Clinical Simulation and Resuscitation Glossary of Training Terms
The Society for Simulation in Health Care (SSIH) and the International Association for Clinical Simulation in Nursing (INACSL) agreed to develop simulation standards and a dictionary. As a result of their collaboration, there are both references that are free and available.
The new simulation standards are free, and found at this site: http://www.inacsl.org/i4a/pages/index.cfm?pageID=3407
The new simulation dictionary is free, and found at this site: http://www.ssih.org/Dictionary
0-9
12 Lead Task Trainer: adult male upper torso with anatomically accurate landmarks designed for 12-lead training.
2010 ECC Handbook: AHA 2010 Guidelines reference tool that provides access to the latest resuscitation science and treatment information.
A
Accreditation: self-regulatory process by which governmental, non-governmental, voluntary associations or other statutory bodies grant formal recognition to educational programs or institutions that meet stated criteria of educational quality.
ACLS Course DVD: AHA 2010 Guidelines DVD presents demonstrations of emergency cardiovascular care procedures, and includes seven video segments.
ACLS Instructor Manual with Lesson Maps: AHA 2010 Guidelines manual includes essential information and lesson maps instructors need to teach the initial ACLS course and the ACLS renewal course.
ACLS Posters: AHA 2010 Guidelines Posters depicting commonly used ACLS algorithms.
ACLS Student Workbook: AHA 2010 Guidelines classroom- and video-based, instructor-led course builds on the foundation of lifesaving skills from the Basic Life Support (BLS) for Healthcare Providers course. In the ACLS course, skills are taught in large-group sessions and small-group learning and testing stations where case-based scenarios are presented.
Active Error: errors that occur every day, at the front line (sharp end); effects are felt immediately.
Adjunctive Learning Modalities: can be readings, videos, on-screen simulations, role-plays, or seminar discussions.
Adult Pocket Mask: mask with a one-way and hydrophobic filter which allows effective ventilations. Can be used in CPR instruction.
Advanced Initiatives in Medical Simulation (AIMS): meeting of healthcare, industry, and government.
Advanced Life Support (ALS): a higher level of emergency medical care, usually provided by EMT-intermediates or paramedics. Typically ALS includes invasive techniques such as IV therapy, intubation, and/or drug administration.
Adverse Event: injury resulting from a medical intervention.
Airway Management: a nursing intervention from the Nursing Interventions Classification (NIC) defined as facilitation of patency of air passages.
Albuterol: a common bronchodilator drug.
Algorithm: is a sequence of clinical response protocols that is used as the basis for programming the physiological responses in high-fidelity patient simulators.
ALS Skills Trainer: a realistic interactive training mannequin for simulating a wide range of advanced life-saving skills in medical emergencies.
American Board of Anesthesiologists: the medical specialty organization responsible for accrediting specialist anesthetists.
American Medical Association (AMA): a professional association that represents the voice of the American medical profession and constitutes the partnership of physicians and their professional associations dedicated to promoting the art and science of medicine and the betterment of public health.
Anesthesia Technician: anesthesia Department Orderly:a trained anesthesia assistant who does not generally give direct patient care.
Analytic Scale: items allow multiple-level rating of specific behaviors; for example, "Student followed up on patient non-verbal cues: frequently | sometimes | rarely | never".
Andragogy: the art and science of helping adults learn.
Anesthesia Crisis Resource Management (ACRM): course stresses CRM principles-behavioral techniques used to improve the management of acute, dynamic situation (teamwork, communication, resource management, etc).
Anesthesiologist: a physician who administers anesthesia.
Application-Oriented Simulation Software: is designed for specialized domains, such as manufacturing, health care, or airlines.
Assessment: learner is assigned a VP for formative or summative assessment of skills.
Attending; Faculty: a medical practitioner who has undergone train in a specialty and is practicing in that specialty.
Author: the educator who conceives and principally creates a VP (Virtual Patient).
Automatic External Defibrillator (AED): an electronic device that administers an electric shock of preset voltage to the heart through the chest wall in an attempt to restore the normal rhythm of the heart during ventricular fibrillation.
Avatar: the participant's graphic representation in a virtual reality simulation or game.
B
Basic Life Support (BLS): key skills in basic life support are assessment of consciousness, identifying and removing airway obstruction, opening the airway using head tilt/chin lift or jaw thrust maneuvers, insertion of an oropharyngeal airway, and artificial ventilation using expired air techniques or a self-inflating resuscitator.
Best Evidence-Based Assessment (BEBA): an evaluation performed by properly selected measurement methods under methodological rigor with which the instruments are constructed and administered; assessment must be congruent with evaluation questions and designed to demonstrate acquired competencies.
