Simulation-based learning in cardiovascular medicine: benefits for the trainee, the trained and the patient

The British Cardiovascular Society recently commissioned a working group to report on the role of simulation-based learning (SBL) in cardiology (http://www.bcs.com/documents/231\_SBL\_Report\_BCSv7\_FINAL.pdf). Why was the report commissioned now, and what is the relevance of the findings to the wider cardiology community? Simulation is a technique to replace or amplify real experiences in an interactive setting. SBL applies this, through the use of role play, simulated patients, part-task trainers, virtual reality devices and electronic manikins. Simulators have the theoretical potential to enhance learning, enhance practice, especially of teams, and thereby improve patient care and there are several factors that create a pressing need to enhance training and practice. Training time is being compressed by the European working directive and opportunities are further reduced by the less frequent undertaking of certain procedures—for example, right and left cardiac catheterisation. Patient safety priorities are at the forefront of health providers' concerns and this has driven a more consultant-led service. The see one, do one, teach one philosophy has hopefully been, and certainly should be, eliminated. Furthermore, for trained cardiologists, revalidation is developing both in the UK and in Europe, and has long since formed part of practice in the USA. The field of cardiology is evolving rapidly and the use of new equipment and procedures requires training. The primary qualities of SBL would seem to make it ideal to help us adapt to this changing environment. SBL can take place without exposing patients to risk, at the speed of the learner, with immediate feedback and the ability to adapt to the learner in a completely flexible way. Perhaps this is best summarised by saying that simulators have the potential to take the early and dangerous part of the learning curve away from patients …