High fidelity immersive simulations with immediate individual feedback

As opportunities for cooperative & work-integrated learning placements became more difficult and the provision of real-life work environments more challenging; the use of simulated work experience expanded. The Canadian Association of Schools of Nursing (CASN) 2006-7 inventory of the use of simulated clinical learning experiences and the evaluation of the effectiveness thereof states (p. 9) that “simulation involves techniques and technologies that create guided, interactive, and often immersive activities mimicking experiences of a real-world environment”. The report (pp. 9-10) qualifies:

• Immersive nature of simulations as “the ability to evoke or replicate substantial aspects of the real world in a way that engages the student in the simulation” and give the student a sense of real-life experience.
• Degree of fidelity refers to the extent “to which a simulation recreates the characteristics of the real world” and “provides an accurate and truthful representation”. High Fidelity Simulations replicate to a very high degree, for example a flight simulator. Intermediate-fidelity replicates only partially.
• Immediate individualised formative feedback enhances the learning benefits driveable from simulations, which requires analysis by an experienced tutor or some form of artificial intelligent system to provide the feedback

The recommendations contained in the Health Workforce Australia (2010) report on the use of simulated learning environments (SLE) in professional entry level curricula of selected professions in Australia offer valuable guidance for Unisa’s investment in simulation techniques. Recommendations (emphasis added) about the simulation environment include (pp. 4 & 12):

1. investment in human resources including training of educators and technicians and the provision of recurrent funding for staffing simulation programs;
2. promotion of collaboration within university schools, across multiple campuses and between schools;
3. increased geographical access to programs for all students;
4. engaging in site visits to centres to ascertain site readiness;
5. investing in enhancing current programs;
6. encouraging interprofessional learning by using simulation as the catalyst;
7. maintenance of standards in simulation through the adoption of certification and accreditation programs; and
8. simulation programs which are underpinned by strong governance and strategic business planning.

Recommendations (emphasis added) within the HWA report pertaining to the educational approaches include (pp. 5 & 12):

1. the development and maintenance of a case bank within professions and across professions;
2. investment in new technologies, virtual and web-based to enable broader reach;
3. evaluation and research to be embedded into all simulation programs;
4. aligning simulation curricula with professional standards and frameworks;
5. development and maintenance of universal skills boxes by profession; and
6. flexibility within simulation curricula to meet local curricula needs.