In healthcare simulation, the primary goal remains constant: to prepare healthcare professionals for the actual patient populations they will serve. This HealthySimulation.com article by Rémy Roe, Ph.D. and Simulation Technology Specialist at the Stanford University School of Medicine’s Center for Immersive and Simulation-based Learning (CISL), explores strategies for the development of authentic simulation scenarios that accurately reflect real-world patient demographics and healthcare situations. The focus centers on the creation of high-fidelity experiences that naturally incorporate the full spectrum of human diversity encountered in clinical practice.
In this article, Dr. Roe brings unique expertise through his Ph.D. research on mental health in minority populations, over a decade of working in healthcare simulation, and extensive global experience as a retired special forces operator across six continents. With this distinctive combination of academic research and worldwide operational experience, this article offers valuable insights into the creation of high-fidelity clinical simulations that naturally incorporate the full spectrum of human diversity encountered in clinical practice.
The Comprehension of Real-World Patient Demographics
Healthcare professionals must prepare to treat patients from all backgrounds, ages, cultures, and life circumstances. Census data and local hospital statistics provide valuable insights into community demographics. This information helps healthcare simulation centers design clinical simulations that reflect their actual patient population. For example, a healthcare simulation center in an urban area with a large immigrant population should include simulation scenarios that involve patients who speak different languages or hold various cultural beliefs about healthcare. These scenarios emerge naturally from local demographic data rather than from artificial quotas.
Authentic Scenario Development
The development of authentic clinical scenarios starts with real patient cases, modified to protect privacy while still able to maintain essential elements. Medical records, case studies, and clinician experiences provide rich source material for creating true-to-life simulation experiences. A well-designed clinical scenario bank should reflect the natural variety of patients healthcare providers encounter. Variables like variations in age, language, physical ability, cultural background, socioeconomic status, and other factors impact healthcare delivery and outcomes.
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Clinical accuracy demands attention to how different conditions present across various populations. For example, cardiac symptoms often present differently in women compared to men, and certain conditions occur at different rates among different ethnic groups. These variations reflect medical reality rather than social concepts.
Training Standardized Patients
Standardized patients (SP’s) are trained to portray authentic characters based on real patient presentations. SP’s give healthcare simulation scenarios the ability to accurately represent symptoms, behaviors, and communication styles typical of different patient backgrounds and conditions. The focus remains on clinical authenticity. A standardized patient that portrays an elderly patient with limited English proficiency should accurately demonstrate both the medical condition and the communication challenges such a patient might face.
Task-Trainers and Manikins
Physical simulation equipment requires careful consideration to ensure an accurate representation of the diverse patient characteristics that healthcare providers will encounter in practice. Task trainers and manikins should reflect various skin tones, as this variation proves crucial for the development of clinical assessment skills. For example, cyanosis presents differently across different skin colors, and learners must develop competency in the recognition of these variations. Similarly, physical assessment findings such as jaundice, pallor, or rashes manifest differently across diverse skin tones.
Body habitus also plays a crucial role in procedural training. Practitioners must learn to perform procedures on patients of various sizes and shapes. For example, participants must learn how to understand anatomical landmarks on different body types, adapt their techniques for various physical characteristics, and recognize how body mass affects medical interventions. Modern simulation centers should maintain an equipment inventory that reflects these natural variations, which enables learners to develop competency across the full spectrum of patient presentations they will encounter in clinical practice.
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Current HealthySimulation.com Vendors to Meet the Demographic Needs
There are many vendors to meet healthcare simulation vendors that have products to meet specific population needs. Here are some of these products from current HealthySimulation.com vendors:
- Avkin: Various skin tones on all products and birthing simulator overlay
- Bodyswaps: VR simulations that include various demographics and are designed to address personal and professional biases.
- Elevate Healthcare: Various skin tones on products. Multiple task trainers in light and dark skin tones. Specific demographics include birthing, neonatal, and pediatric.
- Laerdal: Various skin tones on all products. Bariatric suits to apply over manikins. Multiple task trainers in light and dark skin tones. Specific demographics include birthing, neonatal, pediatric, and geriatric
- Limbs and Things: Various manikins and task trainers in dark and light skin tones, and augmented reality (AR) training with various skin tones.
- Medical Shipment: Distributor of various products and manikins to meet the demographic needs of healthcare simulation programs.
- PCS: AI wide range of digital patients from diverse demographics
- SimConverse: AI wide range of virtual patients from diverse demographics
- SimX: SimX Virtual Manikin allows the educator to customize the patient and patient appearance to demographics, age, and sex
- Tactical Medical Solutions: Products to meet EMS and military human patient demographics and also include canine manikins.
Communication Skills Development
Healthcare providers must develop effective communication skills for all patient interactions. Clinical simulation scenarios should challenge learners to adapt their communication style to meet patient needs, whether due to language differences, cultural practices, or other factors. These skills develop through practice with realistic scenarios. For example, learners might work with interpreters, navigate family dynamics, or address cultural beliefs that impact treatment decisions. Each clinical simulation scenario should emerge naturally from real clinical situations.
Clinical Documentation
Documentation practices in healthcare simulation should mirror real-world requirements. Some examples include accurate recording of relevant patient characteristics that impact care decisions or treatment modifications. The focus remains on clinically relevant information. Healthcare providers must learn to document important cultural, linguistic, or physical characteristics that affect patient care and maintain professional medical terminology and standards.
Resource Management
Simulation centers can develop scenario resources based on actual community needs. Community needs might include language interpretation services, cultural liaison contacts, religious accommodation protocols, mobility assistance equipment, or even modified communication tools These resources reflect standard healthcare practices rather than special accommodations. Their inclusion in clinical simulations prepares learners for routine aspects of patient care.
Quality Assurance Measures
Regular review of simulation scenarios ensures they maintain clinical accuracy and relevance. This process should include analysis of local patient demographics and healthcare trends to ensure scenarios remain current. Another inclusion should be feedback from clinical practitioners about real-world patient care challenges they encounter. Finally, assessment of learner performance data to identify areas needing additional scenario development should be implemented.
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The Focus is Fidelity
Through experience across multiple cultures and healthcare systems worldwide, it becomes clear that quality healthcare simulation transcends artificial categories. Instead, it focuses on the fundamental truth that healthcare providers must prepare to treat real people with real medical conditions in authentic ways.
Through scenario development grounded in real patient demographics and clinical cases, healthcare simulation centers create meaningful learning experiences that prepare healthcare providers for their future practice, and in turn, improve patient outcomes. This approach maintains high educational standards and ensures learners develop the skills necessary to provide excellent care to all patients. The future of healthcare simulation lies in the continuation to enhance the authenticity of our educational experiences. Through careful attention to clinical accuracy and real-world representation, healthcare simulation centers can prepare healthcare providers to serve their communities effectively.
As healthcare simulation technology and practices evolve, a focus on accurate representation of actual patient populations will remain essential. This commitment to authenticity ensures that healthcare simulation continues to advance its fundamental purpose: to prepare competent, skilled healthcare providers ready to serve all members of their community.
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