Virtual Simulation: A Flipped Classroom Teaching Tool for Healthcare Education

1. Background

Virtual simulation for healthcare education is defined as a learning tool that employs specific hardware and software technology for simulation-based provider training within a digital domain. With either a provider- or patient-centered focus, the earliest virtual simulation programs have evolved over several decades and pioneered a pathway for the vast array of both hardware and software technology that is available today (Chang, 2020; Muguerza & Canelas, 2021). Despite significant technological advancements, much of these tools still reside within a dedicated simulation center or other formal training space. More recently, many simulation programs have adopted training software for remote, asynchronous learning.

The COVID-19 pandemic magnified our need in medical training for remote learning alternatives. Some have described this pandemic as an “unintended digital accelerator” of virtual learning technology due to the rapid need for remote learning resources in all sectors of education, including healthcare (Hennick, 2021 & Towers-Clark, 2021). While historically cost-prohibitive for many resource-limited programs, virtual simulation software will likely become more accessible and affordable in future years (Breining, 2018). Regardless of cost, quality virtual simulation should employ all best-practice principles of traditional, manikin-based simulation. In addition, many digital programs offer the unique advantages of remote learning flexibility, a broad diversity of learning content and fewer staffing needs. The vast array high- and mid-fidelity manikins, low-fidelity task trainers and digital, on-site teaching tools in traditional simulation remain a critical component of current healthcare training. Accelerated by the remote-learning needs of the COVID-19 pandemic, virtual simulation, a previously lesser component of traditional simulation, will likely evolve to become a more mainstream complement to this widely utilized practice.

The field of aviation, from the military to NASA to commercial airlines, has embraced flight simulators in aeronautics education for nearly a century (McKnight et al., 2020 & Oman et al., 2020). The earliest simulators in healthcare education emerged in the early 1900s with Mrs. Chase, in the field of nursing simulation. Mrs. Chase was one of the first manikins for classroom-based, clinical skills training at the Hartford Hospital Training School (Cockrell, 2021; Hyland, 2008). In the1950s, mostly developed by pioneers in the field of anesthesiology, physician educators began to utilize full-body manikins for healthcare education. Since these early training programs in both nursing and physician education, the widespread adoption of simulation in healthcare education has soared in the last few decades. Fully remote, virtual simulation has historically involved a smaller proportion of overall users but will likely grow in popularity in the coming decades. This trend will likely mirror the success of simulation in dedicated, physical training spaces (Pottle, 2020 & Kyaw et al., 2019). The International Data Corporation (IDC) has projected a six-fold increase in spending on XR technology between 2020 and 2024 (Hennick, 2020). An estimated twelve billion dollars were spent on this technology in 2020 and there is projection that spending will increase to over 70 billion dollars by 2024 (Hennick, 2020). This trend indicates that virtual simulation software may grow tremendously in the upcoming years within the world of healthcare simulation.