Best Practices: is a technique, method, process, activity, incentive, or reward which conventional wisdom regards as more effective at delivering a particular outcome than any other technique, method, process, etc. when applied to a particular condition or circumstance. The idea is that with proper processes, checks, and testing, a desired outcome can be delivered with fewer problems and unforeseen complications. Best practices can also be defined as the most efficient (least amount of effort) and effective (best results) way of accomplishing a task, based on repeatable procedures that have proven themselves over time for large numbers of people.
Biphasic: having two phases.
BLS Healthcare Provider DVD: AHA 2010 Guidelines DVD for Healthcare Providers teaches skills using the AHA's research-proven Practice-While-Watching technique, which allows Instructors to observe the students, provide feedback and guide the students' acquisition
BLS Instructor Manual with Lesson Maps: AHA 2010 Guidelines Video-based, Instructor-led course teaches both single-rescuer and team basic life support skills for application in both in- and out-of-hospital setting.
BLS Student Workbook/Provider Manual: AHA 2010 Guidelines course that trains participants to promptly recognize several life-threatening emergencies, give high-quality chest compressions, deliver appropriate ventilations and provide early use of an AED.
Branched Narrative: a virtual patient design that affords multiple narrative paths with more than one outcome.
Briefing: a team huddle- allows the team to identify roles, responsibilities and goals prior to a caring for a patient-particularly in an acute or critical setting.
C
Call Out: team member alerts the team when an ordered procedure is complete.
Cardiac Arrest: also known as cardiopulmonary arrest or circulatory arrest) is the cessation of normal circulation of the blood due to failure of the heart to contract effectively.
Cardio-Pulmonary Resuscitation (CPR): an emergency procedure in which the heart and lungs are made to work by manually compressing the chest overlying the heart and forcing air into the lungs. CPR is used to maintain circulation when the heart stops pumping, usually because of disease, drugs, or trauma.
Case Blueprint: the case blueprint provides an overview of all elements involved in a simulation (e.g. educational goals, leaner descriptions, learner instructions, patient case, evaluation tool, setup needs).
Case Specificity: a phenomenon where performance on one clinical case is not a good predictor of performance on another case.
Certification: the process by which governmental, non-governmental or professional organizations or other statutory bodies grant recognition to an individual who has met certain predetermined specified qualifications. In most cases such recognition is on a voluntary basis.
Certified Registered Nurse Anesthetist (CRNA): a nurse who has completed graduate education in the field of anesthesia.
Checklist: is an objective evaluation tool commonly used in an OSCE (Objective Structured Clinical Exam) by instructors and standardized patients to evaluate learners' performances. Usually checklists are dichotomous (rather than scaled), meaning that the learner is evaluated on whether they did or did not meet a performance criterion.
Clinical Simulation: a clinical simulation is an imitation of clinical practice.
Closed-Loop Communication: exchange of information between team members, in which team members verify orders, medications, and procedures.
Cognitive Simulators: are used for training didactic information or rehearsing clinical scenarios. These are often screen-based, and may teach the steps of a procedural task but do not actually require physical performance of the task.Combitube Training Tube: tube that allows blind intubation to accomplish airway, without the need of a laryngoscope or visualization of the airway.
Community of Practice (CoP): is, according to cognitive anthropologists Jean Lave and Etienne Wenger, a group of people who share an interest, a craft, and/or a profession. The group can evolve naturally because of the members' common interest in a particular domain or area, or it can be created specifically with the goal of gaining knowledge related to their field. CoPs can exist online, such as within discussion boards and newsgroups, or in real life, such as in a lunchroom at work, in a field setting, on a factory floor, or elsewhere in the environment.
Computerized Tomography Angiography (CTA): a non-invasive technique for imaging the coronary arteries and extracting morphometric data.
Concurrent Validity: results correlate with other measures of same ability.
Confederate: a confederate is an individual other than the patient who is scripted in a simulation to provide realism, additional challenges, or additional information for the learner (e.g. paramedic, receptionist, family member, lab technician).
Confidentiality: is an ethical principle associated with several professions (e.g., medicine, law, religion, professional psychology, and journalism). In ethics, and (in some places) in law and alternative forms of legal dispute resolution such as mediation, some types of communication between a person and one of these professionals are "privileged" and may not be discussed or divulged to third parties. In those jurisdictions in which the law makes provision for such confidentiality, there are usually penalties for its violation.
Construct Validity: able to discriminate between levels of performance.
Content Validity: task contains the relevant subject material.
Continuing Medical Education (CME): a formal system of further education in a medical, nursing or paramedical field.
Continuous Positive Airway Pressure (CPAP): A ventilation device that blows a gentle stream of air into the nose during sleep to keep the airway open.
