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| Research article summary (published 30 Jul 2003): |
Simulation-based medical education: an ethical imperative.
Full Abstract
Medical training must at some point use live patients to hone the skills of health professionals. But there is also an obligation to provide optimal treatment and to ensure patients' safety and well-being. Balancing these two needs represents a fundamental ethical tension in medical education. Simulation-based learning can help mitigate this tension by developing health professionals' knowledge, skills, and attitudes while protecting patients from unnecessary risk. Simulation-based training has been institutionalized in other high-hazard professions, such as aviation, nuclear power, and the military, to maximize training safety and minimize risk. Health care has lagged behind in simulation applications for a number of reasons, including cost, lack of rigorous proof of effect, and resistance to change. Recently, the international patient safety movement and the U.S. federal policy agenda have created a receptive atmosphere for expanding the use of simulators in medical training, stressing the ethical imperative to "first do no harm" in the face of validated, large epidemiological studies describing unacceptable preventable injuries to patients as a result of medical management. Four themes provide a framework for an ethical analysis of simulation-based medical education:
best standards of care and training, error management and patient safety, patient autonomy, and social justice and resource allocation. These themes are examined from the perspectives of patients, learners, educators, and society. The use of simulation wherever feasible conveys a critical educational and ethical message to all:
patients are to be protected whenever possible and they are not commodities to be used as conveniences of training.
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Author information
Author/s: Ziv, Amitai (A); Wolpe, Paul Root (PR); Small, Stephen D (SD); Glick, Shimon (S);
Affiliation: The Chaim Sheba Medical Center, and Israel Center for Medical Simulation (MSR), Tel-Hashomer, Israel.
Grants: P20 HS 11553 (Agency:United States AHRQ) ; U18 HS 11905 (Agency:United States AHRQ)
Journal and publication information
Publication Type: Journal Article; Research Support, U.S. Gov't, P.H.S.; Review
Journal: Academic medicine : journal of the Association of American Medical Colleges (Acad Med), published in United States. (Language: eng)
Reference: 2003-Aug; vol 78 (issue 8) : pp 783-8
Dates: Created 2003/08/13; Completed 2003/09/17; Revised 2007/11/14;
PMID: 12915366, status: MEDLINE (last retrieval date: 11/6/2008)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
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