Human Capital Accumulation in Medical Simulated Learning Environments: A Framework for Economic Evaluation

Human Capital Accumulation in Medical Simulated Learning Environments: A Framework for Economic Evaluation

Fiorentina Angjellari-Dajci (Jacksonville University, USA), Christine Sapienza (Jacksonville University, USA), William F. Lawless (Paine College, USA) and Kathleen Kavanagh (Jacksonville University, USA)
DOI: 10.4018/978-1-4666-9652-5.ch004


Economic evaluations of the use of medical simulation in nursing curricula to enhance human capital and positively affect clinical and patient outcomes are rare. This chapter first provides a conceptual model of the use of simulated learning environments (SLEs) in nursing curricula and associated clinical and patient outcomes. Second, it reviews economic evaluation methods in medical simulation drawing from similar fields, such as aviation. Third, it provides a methodological framework for conducting full economic evaluations of SLE programs, which includes the identification, measurement, valuation and comparison of all relevant economic benefits with economic costs for any competing programs. The framework used in this chapter has applicability to any health care field, in which medical simulations are used as an alternative program, to serve as a guide, or be adopted with ease.
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Some say the best way to learn how to do something is by actually doing it. That statement resonates even more in a field like nursing where decision-making and problem solving are critically important to safe patient care. Creating realistic scenarios to guide and instruct nurses and other healthcare team members is a valuable part of the education process (Aqel & Ahmad, 2014; Gordon, Oriol, & Cooper, 2004; Jeffries, 2005). The surging interest in medical simulation centers is a global phenomenon. Indeed, the embryonic Sidra Medical and Research Center’s Clinical Simulation Center in Qatar, promises to be one of the leading facilities in the world.1 At the association level, the American College of Surgeons’ Division of Education has embraced simulation across the spectrum of education and training programs and has established an accreditation program for simulation centers.2

The National Patient Safety Foundation (NPSF) views simulation through the prism of its very focused mission: improving the safety of the healthcare system.3 To support the mission, the foundation has become a unique proponent of simulation – recognizing its value as an educational tool to assist healthcare professionals as they learn and apply patient safety techniques.4 In medical simulation the training imitates reality, offers almost limitless opportunities to have things “go wrong”, allows practitioners to safely demonstrate how to “do things right”, and provides corrective feedback as a guide to future action (Grant & Marriage, 2011; Good, 2003). Simulation-based education provides an opportunity to practice a variety of clinical situations where error is likely to occur. Medical simulation-based training targets commonly elusive educational objectives, such as practice without risk, curricular standardization, and pedagogic efficiency (Grant & Marriage, 2011; Wayne, Butter, & Siddall, 2005). The effectiveness with which such objectives are achieved, and the metrics and quantitative approaches to estimate both short-term and long-term benefits and costs of building and operating simulated learning environments within the broader field of nursing education remain to be explored.

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