Why Simulation?

The Institute of Medicine’s (IOM) 1999 report on medical errors (To Err Is Human) galvanized the public and health professionals. Before then, providers, healthcare organizations and policy makers lacked the understanding and incentives to generate the changes in culture, systems, training and technology to improve safety. Since 1999 there has been progress, but it has been insufficient. Stronger regulation has helped, as have some early improvements in technology and in workforce organization and training. Error-reporting systems have had little impact, and scant progress has been made in improving accountability. Five years after the report’s publication, we appear to be at ‘‘the end of the beginning.’’ (Robert M. Wachter, Health Affairs 2004).

The creation of EUNetPaS (European Union Network for Patient Safety) reflects the growing recognition throughout Europe that similar challenges highlighted in the US healthcare system applies to Europe as well, and, as such, can and must be addressed. The following comparison illustrates the unfavorable conditions: when a person steps into an airplane, their risk of dying in a crash is one in 10 million. When a person is admitted to hospital, the risk of dying or being seriously harmed by medical error is one in 300 (England's Chief Medical Officer’s report, 2009).

High-quality healthcare education is a crucial, however not the sole premise to ensure high-quality patient care. The shortage of healthcare personnel, in particular qualified nurses, is becoming an increasing obstacle in attaining and maintaining acceptable standards in healthcare. Several countries are now addressing the shortage problem by looking for ways to speed up the educational process. As a remedy, Denmark recently shortened the duration of mandatory clinical training for medical students, whereas the state of California has developed a strategic action plan to build educational capacity in nursing schools. The rationale for integrating clinical simulation in California is that - "simulation, technology, and informatics offer new opportunities for educators to teach more effectively and for students to learn safely and with minimal risk to patients" (California Institute for Nursing & Health Care, 2008).