Virtual patient simulation for prevention of medical error: beyond just technical upskilling.

Virtual patient simulation is a well established mode of medical education for many technically oriented clinical skills. Resuscitation Annie has been used for teaching cardiopulmonary resuscitation for many years and other similar simulation has been used extensively for teaching colonoscopy, delivering babies, suturing, and a variety of surgical techniques and procedures. There are very few medical schools that would not routinely use such simulation as a standard part of their curriculum. This is not because they are cost effective (although they are) but rather because they have been shown to reduce human error in performing these clinical skills and provide a safe environment for doctors to learn such procedures without endangering real patients. Simulation has taken many forms in Medicine including: (1) Computer-based simulations; (2) Standardised patients widely used in OSCE training and examination; (3) Virtual environments; (4) mannequins such as Resuscitation Annie, and (5) so-called "high fidelity" simulations resembling as much as possible the actual clinical situations. These forms of simulation have been used to teach the important skill of clinical decision-making as well as technical procedures (Owen, 2008).