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Simulation in Procedural Training: At the Tipping Point

Susan Murin, MD, FCCP; Nicholas S. Stollenwerk, MD
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, UC Davis School of Medicine; and the VA Northern California Health Care System.

Correspondence to: Susan Murin, MD, FCCP, Division of Pulmonary, Critical Care, and Sleep Medicine, UC Davis, 4150 V St, Ste 3400, Sacramento, CA 95817; e-mail: susan.murin@ucdmc.ucdavis.edu


Financial/nonfinancial disclosure: The authors have reported to CHEST the following conflicts of interest: Dr Murin serves on the American Board of Internal Medicine Pulmonary Board and the Accreditation Council for Graduate Medical Education-Internal Medicine Residency Review Committee. The views expressed are her own and do not necessarily reflect the position of either of these organizations. Dr Stollenwerk has reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(5):1009-1011. doi:10.1378/chest.10-0199
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Extract

Clinical medicine has long relied on the apprenticeship model for educating physicians in training. This model, although well suited for complex and dynamic learning environments, also has limits and flaws.1 For medical procedures, the most serious problem with the apprenticeship model is that it is high risk: Learners train in real-life environments, and the burden of procedure-related training is borne by individual patients exposed to the increased risk of procedural complications posed by novice operators. Another serious shortcoming of the apprenticeship model is its lack of emphasis on objective measurement of trainee competence. Evaluation is usually subjective and global, with training time and/or volume of experience used as proxies for competence.

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