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• W30578964 abstract "Simulation has been used in medicine for decades to teach various skills and competencies. First seen as a way to enable the acquisition and repetition of primarily technical skills, simulation has gradually evolved into a key tool to teach more universal competencies. Consequently, simulation is now considered by many as the best method to learn non-technical skills such as collaboration, communication, and leadership. Various elements are behind this transition. The increasing complexity of modern health care and the explosion of knowledge specific to the various medical specialties have left little room for the physician’s traditional role as an omnipotent and omniscient practitioner. After a number of decades during which medical faculties promoted curricula focused on scholarly knowledge and acquiring technical skills, the need to identify and incorporate a broader range of non-technical competencies has emerged. At the same time, several experts showed that events involving poor non-technical skills, particularly communication, were responsible for a significant portion of patient morbidity and mortality. Numerous organizations and coalitions dedicated to the promotion of safer health care networks joined forces in urging academic and hospital administrations to work together to build curricula in which teamwork skills play a key role. All these elements contributed to the establishment of a new paradigm based on the need for acquiring and assessing teamwork skills, and for obtaining the tools to do so. Medical schools and hospitals responded by investing heavily in the creation and development of simulation-based learning centres. The attention that pedagogical experts and health managers have directed towards the acquisition and support of teamwork skills helped foster anesthesiologists’ involvement in the development and operation of the simulation centres. Applying concepts such as CRM (‘‘Crisis’’ or ‘‘Crew Resource Management’’), which aims to optimize teamwork, to the various fields of specialized medicine has largely resulted from the work of anesthesiologists. Indeed, the different environments in which anesthesiologists work (operating rooms, intensive care units, etc.) are often a source of complex professional interactions that are likely to influence quality of care and patients’ outcome. It is no surprise, therefore, that some institutions devoted considerable efforts and resources in order to simulate the professional activities taking place in those environments. Costly investments were often necessary in order to acquire the infrastructure and hardware used in the simulation centres. Personnel also had to be hired to operate these facilities and to design and implement the pedagogical contents. Even if an impressive number of tools dedicated to simulation-based teaching of non-technical skills have been developed in the past few decades, it should be emphasized here that their impact on patients’ outcome remains uncertain. Despite major investments in this field, few studies have dealt with the direct effects of simulationbased teaching on actual clinical performance or patients’ mortality. In this issue of the Journal, we find one of the rare papers addressing these issues. In their review, Boet et al. identified studies that attempted to measure the impact of CRM or non-technical skills teaching on quality of care and patients’ outcome. Despite abundant literature P. Drolet, MD (&) Departement d’Anesthesiologie, Faculte de Medecine, Universite de Montreal, C.P. 6128, Succursale Centre-ville, Montreal, QC H3C 3J7, Canada e-mail: pierre.drolet6060@videotron.ca" @default.
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• W30578964 date "2014-04-24" @default.
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• W30578964 title "Measuring the impact of simulation: from utopia to reality" @default.
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• W30578964 doi "https://doi.org/10.1007/s12630-014-0144-7" @default.
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