There’s no such thing as the perfect clinical training environment – e-simulations bridge the gap

While a healthcare educator’s dream might be of labs available whenever and wherever students want them, fully-equipped sim centers, and patients obliging with the right symptoms for the procedure of the week during student externships, this is seldom the reality.

According to Cherry Vanderbeke, CEO of web-simulation learning company, SIMTICS,

‘Educating new healthcare professionals is resource intensive. The demand on labs and equipment usually outstrips availability: the facility’s schedule often means it’s not available when a student would like, and there may not be enough equipment for everyone. An instructor can only observe one or two students at a time. There are only so many opportunities to practice in a risk-free environment before the students are out in the field working with real patients. And what happens when they need to perform a procedure that they learned months ago and haven’t practiced recently?’

This is where web-based e-simulations can fill a gap. They allow students to learn by doing, but without needing all the resources of a physical lab. How is this possible?

Any medical procedure has two key parts: cognitive and technical. But they don’t have to be learned at the same time.

The cognitive part is understanding what to do, when, in what sequence, using what instruments and equipment, and making decisions to achieve particular results. You don’t have to perform the procedure in real life to learn all these cognitive elements. E‑simulations are perfect for this type of learning.

The technical part of a procedure is hands-on, using psychomotor skills to handle equipment and perform physical movements correctly.

Cognitive and technical knowledge come together when you put it all into practice in a real-life setting. Even the term “psychomotor” itself emphasizes the important role of the brain (“psycho”) in controlling physical actions (“motor”).

E-simulation is a valuable cognitive learning tool because it engages your brain and forces you to develop and use your knowledge in a way that textbooks, pictures and even watching a video can’t. Simulations allow you to assess a situation, decide on the best method to use, select and apply the right tools, and make the right decisions to produce a successful outcome.

Investing in this type of interactive learning has many advantages for healthcare educators and learners.

Web-based simulations are available anytime, anywhere. Whether learning a skill for the first time, revising for an exam, getting ready for a clinical externship, or refreshing knowledge on the job, e-simulation is only a browser window away. This is a learning method that fits in with the schedules, locations and commitments that most students juggle every day. And the student isn’t on their own: the simulation software will guide them and provide immediate, formative feedback.

For students still developing confidence, e-simulations allow them to practice at their own pace, as often as they need, and in private. Washington-based allied health educator, Nicole Carter, RMA, has seen first hand the difference e-simulation can make. One of her students had been struggling with clinical procedures for a while, when Nicole came across SIMTICS at a conference. She quickly adopted it and let the student practice venipuncture multiple times with SIMTICS. After that the student breezed through a real blood draw in the lab. ‘She said it was just like the simulation she did,’ says Nicole. ‘After she’d finished, she was so excited. She was a changed person.’

Nicole adds, ‘I won’t teach without this tool anymore.’

Dr Trish Berry, Associate Dean and Director, Clinical and Practicum Programs at Purdue Global University, agrees. She says that simulations prepare their students for clinical placements. ‘What happens when you pick the wrong needle, place it at the wrong angle, or give the wrong medication? With e-simulations you’ll find out without high stakes consequences.’

When students come to class having already learned and practiced a procedure with a cognitive e-simulation, instructor time is optimized. Rather than starting from square one, instructors can discuss with students what they’ve already learned, and target the difficult aspects of the procedure. Discussions can be deeper and richer when students ask questions based on their simulation experiences. And with the monitoring tools embedded within good e-simulation programs, instructors can track students’ progress over time and even their performance on a particular day. This information can be leveraged to tailor classes and homework to the needs of individual students.

The teaching dividend also extends to labs, sim centers and the use of manikins.

When they have already used e-simulations, students may require less lab time to physically practice each skill, freeing up resources for other students, and time can be used for deeper learning. The side benefit is less wear and tear on equipment, and fewer consumables used up. For sim center sessions, when students arrive with relevant pre-learning, students feel more confident, their questions are more meaningful, and more of the time can be dedicated to technical, team and higher order skills.

More varied experiences lead to better prepared students when the time comes to work with patients. E-simulations allow students to encounter a larger range of patient types and habitus than available manikins may allow. Also, procedures that a student may not be able to perform during an externship can still be experienced virtually.

And there are times when all of us need a reminder of skills previously learned but not performed for some time. In these moments, a ‘just in time’ solution is best. Web-based e-simulations are available whenever and wherever needed, and provide an interactive experience that puts the learner in charge and and allows them to check their competence.

To learn more about e-simulation and how it can support teaching and learning at your institution, see