Simulator Limitations and Their Effects on Decision-Making

Abstract

The use of simulators for skill evaluation is common in a number of fields, but the effect that various characteristics of simulators have on subject performance is not fully understood. Ten experienced trauma anesthesiologist participated in a full mission simulation of a real video taped trauma case management. This case contained critical events that require the participants to use clinical examinations and familiar and unfamiliar equipment contained in the simulator. Participants' performance differed from both the performance in the real case and ideal performance. The unfamiliarity with one complex piece of the equipment (ventilator function and controls) caused 4 out of 10 participants to be unable to finish the simulation. Surprisingly, unfamiliarity with another piece of equipment (new to all participants) did not have any dramatic impact. Anesthesia simulators have been successfully used in training anesthesiologists, but the demands of evaluation of clinical skills differ from training. Complex equipment and the limitation in realism of the mannequins in the anesthesia simulators prevent fair assessment of clinical diagnostic skills.