Control Booth: booth situated adjacent to the simulation room with a one-way viewing window to allow students to be observed, contains the computer that controls the AV system which allows capability for recording and audio/video reproduction of the simulation room and its events into a separate breakout room or onto a large screen in the main room.
Cricothyrotomy: (also called cricothyroidotomy) is a procedure that involves placing a tube through an incision in the cricothyroid membrane to establish an airway for oxygenation and ventilation.
Crisis Resource Management (CRM): a curriculum that is 60% or more behavioral and 40% or less medical/technical. Crisis Resource Management has become a generic term for courses that address the principles of CRM using simulation. The term has come to define the cognitive and teamwork skills that facilitate management of medical events bearing a high risk to patient well being.
Critical Path: the sequence of events (nodes) that define an ideal storyline where the learner makes all the right decisions from beginning to end.
Critical Thinking: clarifies goals, examines assumptions, discerns hidden values, evaluates evidence, accomplishes actions, and assesses conclusions.
CSE, CSA, CPX: a clinical skills or clinical practice examination (CSE, CSA, CPX) is a station or series of stations designed to assess the key clinical competencies of history-taking, physical examination, communication, and interpersonal and professionalism skills.
D
Debriefing Session: dedicated time to review the scenario that just occurred and extract important lessons.
Debriefing: a post performance evaluation of team performance and opportunity to identify strengths, weaknesses and systems issues.
Dedicated Simulation: simulation activities that take place in a dedicated simulation teaching center.
Defibrillation: treatment consisting of delivering a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator. This depolarizes a critical mass of the heart muscle, terminates the arrhythmia, and allows normal sinus rhythm to be reestablished by the body's natural pacemaker, in the sinoatrial node of the heart.
Diagnosis: process of determining health status and the factors responsible for producing it; it may be applied to an individual, family, group or community. The diagnosis should take into account etiology, pathology, and severity of the clinical state.
Dichotomy: is any splitting of a whole into exactly two non-overlapping parts, meaning it is a procedure in which a whole is divided into two parts, or in half.
Discrete-Event Simulation (DES): simulation model having dynamic, stochastic, and discrete characteristics.
Distance learning: learner independently accesses an online VP case but has remote synchronous (chat) or asynchronous (discussion board/email) engagement with the expert/author.
Distributed Learning: synonym for laptop or web-based simulation.
E
Efficacy: the ability to produce the necessary or desired result.
Electrocardiogram (EKG): used to study and record the electrical activity of the heart.
Emergency Medical Technician (EMT), Paramedic: a trained professional who delivers emergency pre-hospital care.
Emergency Medicine Crisis Resource Management (EMCRM): course adapts the general structure of the ACRM course using scenarios specific to emergency medicine.
Emergency Room (ER): a dedicated area in a hospital for the treatment of emergencies.
Empirical: pertaining to information that is derived from observation, experiment, or experience.
Epinephrine: a vasopresser drug used in resuscitation and treatment of anaphylaxis.
Evidence Based Practice (EBP): is an approach which tries to specify the way in which professionals or other decision-makers should make decisions by identifying such evidence that there may be for a practice, and rating it according to how scientifically sound it may be. Its goal is to eliminate unsound or excessively risky practices in favour of those that have better outcomes.
F
Face Shields: face shields (can be disposable) that fit over mannequin face.
Face Validity: the simulated tasks resemble the real.
Family & Friends CPR DVD with Facilitator Guide: AHA 2010 Guidelines DVD used by instructors and facilitators to conduct Family & Friends CPR classes.
Family & Friends CPR Student Manual: AHA 2010 Guidelines student workbook
Features/Feature Set: Is used for describing what a specific mannequin-based simulation device can or cannot do, as well the degree to which a given feature replicates the physical appearance or physiologic behavior of a human being.
Feedback: focuses more on instructor-driven transfer of information or critique.
Fidelity: Refers to the simulation - how the simulator is used in context to represent a patient care situation - rather than to the simulator device itself.
First Aid: - emergency care given before regular medical aid can be obtained.
For Training Purposes Only: a label affixed to medical equipment indicating that the unit is used for training purposes only.
Formative Feedback: information about performance is given to the learner immediately, allowing him/her to incorporate constructive criticism and improve performance.
Formative OSCE: a formative OSCE is an Objective Structured Clinical Exam used for teaching.
Frame of Reference Training: raters observe and individually score a live or recorded performance such as an SP encounter or chart note, and then together they discuss their ratings and reach a consensus on the observed behaviors corresponding to the checklist items and rating anchors.
Fulcrum Effect: perceived inversion of movements.
Full Scale Simulation: a high-fidelity representation of the clinical care environment including realistic contextual cues, team members and mannequins.
Full-body patient simulator: has active and programmable physiology suited to invasive clinical interventions (e.g. vocal ability, vitals, IV access, blood gas exchange, cardiac convertibility).
