Introduction

Article Outline

• Copyright

Health care educators have a tremendous responsibility to their students, patients, and to society as a whole. Participating in the transformation of a newly graduated medical student into a competent, independent practicing clinician, who recognizes their own limitations, knowledge gaps, and responsibly fills these voids, is truly a daunting task. It is even more challenging when one considers that our clinical classrooms are unpredictable, variable, fast-paced, complex environments where patient well-being is paramount. Insurance companies, state-reporting agencies, hospital quality improvement and risk management committees, Medicare and Medicaid regulations, and the Accreditation Council of Graduate Medical Education make our clinical teaching environment even more challenging. As clinical educators, we are not only responsible for educating future physicians, but also must appraise the success of our programs through the evaluation of our residents' abilities in the 6 competency domains as defined by the Accreditation Council of Graduate Medical Education and American Board of Medical Specialties. Program directors, chairmen, and supervising academic faculty have the tremendous responsibility of documenting, confirming, and anointing the title “competent” upon graduating students. How then does a clinical educator convince himself or herself that their educational goals have been met and that their program graduates clinically competent physicians, capable of independent safe patient care?

Simulation, simulators, and the simulated environment may very well prove to be the ideal adjunct in the arsenal of clinical educators. However, not even the staunchest of proponents would argue that simulation, in its present form, serves only to enhance actual clinical education, not substitute or supplant it. It is agreed that the ideal setting for clinical education is the actual clinical environment; unfortunately, ideal is not always practical. Simulation, in all its incarnations, is a tremendous tool for health care educators. Simulation creates an ideal educational environment that is predictable, consistent, standardized, safe, and reproducible. This environment encourages learning through experimentation and trial and error with the ability to rewind, rehearse, and practice without negative patient outcomes.

Four decades ago, anesthesiologists experimented with simulation technology. Two decades ago, anesthesiologists took the lead from other industries and introduced mechanical simulation into education and evaluation programs. Approximately 5 years ago, it seemed that the use of mechanical simulation in the health care industry was a well-kept secret. Since that time, the interest and expansion of the use of new technology to replicate clinical encounters have expanded exponentially. We are at the start of yet another great expansion. Although other societies and specialties have adopted and incorporated simulation into their training and assessment process and have even started credentialing specialty-specific simulator centers, anesthesiologists will always be recognized for their insight and innovative thinking. As 2007 came to an end, the American Society of Anesthesiologists sought applications to credential anesthesiology simulator programs. 2008 represents the year that the American Board of Anesthesiology (ABA) initiated requirements that mandates simulator-based training to fulfill Maintenance of Certification for Anesthesia. The following articles represent a variety of topics on simulation that reflect the diversity and innovation of our specialty and why anesthesiologists will remain at the forefront of these innovative teaching and assessment tools.