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Acute cardiovascular care
The role of simulation-based education in cardiology
  1. Khalid Barakat
  1. Correspondence to Dr Khalid Barakat, Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, St Bartholomew’s Hospital, London EC1A 7BE, UK; khalid.barakat{at}

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Learning objectives

  • To develop an understanding of the potential use of simulation in healthcare.

  • To understand the importance of identifying a trainee’s or learner’s needs before developing simulation-based training.

  • To develop an understanding of the minimal standards for delivering high-quality simulation as set out by the Association for Simulated Practice in Healthcare.


Simulation-based education (SBE) is a ‘technique and not a technology’ which aims to ‘replace or amplify real-life experiences with guided experience that evoke or replicate substantial aspects of the real world in a fully interactive environment’.1 Many simulations within healthcare can achieve a high degree of fidelity in which participants behave and act in a manner in which they would in a real-life scenario.1

Despite the paucity of evidence underpinning the traditional apprenticeship model for training,1 most reviews discussing the potential of SBE in medical healthcare examine the evidence that SBE is either equivalent to or better than this traditional model. The purpose of the current review is to explore some of the wider educational principles underpinning the use of SBE in medical healthcare and to examine both the potential drivers and obstacles to the development of SBE in cardiology training, human factors training and in the maintenance of competency. Commonly used terminology in suimulation based education are summarised in table 1.

Apprenticeship training model and SBE: two sides of the same coin

In an ideal training programme, a novice learning a new practical skill would be guided by an expert through five different stages of skill acquisition described by Dreyfus and Dreyfus.2–6 In this model, the following four components will contribute to successful learning:

  • The pace of learning is determined by the learner.

  • There would be immediate feedback for the trainee on their performance.

  • There is as little risk to the patient as possible through a combination of case selection (simple cases initially, moving to more …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Author note References which include a * are considered to be key references.