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      Clinical Cadavers as a Simulation Resource for Procedural Learning

      , MD, MHPE, FRCPC , 1 , 3 , 4 , , MD, FACEP 5 , 2

      , MD

      AEM Education and Training

      John Wiley and Sons Inc.

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          Abstract

          “See one, do one, teach one” remains an unofficial, unsanctioned framework for procedural skill learning in medicine. Appropriately, medical educators have sought alternative simulation venues for students to safely learn their craft. With the end goal of ensuring competence, educational programming will require the use of valid simulation with appropriate fidelity. While cadavers have been used for teaching anatomy for hundreds of years, more recently they are being repurposed as a “high‐fidelity” procedural skill learning simulation resource. Newly deceased, previously frozen, and soft‐preserved cadavers, such as those used in Baltimore and Halifax, produce clinical cadavers with high physical and functional fidelity that can serve as simulators for performing many high‐acuity procedures for which there is otherwise limited clinical or simulation opportunities to practice. While access and cost may limit the use of cadavers for simulation, there are opportunities for sharing resources to provide an innovative procedural learning experience using the oldest of medical simulation assets, the human body.

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          Most cited references 75

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          The assessment of clinical skills/competence/performance.

           Eric Miller (1990)
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            Low- to high-fidelity simulation - a continuum of medical education?

             N J Maran,  R J Glavin (2003)
            Changes in medical training and culture have reduced the acceptability of the traditional apprenticeship style training in medicine and influenced the growth of clinical skills training. Simulation is 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. The number and range of commercially available technologies used in simulation for education of health care professionals is growing exponentially. These range from simple part-task training models to highly sophisticated computer driven models. This paper will review the range of currently available simulators and the educational processes that underpin simulation training. The use of different levels of simulation in a continuum of training will be discussed. Although simulation is relatively new to medicine, simulators have been used extensively for training and assessment in many other domains, most notably the aviation industry. Some parallels and differences will be highlighted.
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              The minimal relationship between simulation fidelity and transfer of learning.

              High-fidelity simulators have enjoyed increasing popularity despite costs that may approach six figures. This is justified on the basis that simulators have been shown to result in large learning gains that may transfer to actual patient care situations. However, most commonly, learning from a simulator is compared with learning in a 'no-intervention' control group. This fails to clarify the relationship between simulator fidelity and learning, and whether comparable gains might be achieved at substantially lower cost. This analysis was conducted to review studies that compare learning from high-fidelity simulation (HFS) with learning from low-fidelity simulation (LFS) based on measures of clinical performance. Using a variety of search strategies, a total of 24 studies contrasting HFS and LFS and including some measure of performance were located. These studies referred to learning in three areas: auscultation skills; surgical techniques, and complex management skills such as cardiac resuscitation. Both HFS and LFS learning resulted in consistent improvements in performance in comparisons with no-intervention control groups. However, nearly all the studies showed no significant advantage of HFS over LFS, with average differences ranging from 1% to 2%. The factors influencing learning, and the reasons for this surprising finding, are discussed. © Blackwell Publishing Ltd 2012.
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                Author and article information

                Contributors
                gkovacs@dal.ca
                Journal
                AEM Educ Train
                AEM Educ Train
                10.1002/(ISSN)2472-5390
                AET2
                AEM Education and Training
                John Wiley and Sons Inc. (Hoboken )
                2472-5390
                06 June 2018
                July 2018
                : 2
                : 3 ( doiID: 10.1002/aet2.2018.2.issue-3 )
                : 239-247
                Affiliations
                [ 1 ] Departments of Emergency Medicine Anaesthesia, Medical Neurosciences & Division of Medical Education Halifax Nova Scotia Canada
                [ 2 ] Department of Medical Neurosciences Halifax Nova Scotia Canada
                [ 3 ] Clinical Cadaver Program Dalhousie University Halifax Nova Scotia Canada
                [ 4 ] QEII Health Sciences Centre Halifax NS Canada
                [ 5 ] Dartmouth Geisel School of Medicine Department of Medicine Dartmouth‐Hitchcock Medical Center Lebanon NH
                Author notes
                [* ]Address for correspondence and reprints: George Kovacs, MD, MHPE, FRCPC; e‐mail: gkovacs@ 123456dal.ca .
                Article
                AET210103
                10.1002/aet2.10103
                6050063
                © 2018 by the Society for Academic Emergency Medicine

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                Page count
                Figures: 2, Tables: 0, Pages: 9, Words: 6169
                Product
                Categories
                Commentary and Perspective
                Commentary and Perspective
                Custom metadata
                2.0
                aet210103-007
                July 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.3 mode:remove_FC converted:17.07.2018

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