G
General-Purpose Simulation Software: can be used for any application, with the provision for special constructs for one or more specific applications (such as manufacturing or process engineering).
Guidelines 2010 Ready: up to date and reflects new science in the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
H
Halo Effect: deference given to someone due to his/her position or reputation.
Haptic: conveying the sense of touch; also refers to all the physical sensors that provide a sense of touch at the skin level and force feedback information from muscles and joints.
HeartCode ACLS: AHA 2010 Guidelines web-based, self-paced instructional program that uses eSimulation technology to allow students to assess and treat patients in virtual healthcare settings. Successful completion of the full ACLS Course (using HeartCode ACLS Part 1) includes three parts: HeartCode ACLS Part 1, Part 2*, a hands-on skills practice session with an AHA ACLS Instructor or using a voice-assisted mannequin (VAM) system, Part 3*, a skills test with an AHA ACLS Instructor or using a VAM system. * a hands-on skills practice session with an AHA ACLS Instructor or using a voice-assisted mannequin (VAM) system.
HeartCode BLS Part 1: AHA 2010 Guidelines web-based, self-paced instructional program that uses eSimulation technology to allow students to assess and treat patients in virtual healthcare settings.
Heartsaver Adult CPR/AED Poster: AHA 2010 Guidelines posters can be placed in many common areas at any worksite to provide employees and designated first responders with a quick reference to recall the steps of CPR AED and relieving choking.
Heartsaver CPR AED Student Workbook: AHA 2010 Guidelines CPR AED student workbook.
Heartsaver First Aid CPR AED DVD Set: AHA 2010 Guidelines DVD set is to be used by AHA Basic Life Support (BLS) and Heartsaver Instructors to teach the video-driven Heartsaver classroom courses, Heartsaver CPR AED, Heartsaver First Aid and Heartsaver First Aid CPR AED.
Heartsaver First Aid Student Workbook: AHA 2010 Guidelines First Aid Student Workbook is for use by a single student and provides information needed before, during and after the course.
Heartsaver First Aid with CPR & AED Student Workbook: AHA 2010 Guidelines First Aid with CPR & AED Student Workbook is for use by a single student and provides information needed before, during and after the course.
High Fidelity Patient Mannequin: (also called model-driven simulators) are those that use a mannequin body or part of a body to physically represent the patient, and have physiologic and pharmacologic models that direct real time autonomous reactions to interventions and therapies.
High Fidelity Patient Simulation Room: a learning environment with a setting that houses the High Fidelity mannequin and has piped in gases (nitrogen, carbon dioxide, and oxygen) and live wall suction.
High-Stakes Testing: the process of using test scores for the purpose of making decisions that have major consequences for the individual being tested.
Human Factors: the discipline or science of studying the interaction between humans and systems and technology. The term covers all biomedical and psychological considerations
Hybrid Simulations: are any simulation that combines standardized patients and simulators, including table top models, task trainers, and mannequins.
Hybrid Simulation: the use of two or more simulation modalities together in one training activity.
Hybrid Simulators: incorporates components of multiple simulator types. For example: a mechanical box trainer that also incorporates position and force sensors, allowing for computerized assessment of surgical performance and delivery of feedback to the learner.
I
Immediate Feedback: occurs during the event, usually due to a cause and effect event.
Improving the Management of Patient Emergency Situations (IMPES): multi-disciplinary, team training course that applies the CRM principles to managing emergency situations in the intensive care unit.
In-Situ Simulation: (In-Situ ~ Latin for "in place") simulation activities that take place in the actual clinical work environment.
Intensive Care Unit (ICU)/Critical Care Unit (CCU): dedicated ward for the care of critically ill patients.
Intensivist: medical specialist in Intensive Care Medicine.
Intermediate Fidelity Patient Mannequin: partial or full body mannequin as a physical presence on which to practice interventions. The simulators may interact with the user in limited ways, but the bulk of responses are created by the instructor.
Intermittent Positive Pressure Breathing (IPBB): the active inflation of the lungs during inhalation under positive pressure from a cycling valve. A form of respiratory therapy using a ventilator for the treatment of selected patients with atelectasis, those needing occasional assistance breathing, or those requiring some types of aerosol medications. Also called Intermittent positive pressure ventilation.
Introduction to the Management of ILL Patients: course uses two to three short scenarios to introduce pre-clinical medical students to the dynamic clinical management of a variety of patients.
Intubation Stylet: tool used that provides a positive aid to intubation.
