THE ROLE OF SIMULATION IN UNDERGRADUATE AND POSTGRADUATE MEDICAL EDUCATION IN INDIA

Simulation-based education enables medical learners to practice and refine clinical skills without risking patient safety; enhancing competence and confidence

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"A disease is not cured by merely repeating the name of the medicine. It requires direct realisation": Vivekachudamani

Donald Schon, an American philosopher, who developed the concept of reflective practice said that professional growth begins when an experience is viewed through a critical lens. A critical reflection is one that contemplates with evaluation, balances reasoning and develops future options and plans.

Healthcare involves a complex interaction (human factors) between people: person and environment and person and machines. These interpersonal interactions involve not only the doctor-patient relationship but also interprofessional dynamics including administrative challenges. Dynamic decision making associated with these complex interactions can result in significant medical errors and adverse patient outcomes.

Simulation has been used successfully in many fields to assess and to create models. In medicine, a field that involves high stakes, simulation was introduced relatively late, by David M. Gaba, who built the first patient simulator in 1986. He describes simulation as a technique and not a technology. The technique was to deliver real-world problems as guided experiences. This experience is followed by a facilitated reflection.

Simulation-based medical education can be delivered either in a lab, in-situ (at the actual place of work) or even in the community. The various modalities involved include mannikin-based simulation, screen-based, model-based, simulated participant or the use of virtual or augmented reality.

The National Medical Commission aims to produce an Indian Medical Graduate with essential skills involving leadership, communication and lifelong learning rather than mere clinical practice. The traditional method of teaching in medical colleges involves lectures, observation and assisting, followed by a learning curve largely relying on a “role model theory”.