Motor skills are crucial in the medical field, particularly for life-saving procedures that are rare or infrequently performed. Task trainers provide a valuable tool for acquiring and retaining these essential manual skills. [1] However, due to their high cost, task trainers are often shared among multiple trainees, resulting in limited opportunities for hands-on practice. Trainees may only have the chance to perform a procedure a few times on a manikin, and then go months without the opportunity to repeat the training, leading to a decline in their skills.
At Decent Simulators, our primary goal is to increase accessibility to task trainers and focus on their functionality. You may be able to find more realistic-looking, expensive models on the market, and it might seem that they would be a better training aid, but there is a big chance they are not. And here is why:
Why too much realism is bad
People often think that the more realistic a task trainer looks, the better the training and skill transfer to a clinical setting. While appearance is important, it's important for different reasons. A strange or cheap-looking simulator can distract the trainee and negatively affect their training. [2] However, too much detail and realism can also interfere with learning basic skills and procedures, especially in the early stages of training.
When training for complex tasks, too much realism and detail can actually make it harder to learn the basics. It's better to start with a simplified version and gradually add complexity. Later on, a high level of accuracy might be necessary for advanced training, but in the initial stages, excessive realism and detail can interfere with learning. [3-5]
Creating realistic models can be expensive, so it's important to find a balance between accuracy and affordability. The goal should be to create a model that is not overly realistic but realistic enough.
It is all about objectives
Research has found that the most important factor in simulator training is functional fidelity or "functional task alignment" (FTA) It's crucial for trainees to be able to repeat every step of a procedure, especially critical moments, as many times as necessary to master the skill.
The physical resemblance is now considered less important as long as the simulator's functional aspects correspond to the real-world context. This can include cues like staffing or spatial arrangement, or proper orientation during the simulation. While physical resemblance should still be considered, it's secondary to FTA. [6-8]
Our design process
Our task trainer design process begins with extensive research. We decide whether the model will be used for teaching or for evaluation, and if the models will be used by novices or advanced users. We work with healthcare professionals to create a detailed list of all the steps involved in the procedure. Based on these requirements, we design the model and test it internally.
Once the initial testing is complete, we send the model to specialists in the field for further testing. After evaluating the results, we re-design the model, conduct additional internal tests, and send it to specialists again. This iterative process is repeated until everyone is satisfied with the results. Sometimes it takes more than five full iterations to create a good model.
Throughout each iteration, we also work to make the model more cost-effective, user-friendly, and durable. Finally, the process is completed with comprehensive mechanical tests and short production runs.
Summary
Creating a good task trainer is more complex than it may seem. While realism is important, it's not the best approach to focus entirely on the physical aspects of the model. Designing effective task trainers requires a lot of thought and effort.
To ensure high-quality training, ongoing improvements and updates are necessary. We are constantly refining our processes and models to make them even better.
[1] Paul Fettes, Skills Training for Novice Anaesthetists - Why Simulation Based Mastery Learning, DAS
[2] Aarkrog V. ‘The mannequin is more lifelike’: The significance of fidelity for students’ learning in simulation-based training in the social-and healthcare programmes. Nordic Journal of Vocational Education and Training. 2019 Sep 20;9(2):1-8.
[3] Norman G. May: a month of myths. Advances in Health Sciences Education. 2018 Aug;23:449-53.
[4] Lane NE, Alluisi EA. Fidelity and validity in distributed interactive simulation: Questions and answers. INSTITUTE FOR DEFENSE ANALYSES ALEXANDRIA VA; 1992 Nov 1.
[5] Grober ED, Hamstra SJ, Wanzel KR, Reznick RK, Matsumoto ED, Sidhu RS, Jarvi KA. The educational impact of bench model fidelity on the acquisition of technical skill: the use of clinically relevant outcome measures. Annals of surgery. 2004 Aug;240(2):374.
[6] Jones MA. Fidelity in simulation-based training in diverse professions: a proposed taxonomy.
[7] Hamstra SJ, Brydges R, Hatala R, Zendejas B, Cook DA. Reconsidering fidelity in simulation-based training. Academic medicine. 2014 Mar 1;89(3):387-92.
[8] Norman G, Dore K, Grierson L. The minimal relationship between simulation fidelity and transfer of learning. Medical education. 2012 Jul;46(7):636-47.