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  1. W R Hamman
  1. United Airlines;

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    What is fascinating about the study by Abrahamson et al1 are the similarities between medicine and aviation in the technology and use of simulation 35 years ago. What is also surprising is the advancement made by aviation to integrate simulation into training over the past 35 years compared with medicine in which simulation remains relatively unchanged. Medicine is asking the question—does simulation really work and is there a place for it in medical training? It should be asking why simulation in medicine is still a stand alone device used to practice very limited tasks, with narrow integration of the devices into the training curriculum of medical professionals.

    Although there are many reasons why it has not done so, medicine must become proactive and move beyond traditional methods of medical training. It needs to embrace simulation, create an effective model of training with simulation, and integrate simulation into a system design approach to training before the effectiveness of simulation can be assessed.

    Use of simulation in aviation

    I will briefly address the history of simulation in aviation and how it has developed and will then apply some of these aviation concepts to the study by Abrahamson et al in the context of an integrated system approach. Although I am applying what has been learned in aviation to this study, it can be applied to simulation in any of the disciplines of medicine that are developing simulations for their future training. My hope is to paint a picture of the future of medical training in which simulation will be an integral part of the training design. Simulation will not replace patient care but will enhance the quality of training.

    In aviation, simulators were very limited devices 35 years ago, used to train very specific tasks to individual pilots. The aircraft was used as the primary trainer …

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