Building Partnerships to Improve Learning From Health Care Simulation.

Abstract

To the Editor: Henriksen and colleagues ask rightly if “we are learning something new about the effective use of health care simulation in relation to improving patient safety and quality of care.”1 The authors also express three other messages that we endorse. First, we agree that “outcome measurement remains a challenge.”1 Linking outcomes in proximal education settings to distal metrics of improved patient care practices and patient health outcomes is crucial, but not easy. Second, we concur that simulation-based learning should be integrated with clinical setting experiences.1 Finally, we agree that “the question needs to shift from ‘Is simulation effective?’ to ‘How can it be most effective?’”1 Although we agree with the above points and applaud funding agency representatives for reaching out to the medical education research community, we believe the Perspective does not fully describe the state of the art of simulation-based health care education. In particular, simulation-based mastery learning (SBML) has demonstrated its effectiveness in addressing a variety of clinical skills including procedural techniques, communication with patients and families, and management of complex clinical problems such as care for patients in the intensive care unit. This research has been synthesized in research reviews that demonstrate that SBML produces translational science outcomes (T) measured rigorously as short-run educational effect (T, Level 1), improved and safer quality of patient care (T, Level 2), and better patient health outcomes (T, Level 3).2,3 The bottom line: Rigorous SBML interventions are extremely effective educational tools, especially when embodied in evaluation research programs that are thematic, sustained, and cumulative. The history of medical education teaches that only the innovator is expected to present data to demonstrate that new pedagogies are effective. No one is ever asked for evidence to support maintenance of the educational status quo. A growing body of new empirical data underscores the value of SBML to improve patient care quality.2,3 We are encouraged by the views of Henriksen and colleagues1 because those of us in health professions education must develop better and stronger partnerships to fund and design studies that will move the simulation research agenda forward and improve health outcomes among our patients. William C. McGaghie, PhDProfessor of medical education, Northwestern University Feinberg School of Medicine, Chicago, Illinois; [email protected]; ORCID: http://orcid.org/0000-0003-1672-0398. Jeffrey H. Barsuk, MD, MSProfessor of medicine and professor of medical education, Northwestern University Feinberg School of Medicine, Chicago, Illinois; ORCID: http://orcid.org/0000-0001-6584-9943. Diane B. Wayne, MDVice dean for education and Dr. John Sherman Appleman Professor of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; ORCID: http://orcid.org/0000-0001-6468-0744.