Intubation: refers to the placement of a tube into an external or internal orifice of the body. Although the term can refer to endoscopic procedures, it is most often used to denote tracheal intubation. Tracheal intubation is the placement of a flexible plastic tube into the trachea to protect the patient's airway and provide a means of mechanical ventilation. The most common tracheal intubation is orotracheal intubation where, with the assistance of a laryngoscope, an endotracheal tube is passed through the mouth, larynx, and vocal cords, into the trachea. A bulb is then inflated near the distal tip of the tube to help secure it in place and protect the airway from blood, vomit, and secretions. Another possibility is nasotracheal intubation where a tube is passed through the nose, larynx, vocal chords and trachea.
In-Vivo: in real life.
J
K
Kinesthesia: the perception of movement or strain from within the muscle, tendons and joints of the body.
L
Laryngeal Mask Airway (LMA): a mask used in anesthesia and emergency medicine.
Laryngoscope: is a medical instrument that is used to obtain a view of the vocal cords and the glottis, which is the space between the cords.
Latent Error: errors in the design, organization, training, maintenance that may lead to errors. Effects may lie dormant or unnoticed in system for a period of time.
Latent Threats: aspects of the organization that are not always easily identifiable but predispose to commission of errors.
Learner instructions: are the information provided to the learners prior to the encounter to prepare them specifically for it. These can include information about logistics (e.g. amount of time allotted for the encounter), the patient (e.g. vitals, chief complaint, relevant medical history), and their tasks (e.g. focused history, physical exam, counseling).
Lidocaine: a local anesthetic drug, also used in treatment of arrhythmias.
Likert Scale: a tool used to determine opinions or attitudes; it contains a list of declarative statements, each followed by a scale on which the subject is to indicate degrees of intensity of a given feeling.
Local Area Network (LAN): a communication network that provides interconnection of a variety of data communicating devices within a small geographical area.
M
Mannequin: (the term "manikin" scan also be used). Full or half body representation of a patient for practice.
Mannequin-Based Simulation: encompasses the modalities of simulation that use a physical mannequin (typically of a whole body) to replicate the patient in clinical encounters.
Measurement of Outcome (MOO): Measurement of competence by using a range of assessment instruments to provide objective measures of skills, knowledge and attitudes.
Mechanical Simulators: are the simplest and often constructed to teach discrete tasks i.e. Knot-tying boards, artificial tissue blocks for suturing practice, and box trainers for laparoscopy.
Methodology: system of principles, practices, and procedures, applied to a specific branch of knowledge.
Microsimulation: synonym for laptop or web-based simulation.
Modality: A therapeutic method or agent, such as surgery, chemotherapy, or electrotherapy, that involves the physical treatment of a disorder.
Model-Driven Approach: creating complex mathematical models of the physiology of the human body in normal and abnormal clinical conditions as well as its response to drugs and other interventions.
Models: are mannequins constructed to respond realistically to actions, allowing examinees to reason through a clinical problem without risk to a real patient.
Moulage: the art of applying mock injuries for the purpose of training. Moulage may be as simple as applying pre-made rubber or latex "wounds" to a healthy "patient's" limbs, chest, head, etc., or as complex as using complicated makeup and theatre techniques to provide elements of realism (such as blood, vomitus, open fractures, etc.) to the training simulation.
N
Nasal Airway: a flexible, curved piece of rubber or plastic, with one wide, trumpetlike end and one narrow end that can be inserted through the nose into the pharynx.
Node: a step along a branched narrative story, typically represented by a single screen or web page; the learner progresses from one node to the next based on his/her decisions.
Non-technical Skills: behavioral Skills. Can be categorized as either a) skills of dynamic decision-making (e.g., anticipation and planning, use of cognitive aids, avoiding fixation errors) or b) skills of teamwork and team management (e.g., workload distribution, communication, and/or role clarity).
Nor-epinephrine: a vasopressor drug used in resuscitation and treatment of cardiovascular emergencies.
O
Objective Structured Assessment of Technical Skill (OSATS): combines a task-specific checklist with global ratings of performance, or the Global Operative Assessment of Laparoscopic Skill (GOALS).
Objective Structured Clinical Exam (OSCE): is a performance-based exam designed to assess learners' clinical skills in a simulated environment. Learners rotate through one or more stations, each simulating a specific clinical situation and challenge intended to elicit demonstration of specific behaviors and skills.
Objective: in medical education, it is what the learner will be able to know or do after taking part in educational activities. Objectives should result from assessment of the needs of the patient or population.
Operating Room (OR): a dedicated area where surgery is performed.
Operator-Driven Approach: relying on direct control by the operator of all the clinical data and features, sometimes augmented by software "scripts" to automate certain stereotyped responses in well-defined clinical situations.
Oral Airway: a curved tubular device of rubber, plastic, or metal placed in the oropharynx during general anesthesia and other situations in which the level of consciousness is impaired. Its purpose is to maintain free passage of air and keep the tongue from obstructing the trachea. The artificial airway is not removed until the patient begins to awaken and regains pharyngeal, cough, and swallowing reflexes.
