Bridging the skills gap with medical simulation

Simulation in the broadest sense can be defined as the imitation or representation of one act or system by another. Medical simulation is a type of training whereby learners can practise anything from hands-on technical skills with task trainers, communication skills within hybrid simulations, complex interdisciplinary patient cases with full body simulators, to complex surgical procedures with virtual technology simulators.

Medical simulation is rooted in methodology similar to aeronautics and flight simulation; and military flight simulators helped establish the use of simulation as a cost-effective teaching methodology.1 Edwin Link, the inventor of the first flight simulator, patented a ‘blue box’ flight trainer in 1929, as he believed there must be an easier, safer and less expensive way to learn how to fly. Following this invention, many different field experts attempted to adapt simulation to their own needs. Due to limitations in technology, overall medical knowledge at the time and a limited appreciation for the power of the method, medical simulation did not take off as acceptable training until much later.2

The history of medical simulation is interwoven with the development of medical education as a whole; but is epitomised by Madame Du Coudray, a practising midwife in Paris in the 18th Century. Most famous for her revolutionary midwifery teaching techniques, she released a midwifery manual to help increase birth survival rates after witnessing the horrors of untrained peasant midwifery in 1751. Soon after, King Louis 15th appointed her to spearhead a nationwide public health campaign, where she was able to educate female students and male surgeons in rural provinces. During this time, she designed and made child-bearing machines constructed from leather, dyed fabric, padding and real pelvic bones to replicate deliveries. Her teaching technique was a huge success, lasting 30 years and educating nearly 400,000 women and male surgeons. Most importantly, her training technique was reflected in the increased numbers of successful births that appeared in the 1780 and 1790 consensus.