The edge of reality: challenges facing educators using simulation to supplement students' lived experience

Employing simulation to help students acquire a specific skill or get closer to a particular issue or problem in order to understand applications to the real world is hardly new. The Ancient Greeks employed descriptive scenarios to convey their social, ethical and moral positioning in society. Today simulation-based learning is used to supplement students' work-based experiences and to integrate traditional knowledge with experience gained in the actual professional setting. Simulation has gained particular recent momentum in the health/medical area as a way to bridge the gap between theory and clinical practice. Simulation is gaining ground as a medium to deliver a whole range of core skills to aspiring graduates. Despite a growing popularity, there is an apparent absence of discussion in the literature of the respective roles and prerequisite knowledge of the human agents involved in any simulation-based learning process. The result is an 'objectified' perception of simulation: 'simply light the blue touch paper and the learning outcomes will be achieved'. What we do know is that educator(s) and students will together determine the success or otherwise of simulation-based learning. This chapter aims to reposition educators and students back into the centre of the simulation learning process. Their involvement as unique individuals will generate sets of challenges likely to influence simulation success, namely: learner-focussed, educator-focussed, situation-focussed, and curriculum focussed challenges respectively. The chapter ends with a summary of the ways educators might deal with inherent challenges confronting the use of simulation in healthcare settings