OSCE Blueprint: provides an overview of the link between educational goals and each station and serves as a valuable tool for OSCE (Objective Structured Clinical Exam) development as cases evolve.
P
Patient case: provides complete information for the standardized patient to use to portray the patient and includes information such as patient demographics, general affect and motivation, chief complaint, history of present illness, past medical history, and social history. Patient cases can also be written to indicate any information to be volunteered and any other specific prompts required of the patient. The details of the patient case may be referred to as the patient instructions.
Patient Educator: is a lay person trained to provide instruction on head-to-toe or invasive exam (breast and pelvic exam or male genital rectal exam) using their own bodies. Additionally, patient educators are trained to facilitate small group learning.
Patient Encounter (or Encounter): is a general term to describe the interaction between the learner and patient during the simulation. More generally, encounter is used to describe the learner interaction when the simulation scenario is based on something other than a patient.
Pediatric BVM: resuscitator used to ventilate a patient that provides users with tactile and visual feedback.
Pharmacology: the science that deals with the origin, nature, chemistry, effects, and uses of drugs; it includes pharmacognosy, pharmocokinetics, pharmacodynamics, pharmacotherapeutics, and toxicology.
Pinch: intuitive feeling that something may be wrong.
Post-Anesthesia Care Unit (PACU): a dedicated ward that receives patients following anaesthesia and/or surgery.
Post-encounter activities: are activities such as quizzes, SOAP notes or other write-ups, self-reflections, or station or event evaluations that learners complete in the time allotted after the encounter has been completed.
Postevent Feedback: replay that provides an objective and undeniable documentation of events that gives the participants opportunity to view the entire simulation session from a different perspective and encourages them to reflect on their actions and behaviors.
Predictive Validity: task performance predicts real-world performance.
Problem-based learning: small group learning with a facilitator where the students access and engage as a group with the VP (virtual patient) case.
Procedural simulators: are a category of simulators that are built to allow learners to practice a specific procedure (e.g. IV catheterization, intubation, laparoscopy).
Process Modeling: a technique for using computers or other technologies to imitate/simulate the operations of various kinds of real-world facilities or processes and their impacts on health care delivery.
Pulse Oximeter: is a medical device that indirectly monitors the oxygen saturation of a blood (as opposed to measuring oxygen saturation directly through a blood sample) and changes in blood volume in the skin, producing a photoplethysmograph.
Pulse Oximetry: a method used to determine the O2 saturation-SaO2 and desaturation of blood in a continuous noninvasive fashion, through the noninvasive assessment of arterial Hb-bound O2 saturation, based on the combined techniques of optical plethysmography and spectrophotometry; PO is accurate within 5% of a standard co-oximeter when the SaO2 is in the 70-100% range; accuracy plummets below 70%; PO is used to detect O2 desaturation accurately, inexpensively, quickly, safely, and is useful in endoscopy, recovery, intensive care, and for evaluating obstructive sleep apnea syndrome, for which the gold standard is the costly and onerous nocturnal polysomnography.
Q
Quality Assurance: a system of procedures, checks, audits, and corrective actions to ensure that all research, testing, monitoring, sampling, analysis, and other technical and reporting activities are of the highest achievable quality. Quality assurance serves to benefit the quality of care.
Quality of Care: a level of performance or accomplishment that characterizes health care. Ultimately, measures of the quality of care always depend upon clinical outcomes or value judgments, but there are ingredients and determinants of quality that can be measured objectively, such as structure, process or procedures, and outcomes.
Quantified Tests: standardized patient examinations and computer case simulations and the use of relevant research data and information to validate the preferred assessment procedures.
R
Rating scales: provide the opportunity for observers to exercise expert judgment and rate the Global scale, items rate the performance as an integrated whole quality of an action.
Readback: an order is given; it is written down and read back. It is then acknowledged by giver as correct.
Reinforcement (learning principle): conveying desired behaviors by reinforcing positive behaviors during the debriefing.
Reliability: the extent to which a measure is consistent across repeated tests and includes test-retest Reliability correlation of tests applied more than once to same subjects, internal consistency correlation of subsets of scores measuring same construct, and inter-rater reliability degree of agreement between multiple raters of same test subjects.
Remote Feedback: uses all the distant interconnection technology to bring together participants, observers, and instructors for a shared experience, without each and every one of them actually bringing themselves to a common observation/debriefing room.
Research: scientific inquiry or an organized quest for new knowledge and better understanding, such as of the natural world or determinants of health and disease. Research can take several forms: empiric (observational), analytic, experimental, theoretical and applied.
Resident: a trainee in a medical specialty.
Respiratory Therapist (RT): a person trained in respiratory and ventilator care.
