
Introduction:
When you think of being a resident physician or completing a fellowship, many envision dramatic scenes from shows like Scrubs or Grey’s Anatomy. These popular shows, while entertaining, fail to depict one of the most valuable and commonly used methods in medical training today: simulation.
What is Medical Simulation and Why Do I Care?
The Society for Simulation in Healthcare defines simulation as imitating one act or system by another. In healthcare, this concept is applied to medical education, assessment, research, and system integration (SSH, 2025).
Simulation serves as a bridge between education and practice, allowing healthcare providers to perform tasks multiple times before performing them on real patients. This concept is relatively new within the medical community. For years, the "See one, Do one, Teach one" model was the standard approach in healthcare education. In this model, learners watch an instructor perform a task, then do it under supervision, and finally teach another person. While effective in some professions, this method raised concerns in medical education due to patient safety risks.
In 2000, the Institute of Medicine published a report revealing that medical errors caused between 44,000 and 98,000 hospital-related deaths annually (Jarry, 2021). The real number was likely much higher, with some estimates suggesting over 250,000 deaths due to medical errors (Anderson & Abrahamson, 2017). Simulation emerged as a solution to reduce these errors and improve education.
The Value of Simulation in Medical Training
Simulation provides healthcare professionals with the opportunity to practice procedural and problem-based learning in a safe, controlled environment. By refining skills through simulations, providers can ensure competence before working with actual patients.
Consider the choice between two surgeons: One has completed hundreds of simulations, while the other has only observed a mentor perform similar surgeries. Which would you choose? Simulation, especially for complex and rare procedures, helps ensure that clinicians are fully prepared, reducing the risk of errors in real-world scenarios.
New Age of Simulation
Technological advancements in recent decades have dramatically expanded the use of medical simulation. Previously, simulations primarily relied on task trainers (models for specific procedures), mannequin simulators (robots mimicking physiological responses), or standardized patients (human actors) (Leiphrakpam, Armijo & Are 2024).
However, the rise of smart devices has introduced virtual simulations, focused on problem-based learning through virtual cases.
More recently, virtual reality (VR), augmented reality (AR), and extended reality (XR) have further expanded the scope of simulations. These technologies allow clinicians to engage in simulations while maintaining a safe physical and psychological environment (Leiphrakpam, Armijo & Are 2024). Simulations now cover both clinical and non-clinical situations, including delivering bad news or participating in a malpractice investigation.
These advancements enable the shift from “See one, Do one, Teach one” to “See One, Do Many,” enhancing patient safety.
Current State of Simulation in Graduate Medical Education
Simulation is an essential tool in graduate medical education (GME), and accrediting bodies have recognized its importance. For instance, the ACGME has listed simulation as a critical assessment tool for core competencies across various programs (ACGME, 2025). The ACGME also encourages using simulation for interprofessional patient safety activities.
To maximize the benefits of simulation, GME programs should focus on four key areas:
Selecting relevant skills that would benefit from simulation-based learning.
Defining clear learning objectives for each simulation activity.
Creating instructional materials for all participants, including learners, faculty, and standardized patients.
Establishing metrics for assessment and developing effective debriefing strategies to enhance learning.
Simulation is particularly valuable in GME because it allows learners to practice and refine their skills in a controlled environment, minimizing the risk to patients. This approach helps bridge the gap between theoretical knowledge and real-world application, allowing residents and fellows to handle clinical situations, including rare or complex cases they may not frequently encounter in practice.
Beyond technical skills, simulation also promotes the development of non-technical skills, such as communication, teamwork, and decision-making. It provides real-time feedback, helping learners identify areas for improvement and build confidence. Additionally, simulation facilitates mastery of new technologies, ensuring that healthcare professionals can use advanced tools and techniques safely and effectively. Ultimately, simulation prepares learners for independent practice, meeting the requirements set by accrediting bodies like the ACGME and the Royal College of Physicians and Surgeons of Canada.
Simulation is a game-changer in graduate medical education. It not only provides a safe, controlled environment for learners to practice, but it also promotes the mastery of new skills and technologies. With the growing recognition of its value in education, patient safety, and quality improvement, simulation is a key component in preparing healthcare providers for independent practice. As the field continues to evolve, simulation will remain an indispensable tool in ensuring that clinicians are well-equipped to deliver the best possible care to their patients.
References:
Accreditation Council for Graduate Medical Education. (2025). Common Program Requirements (Residency). https://www.acgme.org/programs-and-institutions/programs/common-program-requirements/
Anderson, J. & Abrahamson, K. (2017). Your Health Care May Kill You: Medical Errors. Studies in health technology and informatics, 234, 13–17.
Fair, J., Boucher, L., Angor, C. & Balta, J. (2023), Anatomical and Clinical Education in Physical and Occupational Therapy: Influence on Integration and Soft Preservation. The International Journal of Morphology. 41(5).
Jarry, J. (2021). Medical Error Is Not the Third Leading Cause of Death. McGill University. https://www.mcgill.ca/oss/article/critical-thinking-health/medical-error-not-third-leading-cause-death
Leiphrakpam, P., Armijo, P. & Are, C. (2024). Incorporation of Simulation in Graduate Medical Education: Historical Perspectives, Current Status, and Future Directions. Journal of medical education and curricular development, 11, 23821205241257329. https://doi.org/10.1177/23821205241257329
Society for Simulation in Healthcare. (2025). About Simulation. https://www.ssih.org/About-SSH/About-Simulation
Leading the industry ♥️
Fantastic article, thank you for sharing your insight on this important topic. 😀