High-Fidelity Simulation is a healthcare education methodology that involves the use of sophisticated life-like manikins (sometimes called mannequins), virtual reality patients, or simulated patient actors in realistic patient environments. Healthcare Simulation scenarios can take place anywhere, from austere environments for EMS or Military Simulations, to clinical environments like surgical simulation inside a clinical simulation center. These complex high-fidelity simulators and learning environments, High fidelity manikins are also known as human patient simulators or high-fidelity simulators.
In Healthcare Simulation, the degree to which a particular manikin or other simulator technology can reproduce or mimic human physiology is known as fidelity. The clinical simulators that most closely resemble human anatomy are designated as high-fidelity. In contrast, a static manikin with very limited technological functionality is designated as low-fidelity. Low-fidelity manikins also known as task trainers may be used for repeated practice of clinical skills such catheter placement or wound care.
Most high-fidelity manikins have chests that expand and can breathe, have variable heart rates and tones, measurable blood pressure, and palpable pulses. They vary in their particular components but may include EKG displays, pulse oximeter, arterial waveforms, pulmonary artery waveforms and anesthetic gasses. Various procedures can be performed on the manikins such as bag-mask ventilation, intubation, defibrillation, chest tube placement, cricothyrotomy and others.
Usually high-fidelity patient simulators are computerized, contain hydraulics and compressors and have external monitors which display various physiological functions. Many manikins are articulated, change color, exhibit seizures, speak and cry. Some high-fidelity simulators are very specialized such as trauma manikins with severely damaged or missing limbs, birthing manikins that mimic a woman in labor and delivery, newborn or premature babies and smaller pediatric manikins.
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Most high-fidelity manikins that are used for high fidelity simulation scenarios are operated by specially trained clinical simulation technologists in a separate control room. The clinical simulation technician operator can view the progress of the scenario and make changes to the high fidelity simulator as the session progresses. Typically, a healthcare simulation educator or content expert will also be present in the control room to direct the educational component of the scenario.
Learners must respond to changes in the high fidelity manikin and not from instructor cues in a high fidelity simulation. High-fidelity simulators create more realistic clinical scenarios and thus aid the learner. Several companies manufacture high-fidelity manikins. For example, Laerdal produces the SimMan series, Elevate Healthcare the LucinaAR birthing simulator with hologram capabilities and Gaumard sells Victoria a high-fidelity birthing manikin.
High fidelity simulation scenarios are also undertaken with the use of standardized persons or standardized patients. Standardized patients are real people, usually actors or those who have been trained to perform as is a real patient for health professionals in healthcare simulation scenarios. Standardized persons can also wear a wearable simulator in order to increase fidelity and realism even more. An example of this is the Avkin wearable birthing simulator. Some healthcare simulation programs only use standardized persons and do not use high fidelity manikins. Other healthcare simulation programs use a combination of both high fidelity patient simulators and standardized patients.
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In order to address healthcare performance gaps or learning needs, educators create clinical simulation scenarios based on identified learning objectives and learner needs. For example, emergency room responses to newly admitted chest pain patients were not found to meet nationally accepted standards. By participation in healthcare simulation, emergency room staff are provided an opportunity to practice and improve their knowledge and clinical skills related to care of chest pain patients. High-fidelity manikins can be used to mimic this clinical situation. Every detail of a healthcare simulation scenario is carefully planned and tested to ensure the learners’ needs are met.
Typically, simulators are either set up in a healthcare simulation lab or a human patient simulator is brought to the clinical space for in situ healthcare simulation scenarios. Healthcare professionals or students assume various roles and respond to the patient situation which is assigned in the pre brief. After the healthcare simulation scenario, a debrief session is held where participants reflect and identify practice/knowledge gaps and propose changes to their future responses in a similar situation.
Scenarios have been created for a wide variety of clinical situations such as: rare clinical events, ongoing residency training and undergraduate education in medicine, nursing and other allied health professions. In addition, high-fidelity simulation provides an opportunity for healthcare teams to improve team communication, team dynamics and other soft skills. High fidelity simulation is as close to real life events as possible and teams will completely immerse and care for the high fidelity manikin as if they were a real patient.
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The key advantage of high-fidelity simulation is that this allows learners of all levels an opportunity to immerse themselves in a simulated clinical scenario that looks and feels real. The higher the fidelity, the more likely the learner will to suspend disbelief and engage in the learning activity. Ultimately, the more knowledgeable the healthcare practitioner is, the safer the patient will be.
Examples of High Fidelity Patient Simulators
Laerdal has released MamaAnne, a maternal birth simulator, in 2024. MamaAnne aims to provide quality healthcare education to address the increasing maternal mortality rates. MamaAnne offers healthcare professional learners the opportunity to practice obstetric events to improve maternal outcomes. MamaAnne is a solution for clinical educators and learners to practice focused and efficient clinical simulation education to reduce occurrence of adverse obstetric events.
Gaumard Hal is a new ultra-high fidelity anatomy and physiology high fidelity manikin. Hal supports advanced trauma care algorithms and essential surgical interventions with the ability to use real clinical tools and techniques. Skin, bony landmarks, and internal tissue provide realistic tactile feedback to maximize the development of transferable clinical skills through high fidelity simulation. Internal sensors provide real-time feedback on provider interventions which record event data automatically for debrief.
Elevate Healthcare Aria, is a high-fidelity pediatric manikin. Aria addresses the challenges of pediatric patient clinical care. Aria assists to refresh learners’ reflexes and enhance their response times with a high fidelity manikin designed to develop critical decision-making skills and support life-saving pediatric care interventions. The use of Aria can reduce medical errors, improve performance and enhance care delivery. As a high fidelity manikin of a 7-year-old child, Aria offers interchangeable gender, 60 vocal expressions and sounds, an advanced airway and neurological features as well as many other features to enhance the high fidelity simulation.
High fidelity simulation is the closest to real life that is possible through either high fidelity patient simulators and/or the use of simulated persons with or without a wearable patient simulator. High fidelity is incredibly important to be able to increase immersion of the healthcare simulation participant into the clinical simulation scenario. High fidelity simulation enables learners to have as close to real life clinical experiences as possible to be able to hone their clinical skills and practice for worst case scenarios before they occur.