Retention (learning principle): having the ability to interpret and apply the material, and the ability to assign the correct degree of importance to the material.
Risk Factor: an aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which on the basis of epidemiological evidence is known to be associated with an unfavorable health-related condition and considered important to prevent, if possible. It is used as an indication of increased probability of a specified health outcome such as the occurrence of a disease but is not necessarily a causal factor. The term risk factor is further used to mean a determinant that can be modified by intervention, thereby reducing the probability of occurrence of disease or other specified outcomes.
S
SBAR: acronym for "Situation", "Background", "Assessment", and "Recommendation". It allows a clinical team member to easily and quickly describe the clinical presentation of a patient and make a recommendation for future action. It is a component of effective communication between one healthcare provider and another.
Scenario: an initial set of conditions and time line of significant events used to replicate or recreate a clinical situation in order to achieve exercise objectives.
Science: a branch of knowledge that produces theoretical explanations of natural phenomena based on experimentation and observation.
Screen-based Simulation: a program, exclusively computer-based, that allows learners to interview, examine, diagnose, and treat patients in realistic clinical scenarios.
Self-Assessment: the process of evaluating one's own deficiencies, achievements, behavior or professional performance and competencies. Self-assessment is an important part of self-directed and lifelong learning because it creates a need for improvement while it justifies confidence in ones competence.
Self-directed learning: freestanding case accessed by individual learners and completed with limited interaction with the case author, educators or experts.
Sequenced or blended learning: the learner engages with a VP in conjunction with supportive didactic instruction, small group discussion, or other simulation exercises.
Serious Safety Event (SSE): is a medical error or deviation from the standard of care resulting in serious harm.
Simulation Facility is the physical space where the simulation takes place, excluding in-situ simulation activities.
Simulation Program is a curriculum, whether informal or formal, using simulation as the primary modality to teach learners.
Simulations and Models: tools for assessment of clinical performance in an environment closely resembling reality and imitating real clinical problems to rate the examinees' performance on clinical problems that are difficult or even impossible to evaluate effectively without harming a real patient. They permit examinees to make life-threatening errors and provide instant feedback so examinees can correct a mistaken action.
Simulator Training for Acute Resuscitation Skills (STARS): course designed to teach medical students on an ICU rotation how to manage dynamic situations and to identify treatment priorities in the critically ill patient.
Simulator: a setting, device, computer program, or system that recreates essential elements and cues; to encourage experiential learning related to particular educational objectives.
Situated Learning: was first proposed by Jean Lave and Etienne Wagner as a model of learning in a Community of practice. At its simplest, situated learning is learning that takes place in the same context in which it is applied.
Situational Awareness: is the mental representation and understanding of objects, events, people, system states, interactions, environmental conditions, and other situation-specific factors affecting human performance in complex and dynamic tasks. Stated in lay terms, SA is simply "knowing what is going on so you can figure out what to do."
Sort-Of-Scared (SOS): miniversion of the SCARED course, a 1-hour course for interns to review Advanced Cardiac Life Support and the management of cardiac arrests.
Standard Course on Active Resuscitation, Evaluation, and Decision Making (SCARED): course developed for interns who showed an interest in additional simulator training in managing emergency situations and cardiac arrests.
Standard: refers to a model, example or rule for the measure of quantity, weight, extent, value, or quality, established by authority, custom or general consent. It is also defined as a criterion, gauge or yardstick by which judgments or decisions may be made. A meaningful standard should offer a realistic prospect of determining whether or not one actually meets it.
Standardized Patient: persons who are trained to portray a given patient presentation in a consistent and believable manner, allowing the realistic simulation of patient encounters.
Station: is the physical (or virtual) locale for simulating a specific clinical situation or challenge for teaching or assessing clinical skills. All of the elements of a specific simulation reside within the station.
Step Back: dramatic gesture to get immediate attention of team, allowing for reorganization or refocusing of goals and priorities.
Stethoscope: a Y-shaped instrument that amplifies body sounds such as heartbeat, breathing, and air in the intestine. Used in auscultation.
Subject Matter Expert (SME): is a person who is an expert in a particular area. In software engineering environments, the term is used to describe professionals with expertise in the field of application but without technical project knowledge. Sometimes the acronym is voiced ("smee") and other times spelled ("S-M-E").
Succinylcholine: a short-acting muscle relaxant, often called �sux.'
Summative Feedback: information is provided to the learner at the end of training and used to make a decision about his/her status or advancement.
Summative OSCE: a summative OSCE is an Objective Structured Clinical Exam used for assessment.
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Table top models: are a category of simulators that are a three-dimensional replication of a part of the body (e.g. knee model, skull model, shoulder model).
Target Fixation: focus on a single task to the exclusion of other input.
