Academic journal article British Journal of Occupational Therapy

Enhancing Occupational Therapy Education through Simulation

Academic journal article British Journal of Occupational Therapy

Enhancing Occupational Therapy Education through Simulation

Article excerpt


The development of practice skills is fundamental to the education of health professionals in order to produce practitioners who are fit for practice. The importance of practice placements in gaining necessary skills has long been recognised, in line with the pedagogical value of authentic and context-specific learning (Barab and Duffy 1999). However, university-based learning needs to complement the development of skills for professional practice. As competence is a result of experience (Benner et al 1996), the use of simulation across health education is emerging as an important adjunct to practice-based learning (Bradley and Postlethwaite 2003).


In the context of health care education, simulation has been defined as '... an educational technique that allows interactive, and at times immersive, activity by recreating all or part of a clinical experience without exposing patients to the associated risks' (Maran and Glavin 2003, p22). Teaching and learning activities under the umbrella of simulation include simulating service users through mannequins or actors; simulating authentic environments, such as home and ward environments; and the use of equipment, video footage or interactive computer packages to recreate the required reasoning and actions of specific practice situations. One or several of these approaches can be used and can range from a simple task-based concept to a complex and dynamic environment with multiple and changing scenarios.

The diversity of activities reflects differing levels of fidelity, the extent to which the experiences convince the participants that they are involved in something they would encounter in real life (Seropian et al 2004). High fidelity simulation in health education has often been linked to mannequins and technology to recreate physiological responses and the use of specialist equipment (Seropian et al 2004). However, the difference between the above engineering fidelity and psychological fidelity has emerged, with the importance of the latter--the extent to which the skills in the real task are captured in the simulated task irrespective of the use of technology--being increasingly emphasised (Maran and Glavin 2003).

Within health, the use of simulation was first discussed in the field of medical education and, more recently, has been widely cited in relation to the education of nursing students (Parker and Myrick 2009). The emergence within nursing presents as coinciding with professional concern and drivers regarding essential skills deficiency among newly qualified nurses (Nursing and Midwifery Council 2007).

A number of other factors have been highlighted within the literature as contributing to the growth of simulation within health education. Although opportunities for skill development provided by practice placements are undisputed, growth within the National Health Service workforce led to well reported capacity challenges and practice placement shortages (Moore et al 2003), encouraging creative teaching and learning solutions to support the development of practice skills. The importance of technological advances has contributed to activities being more aligned to real life situations, alongside contributing to a generation of learners who expect the integration of these technological advances into their curricula (Parker and Myrick 2009). The ethical and political need to avoid unnecessary risk taking in health education has been emphasised in response to major incident reviews (Bristol Royal Infirmary Inquiry 2001), supporting the need for safe learning environments to recreate complex or high risk practice activities. The role of simulation in delivering a workforce orientated to patient safety has been further emphasised in the recent World Health Organisation (WHO) (2011) Patient Safety Curriculum Guide.

There is some evidence to suggest that simulation is used within occupational therapy education (Velde et al 2009), although the emergence is less obvious. …

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