healthcare simulation was in its infancy, and mostly delivered around expensive mannequins in dedicated simulation centres. I had just done my first Crisis Resource Management (CRM) course as a participant at Monash simulation that same year, and was an immediate convert to the possibilities. 

In the podcast we look at the clarity Gaba offered us in that paper - how to think about the dimensions for healthcare simulation delivery – the technology used, the participants, the learning objectives, the environment of delivery. 

But he also offered us two future visions of simulation for 2025. One is optimistic – in which healthcare sim is embedded and integrated with care, training and quality improvement. The alternate vision is one in which simulation never really ‘made it’.  

We bring our own biases and hopes to the discussion…..