Wednesday, 10 June 2015

Book of the month: Essential Simulation in Clinical Education (Forrest, McKimm and Edgar (eds))

Disclaimer: The reviewer (M Moneypenny) co-authored a small section of a chapter in this book. He is also a friend of a number of the contributors (but has tried to write an objective piece!)

About the editors
Kirsty Forrest is Professor and Director of Medical Education at the Australian School of Advanced Medicine, Macquarie University, Sydney, Australia. Judy McKimm is Professor of Medical Education and Director of Strategic Educational Development at Swansea University, Swansea, UK. Simon Edgar is Director of Medical Education, NHS Lothian, Edinburgh, UK and Education Coordinator, SCSCHF, Larbert, UK. The three editors combine a significant amount of expertise in medical education, simulation  and clinical practice.

About the contributors

There are 32 contributors (not including the editors), one from Ireland, one from New Zealand, 2 from Canada, 3 from the USA, 4 from Denmark and 21 from the UK. Although perhaps "UK-centric", the geographical spread results in a more diverse authorship than, for example, "Practical Health Care Simulations". 

Who should read this book?

The back cover states: "A superb companion for those involved in multi-disciplinary healthcare teaching, or interested in health care education practices…" In reality the book should probably be on the reading list for anyone who is starting out in simulation-based (medical) education. More experienced educators may find specific chapters, aligned with their own interests, of relevance.

In summary

The book is divided into 14 chapters:

  1. Essential simulation in clinical education
  2. Medical simulation: the journey so far
  3. The evidence: what works, why and how?
  4. Pedagogy in simulation-based training healthcare
  5. Assessment
  6. The roles of faculty and simulated patients in simulation
  7. Surgical technical skills
  8. The non-technical skills
  9. Teamwork
  10. Designing effective simulation activities
  11. Distributed simulation
  12. Providing effective simulation activities
  13. Simulation in practice
  14. The future for simulation

What's good about this book?

Every chapter starts with an overview and concludes with a short summary and an even shorter "key points" which is useful both as a reminder and as a reference for the reader in order to decide if the entire chapter is worth reading.

The editors make it clear in Chapter 1 that simulation is not a panacea. This view has been echoed elsewhere by Andrew Buttery (@andibuttri) on Twitter and by Trisha Greenhalgh (@trishgreenhalgh) in the British Journal of General Practice. Simulation is not magic and not all simulation is "good" simulation. "High fidelity" is also placed into context by Tom Gale and Martin Roberts who state: "…the blind use of the highest fidelity available is a principle which should be avoided" (p.63).

Chapter 3 "The evidence: what works, why and how?" by Doris Ƙstergaard and Jacob Rosenberg is essential reading for all who are involved in designing simulation-based interventions and those undertaking research. They consider the features which make simulation effective, including feedback, deliberate practice and curriculum integration and they also look at some of the challenges faced by researchers in simulation.

What's bad about this book?

The order of the chapters could be reconsidered. The chapters on designing and providing effective simulation activities would logically appear nearer the beginning of the book, and the chapter on assessment nearer the end. In addition, there is a chapter on "Teamwork" but not one on "Leadership" (although one might argue that good leadership is part of good teamwork). Lastly, an entire chapter on distributed simulation (DS), although interesting, is probably not required in a book covering "essential" simulation. A section on DS could have been included in the "Simulation in practice" chapter.

Although overall a very good chapter, Chapter 5 "Assessment" by Thomas Gale and Martin Roberts refers to "assessment tools with appropriate reliability/validity…" (p.61). However the tools themselves are not inherently reliable or valid, the scores produced by the use of the tools may be, and then initially only within the context in which the tool was created.

Final thoughts

This book covers the important topic areas well, including assessment, the roles of faculty and how to create effective simulations. This book therefore deserves a space on every simulation centre's bookshelf, as it provides a good overview of practical simulation in a digestible format.