The History of Simulation

The History of Simulation Posted By:
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As director of a simulation center at an academic institution, it has been exciting to see the remarkable advances made in this field over time.

The use of simulation has been around since China's Song Dynasty, when physician Wang Wei-Yi had two bronze statues made for teaching acupuncture. In the early 1960s, mannequin-based simulation was developed for teaching CPR by Asmund Laerdal with the development of the Resusci Anne. In 1968, Michael Gordon developed the Harvey mannequin for listening to 25 different heart and lung sounds.

Then in 1975, standardized patients and objective structured clinical examinations were first used in medical education in Scotland by Harden. A standardized, or simulated, patient refers to a person trained to portray a patient in realistic and repeatable ways. In the 1980s, high-fidelity anesthesia simulators were developed at Stanford University (Medsim) and the University of Florida (Medical Education Technologies, Inc [METI], currently known as computer-aided engineering) to teach medical students. A variety of advanced task trainers (eg, visible human project, haptic systems, and invasive surgical procedures) were developed in the 1990s.

In the early 2000s, SimMan—a high-fidelity simulator—was designed by the University of Pittsburgh and Medical Plastics Corporation (MPL). High-fidelity wireless technology mannequins were developed in 2004 by METI Ckkws iSTAN, and in 2008, MPL developed the SimMan3G. In 2007, medical simulation appeared in Second Life, a virtual Internet-based world where medical student avatars could role-play patient interactions at the Ann Myers Medical Center.

Simulation companies continue to improve products previously developed, and each year at national and international conferences, new task trainers and high-fidelity mannequins for infants, obstetrics, and adults are presented. What will be next?

References
  • Bradley P. The history of simulation in medical education and possible future directions. Med Educ. 2006;40:254-262.
  • Coerver D, Multak N, Marquardt A, Larson EH. The use of simulation in physician assistant programs: a national survey. J Physician Assist Educ. 2017;28:175-181.
  • Harden RM, Stevenson M, Downie WW, Wilson GM. Assessment of clinical competence using objective structured clinical examination. Br Med J. 1975;1:447-451.
  • Lewis KL, Bohnert CA, Gammon WL. The Association of Standardized Patient Educators (ASPE) standards of best practice (SOBP). Adv Simul (Lond). 2017;2:10.
  • Owen H. Early use of simulation in medical education. Simul Healthc. 2012;7:102-116.
  • Singh H, Kalani M, Acosta-Torres S, El Ahmadieh TY, Loya J, Ganju A. History of simulation in medicine: from Resusci Annie to the Ann Myers Medical Center. Neurosurgery. 2013;73(Suppl 1):9-14.

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