Target Population/Target Audience: groups of participants or learners to whom the education application or discipline is directed to.
Task Trainer: a simulator designed to practice specific clinical skills. Sometimes also called "part task trainer" or "partial task trainer."
Team Building Training (TBT): offers an application that has the potential to fulfill both requirements and could enable training and simulation centers the opportunity to widen their appeal to all areas of healthcare.
Team Communication: the exchange of information between team members that is satisfactorily transmitted, received, and acted upon.
Team: a small number of people with complementary skills who are committed to a common purpose, performance of growth for which they are mutually accountable.
Technical Skills: the actual performance of patient care treatments.
Telemedicine: the application of communications technologies for the provision of health care services (diagnosis, treatment, prevention of diseases and injuries) over spatial distance in a situation where remoteness and/or availability of professional expertise is a critical factor.
Threats: factors that increase the likelihood of an error.
Transference (learning principle): the ability to take the lessons learned from sessions and apply them to a new or novel problem. Once debriefing is complete and students return to their clinical settings, information learned will translate into successful clinical skills that can be used in a critical clinical setting, thereby improving their performance.
Triad: simulation technique using a triad of three people (students or course participants) in all roles. The three roles are typically patient, practitioner and observer.
Triangulation: a method of assessment that is required when validity cannot be achieved with the use of a single assessment tool. If multiple testing methods are used to evaluate a single competence, one can be more certain that the competency has been appropriately assessed.
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Validity: extent to which an assessment tool measures accurately what it is designed to measure.
VE Measurements ~Human Performance Measures: objective performance measures related to the specific task (skill measures), time, accuracy/errors, mental workload, critical incidents, eye movements/head movements, performance lags, situation awareness, team performance measures, sensation of presence, subjective opinions, manual tracking performance, less resistance to training, enjoyment of training, spending more time training.
VE Measurements ~Physiological: visual and motor aftereffects, vestibular aftereffects Cybersickness (Cybersickness questionnaire, EMG), physiological monitoring (heart rate, sweating, blood pressure, EEG, EMG of stomach, etc.), length of time to adapt, length of time in the VE, length of time of aftereffects.
VE Measurements ~Social: amount of interactions among users, type of information shared, social enhancement effects on clinical outcomes, increased motivation.
VE Measurements ~Software and Hardware Measures: system lags, system crashes or failures, processing performance, packages sent across distributed systems.
VE Measurements ~Transfer of Training (ToT): two-group, self-control, subjective opinion, uncontrolled, low fidelity, exams for knowledge, etc.
Venepuncture, venopuncture or venipuncture: is the process of obtaining intravenous access for the purpose of intravenous therapy or obtaining a sample of venous blood.
Ventricular Fibrillation: is a condition in which there is uncoordinated contraction of the cardiac muscles of the ventricles in the heart, making them quiver rather than contract properly. While there is activity, it is undetectable by palpation (feeling) at major pulse points of the carotid and femoral arteries especially by the lay person. Such an arrhythmia is only confirmed by electrocardiography. Ventricular fibrillation is a medical emergency that requires prompt Basic Life Support interventions because should the arrhythmia continue for more than a few seconds, it will likely degenerate further into asystole ("flatline").
Violation: conscious failure to adhere to procedures/regulations.
Virtual Environment: describes a wide variety of computer-based applications, commonly associated with its immersive, highly visual, 3D characteristics. It is generally defined based on the type of technology being used, such as head-mounted displays, stereoscopic capability, input devices, and number of sensory systems stimulated.
Virtual Patient (VP): a computer program that simulates real-life clinical scenarios in which the learner acts as a healthcare provider obtaining a history and physical exam and making diagnostic and therapeutic decisions.
Virtual Reality Exposure Therapy (VRET): an innovative method of conducting exposure therapy. Users are immersed within a computer-generated simulation or VE and increasingly exposed to the feared stimuli within a contextually relevant setting.
Virtual reality simulations (VR): use computers sometimes combined with anatomical models to mimic realistic organ and surface images and the touch sensations a physician would expect examining a real patient. Written and computerized simulations have been used to assess clinical reasoning, diagnostic plans and treatment for a variety of clinical disciplines. They are expensive to create.
Virtual Reality: commonly called Virtual Environments (VE). Often used to describe a wide variety of computer-based applications and is frequently associated with its immersive, highly visual, 3D characteristics. A computer-simulated environment that gives a sense of being present in the virtual environment and within which a participant can interact in a seemingly real or physical way.
Virtual Simulation: a simulation involving real people operating simulated systems.
Vital Signs: a set of clinical measurements of a patient: temperature, pulse, respirations (rate), blood pressure (and perhaps pain score).
Viva (or Viva Voce): an oral examination.
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Wide Area Network (WAN): communication network designed to support interactions across large geographic areas.
