What is simulation?
"Simulation is a technique - not a technology - to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner."
(Professor David M. Gaba, Stanford University).

Simulation training is first and foremost about enhancing the learning environment to promote effective quality learning experiences - and getting started is more about identifying learning needs and objectives than it is about obtaining state of the art equipment. Skills trainers and low-fidelity manikins can fulfill one's basic training needs and provide an excellent introduction into the principals of simulation based training. However, with sufficient funding and other resources available, more advanced equipment that enables full-scale simulation may be appropriate, either as an evolving process in developing training programs or right from the start. 

Simulation facilitates a wide range of training activities

• Individual skills training versus team training (training communication, interaction, and leadership skills with subsequent lengthy, personalized debriefing sessions)
• Initial skills acquisition versus maintenance and enhancement of already acquired skills
• Off-site training versus in-situ training (those who work together train together at their own workplace)
• Just-in-case training (rare medical conditions) versus just-in-time training (arriving patients with life-threatening conditions)
• Low-technology versus high-technology simulation equipment

What makes good simulation programs?

Issenberg et al. (2005) reviewed and synthesized existing evidence in educational science that addressed the question, ‘‘what are the features and uses of high-fidelity medical simulations that lead to the most effective learning?’’ Articles that demonstrate effective learning were purposely selected and reviewed and several important features and aspects of medical simulations were identified. The authors concluded that the weight of the best available evidence suggests that high-fidelity medical simulations facilitate learning, when training is conducted under the right conditions. The ‘’right conditions’’ include the following:

• Feedback is provided during the learning experience
• Learners engage in repetitive practice
• Simulation is integrated into the normal training schedule
• Learners practice with increasing levels of difficulty
• Simulation training is adapted to multiple learning strategies
• A wide variety of clinical conditions are provided
• Learning on the simulator occurs in a controlled environment
• Individualized learning with reproducible, standardized educational experiences is provided
• Learning outcomes are clearly defined
• Validity of simulation