Implementing Simulation in Air Medical Training: Integration of Adult Learning Theory

Abstract

This article suggests the construct of medical simulation education in the air medical industry can integrate principles of crew resource management by training in the same environments that flight crews function. The multidisciplinary crew-centered approach to designing simulation education can improve overall crew performance and reinforce safety in daily operations. This concept is far from novel and has a proven track record in the aviation industry, but air medical medicine can benefit from this proven system as well. In an article titled “Teams, Leaders, and Organizations: New Directions for Crew-oriented Flight Training,” 1 Hackman states that “it is the team, not the aircraft or the individual pilot, that is at the root of most accidents and incidents.” Simulation in aviation has a long history, dating back to early decades of the industry. With cockpit or crew resource management (CRM) becoming a staple of the air medical industry, we find ourselves on the precipice of using simulation to teach the foundational concepts of CRM. Consistent with Hackman’s statement, medical errors in the air medical industry may be caused by system errors and a breakdown in team functions. It is important to acknowledge that all air medical team members are adults and, therefore, adult learning theory becomes relevant and potentially influential; it is, in fact, referenced frequently in current “educational simulation” literature. Respected adult education theorists include Jean Piaget, John Dewey, D.A. Kolb, Malcolm Knowles, and many others; although each theorist has their respective tenets, there appears to be a shared commonality to the science behind adult learning and education. It is generally accepted that adults operate on the following common principles: