Clinician's Commentary on Mori et al.(1).

Abstract

Mori and colleagues' well-done systematic review of simulation learning in physical therapy entry-to-practice curricula raises some interesting issues. As the authors note, simulation learning has been around for several decades, in many different forms. Although Mori and colleagues defined simulation quite broadly, as “the range of learning experiences (e.g., role playing) in which the learner had the opportunity to interact with the simulated clinical scenario,” they still found only 23 articles to include in their review. Their extensive search initially found 800 abstracts, however, which probably reflects the fact that this field is still establishing itself and there is no agreed-upon definition of simulation learning, especially as it relates to entry-to-practice curricula. Depending on the definitions used, simulation learning can include standardized patients (low fidelity) and virtual reality (intermediate fidelity), as well as the high-fidelity simulations with computerized mannequins used for such purposes as practising surgical skills and CPR training, which are shown in the media when any new simulation centre is opened. Patient safety, although not specifically mentioned in this article, has been one of the main drivers of patient simulation, and especially of high-fidelity simulation. Close to a decade ago, the Canadian Patient Safety Institute took the lead in this area, in response to data emerging across the country that showed an increasing number of adverse events in hospitals.2,3 Patient simulation was seen as both a safer and a more ethical way to learn than practising invasive techniques on real patients, and using simulation is also a way to teach patient safety competencies.4 Mori and colleagues divided the studies they reviewed into four key areas, based on the different learning objectives of the simulation activities.