Monday, September 17, 2012

What about training transfer?


Recently published by Advances in Health Sciences Education, “Does training learners on simulators benefit real patients?”  reviews a body of research that has explored the effectiveness of simulator training with regard to training transfer of specific skill-based, rule-based, and knowledge-based clinical tasks. The authors point out that the simulation-based training strategy has been widely adopted in medical schools across Europe and North America without ample research support of both clinical skills transfer and measurable patient benefits.

What may be interesting to discuss here is a parallel line of speculation based on a conflicting premise: Why has it taken medicine so long to embrace simulation-based training in contrast to, for example, the military? In response to this hypothetical, one may venture that medicine requires a new practice to be evidence-based before it is adopted – after all, patient lives are at stake. Therefore, the previous lack of and the current limited body of research supporting clinical training transfer simply have not provided the level of evidence required to prompt widespread acceptance of simulation-based medical training.

That being said, there are fewer and fewer medical schools left that are not incorporating some form of simulation into the curriculum. In “Medical simulation gets real,” Voelker traces the progressive introduction and use of simulation in medical education and training, also highlighting that, “among the greatest challenges for simulation researchers is determining whether simulation training can translate into improved patient outcomes.”  

The papers cited here are only a small sample of those addressing the topic of clinical transfer of skills from simulation-based training. Weigh in below – do you think medicine is “catching up” to the simulation bandwagon?  Do you feel there is enough evidence to support the relatively recent increase in the use of simulation in medical education, perhaps with respect to a given clinical skillset in particular? What areas are particularly lacking when it comes to simulation-based training and studies on resultant patient benefits and why?