Contemporary Review in Critical Care Medicine Simulation Training in the Intensive Care Unit

Abstract Due to an emphasis on patient safety and recognition of the effectiveness of simulation as an educational modality across multiple medical specialties, use of healthcare simulation (HCS) for medical education has become more prevalent in recent years. In this manuscript, the effectiveness of simulation for areas important to the practice of critical care is reviewed. We examine the evidence base related to domains of procedural mastery, development of communication skills and interprofessional team performance, with specific examples from the literature in which simulation has been used successfully in these domains in critical care training. We also review the data assessing the value of simulation in other areas highly relevant to critical care practice, including assessment of performance, integration of HCS in decision science and critical care quality improvement, with attention to the areas of system support and high-risk, low-volume events in contemporary healthcare systems. When possible, we report data evaluating effectiveness of HCS in critical care training based on high level learning outcomes resulting from the training, rather than lower level outcomes such as learner confidence or post-test score immediately after training. Finally, obstacles to implementation of HCS such as cost and logistics are examined and current and future strategies to evaluate best use of simulation in critical care training are discussed.