Simulation Training A Multidisciplinary Approach

legislation, and the evidence behind simulation and explore the art and utilization of medical simulation in a multidisciplinary setting. SIMULATION HISTORY Simulation as a primary tool for developing critical skills training did not begin in the health care field. In the 1930s, simulation became popular in the aviation industry with the advent of the Link trainer, which was used in flight and military applications. After fur-ther review of postcrash “black box ” recordings and analysis of in-flight crises, the aviation industry discov-ered that 67 % of mistakes made during flight involved deficiencies in communication.2 This finding moti-vated the aviation and space industries to mandate annual training in crew resource management (CRM) and flight simulation and require trainees to display true cognitive, technical, and behavioral skills, while working in a realistic environment.3 By placing emphasis on effective teamwork, communication, and skill demonstration, simulation training effec-tively increased safety and reliability within aviation, space, military, and nuclear power industries. Although long recognized as effective, simulation in health care has been slow to evolve secondary to past limitations in technology and cost-effectiveness. Anesthesiologists and members of the operative health care teams were the first to embrace medical simulation for resident training in high-risk opera-tions where human error can result in patient mor-bidity and mortality.4 Video recordings of moc