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Training and simulation for patient safety
  1. Rajesh Aggarwal1,
  2. Oliver T Mytton2,
  3. Milliard Derbrew3,
  4. David Hananel4,
  5. Mark Heydenburg5,
  6. Barry Issenberg6,
  7. Catherine MacAulay7,
  8. Mary Elizabeth Mancini8,
  9. Takeshi Morimoto9,
  10. Nathaniel Soper10,
  11. Amitai Ziv11,
  12. Richard Reznick12
  1. 1Division of Surgery, Imperial College London, UK
  2. 2Department of Health, London, UK
  3. 3Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
  4. 4Medical Education Training International, Sarasota, Florida, USA
  5. 5Medical Equipment Services, International Aid, Spring Lake, Michigan, USA
  6. 6University of Miami Miller School of Medicine, Miami, Florida, USA
  7. 7Joint Commission International, Oak Brook, Illinois, USA
  8. 8School of Nursing, The University of Texas at Arlington, Arlington, Texas, USA
  9. 9Center for Medical Education, Kyoto University Graduate School of Medicine, Kyoto, Japan
  10. 10Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, USA
  11. 11Chaim Sheba Medical Center, Tel Aviv, Israel
  12. 12Department of Surgery, University of Toronto, Toronto, Canada
  1. Correspondence to Mr Rajesh Aggarwal, Division of Surgery, Imperial College London, 10th Floor, Queen Elizabeth the Queen Mother Building, St Mary's Hospital, Praed Street, London W2 1NY, UK; rajesh.aggarwal{at}


Background Simulation-based medical education enables knowledge, skills and attitudes to be acquired for all healthcare professionals in a safe, educationally orientated and efficient manner. Procedure-based skills, communication, leadership and team working can be learnt, be measured and have the potential to be used as a mode of certification to become an independent practitioner.

Results Simulation-based training initially began with life-like manikins and now encompasses an entire range of systems, from synthetic models through to high fidelity simulation suites. These models can also be used for training in new technologies, for the application of existing technologies to new environments and in prototype testing. The level of simulation must be appropriate to the learners' needs and can range from focused tuition to mass trauma scenarios. The development of simulation centres is a global phenomenon which should be encouraged, although the facilities should be used within appropriate curricula that are methodologically sound and cost-effective.

Discussion A review of current techniques reveals that simulation can successfully promote the competencies of medical expert, communicator and collaborator. Further work is required to develop the exact role of simulation as a training mechanism for scholarly skills, professionalism, management and health advocacy.

  • Simulation-based training
  • medical education
  • new technologies
  • healthcare training
  • patient safety
  • team training
  • training

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  • Funding The project was funded by WHO Patient Safety.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.