Issues Raised: The use of realistic medical simulation has expanded worldwide over the last decade. Such technology is playing an increasing role in medical education not merely because simulator sessions are enjoyable, but because they can provide an enhanced environment for experiential learning and interpersonal skill development. High-fidelity patient simulators--full body mannequin-robots that breathe, talk, blink, and respond “like a real person”--allow students of all levels to “practice” medicine without risk, providing a natural framework for the integration of basic and clinical science in a safe environment. Often described as “flight simulation for doctors,” the rationale, utility, and range of medical simulations have been well described in the literature. Yet, the pathway to institutional implementation and testing of new simulator programs in undergraduate medical education--particularly for basic science teaching--has received relatively little attention. Focus of Discussion: During this IAMSE concurrent session, we discussed how high-fidelity patient simulation can be integrated into the existing basic science curriculum of almost any medical school in an efficient and cost-effective manner. While the original simulator-mannequins cost over $150,000, effective scaled-down models are now available for under $50,000. Capital outlays for building or space renovation depend entirely on local preferences and resources. A relatively small room can be inexpensively converted to simulator lab, while more space and renovation are needed for advanced programs. At Harvard Medical School, faculty and residents developed a simulator-based “medical education service”--like any other medical teaching service, but designed exclusively to help students learn on the simulator alongside a instructor, on demand. Typically, at least one clinical instructor is required to run a session along with a technician who also “talks” for the patient. Rather than designing new curricular modules, existing teaching cases can be “brought to life” as part of routine coursework; students and faculty already scheduled for small groups sessions can simply transfer classes from the conference room to the simulator lab. An example of simulator-based teaching cases developed under a grant from the Josiah Macy, Jr. Foundation to the Harvard-MIT Division of Health Sciences and Technology and the Center for Medical Simulation can found at www.harvardmedsim.org. Consensus: High-fidelity patient simulation can be used to animate basic science teaching in a powerful way. For some medical students, simulation may allow complex material to be understood and retained more efficiently than traditional teaching methods.
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