Advances in Health Sciences Education

, Volume 22, Issue 5, pp 1315–1319 | Cite as

Patients with chronic conditions: simulate to educate?



Simulation in healthcare in an way to train professionals but it is not yet use commonly to train patient or their caregivers. Recently, it has been suggested to extend simulations to patients with chronic conditions. Simulations could help patients and caregivers to acquire psychosocial and self-management skills. This approach proved to be effective for the training of healthcare professionals, but its transferability to patients needs to be evaluated. Already, several questions arise. However, by considering simulations as pretexts for debriefing, they enable patients and professionals to assess a concrete situation, implying voluntary and reflexive learning processes. Thus, video recording should be assessed for its role in patient metacognition, defined as knowing about knowing. A taxonomy for simulations dedicated to patients, like that already developed for healthcare professionals, should be considered. Although practical constraints must be identified and addressed, they should not be the primary issue guiding research. The transferability of simulation as an educational technique from professionals to patients and caregivers should be investigated essentially in order to provide a significant benefit to patients.


Chronic disease Patient education Patient involvement Simulation 


  1. Alinier, G., & Platt, A. (2014). International overview of high-level simulation education initiatives in relation to critical care. Nursing in Critical Care, 19(1), 42–49.
  2. Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet (London, England), 380(9836), 37–43.
  3. Barsuk, J. H., Cohen, E. R., Feinglass, J., McGaghie, W. C., & Wayne, D. B. (2009a). Use of simulation-based education to reduce catheter-related bloodstream infections. Archives of Internal Medicine, 169(15), 1420–1423.
  4. Barsuk, J. H., McGaghie, W. C., Cohen, E. R., O’Leary, K. J., & Wayne, D. B. (2009b). Simulation-based mastery learning reduces complications during central venous catheter insertion in a medical intensive care unit. Critical Care Medicine, 37(10), 2697–2701.Google Scholar
  5. Chiniara, G., Cole, G., Brisbin, K., Huffman, D., Cragg, B., Lamacchia, M., & Norman, D. (2013). Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection. Medical Teacher, 35(8), e1380–95.
  6. Coleman, E. A. (2014). Extending simulation learning experiences to patients with chronic health conditions. Jama, 311(3), 243–4.
  7. Cook, D. A., Hatala, R., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., Hamstra, S. J. (2011). Technology-enhanced simulation for health professions education a systematic review and meta-analysis. Jama-Journal of the American Medical Association, 306(9), 978–988.
  8. Fanning, R. M., & Gaba, D. M. (2007). The role of debriefing in simulation-based learning. Simulation in Healthcare: Journal of the Society for Simulation in Healthcare, 2(2), 115–25.
  9. Ford, D. G., Seybert, A. L., Smithburger, P. L., Kobulinsky, L. R., Samosky, J. T., & Kane-Gill, S. L. (2010). Impact of simulation-based learning on medication error rates in critically ill patients. Intensive Care Medicine, 36(9), 1526–1531.
  10. Fortin, M., Bravo, G., Hudon, C., Vanasse, A., & Lapointe, L. (2005). Prevalence of multimorbidity among adults seen in family practice. Annals of Family Medicine, 3(3), 223–228.
  11. Fortin, M., Lapointe, L., Hudon, C., Vanasse, A., Ntetu, A. L., & Maltais, D. (2004). Multimorbidity and quality of life in primary care: a systematic review. Health and Quality of Life Outcomes, 2, 51.
  12. Gaba, D. M. (2007). The future vision of simulation in healthcare. Simul Healthc, 2(2), 126–35.
  13. Holcomb, J. B., Dumire, R. D., Crommett, J. W., Stamateris, C. E., Fagert, M. A., Cleveland, J. A., Mattox, K. L. (2002). Evaluation of trauma team performance using an advanced human patient simulator for resuscitation training. The Journal of Trauma, 52(6), 1078–85; discussion 1085–1086.Google Scholar
  14. Hughes, L. D., McMurdo, M. E. T., & Guthrie, B. (2013). Guidelines for people not for diseases: the challenges of applying UK clinical guidelines to people with multimorbidity. Age and Ageing, 42(1), 62–69.
  15. Issenberg, S. B., McGaghie, W. C., Petrusa, E. R., Gordon, D. L., & Scalese, R. J. (2005). Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Medical Teacher, 27(1), 10–28.
  16. Lefevre, T., d’ Ivernois, J.-F., De Andrade, V., Crozet, C., Lombrail, P., & Gagnayre, R. (2014). What do we mean by multimorbidity? An analysis of the literature on multimorbidity measures, associated factors, and impact on health services organization. Revue D’epidemiologie et de Sante Publique, 62(5), 305–314.
  17. Lorig, K., & Holman, H. (2003). Self-management education: history, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 26, 1–7.CrossRefGoogle Scholar
  18. McGaghie, W. C., Issenberg, S. B., Barsuk, J. H., & Wayne, D. B. (2014). A critical review of simulation-based mastery learning with translational outcomes. Medical Education, 48(4), 375–385.
  19. Menotti, A., Mulder, I., Nissinen, A., Giampaoli, S., Feskens, E. J., & Kromhout, D. (2001). Prevalence of morbidity and multimorbidity in elderly male populations and their impact on 10-year all-cause mortality: the FINE study (Finland, Italy, Netherlands, Elderly). Journal of Clinical Epidemiology, 54(7), 680–686.CrossRefGoogle Scholar
  20. Morris, R. L., Sanders, C., Kennedy, A. P., & Rogers, A. (2011). Shifting priorities in multimorbidity: a longitudinal qualitative study of patient’s prioritization of multiple conditions. Chronic Illness, 7(2), 147–161.
  21. Naik, V. N., Matsumoto, E. D., Houston, P. L., Hamstra, S. J., Yeung, R. Y., Mallon, J. S., et al. (2001). Fiberoptic orotracheal intubation on anesthetized patients: Do manipulation skills learned on a simple model transfer into the operating room? Anesthesiology, 95(2), 343–348.CrossRefGoogle Scholar
  22. Okuda, Y., Bryson, E. O., DeMaria, S. J., Jacobson, L., Quinones, J., Shen, B., & Levine, A. I. (2009). The utility of simulation in medical education: What is the evidence? The Mount Sinai Journal of Medicine, New York, 76(4), 330–343.
  23. Rowe, R., & Cohen, R. A. (2002). An evaluation of a virtual reality airway simulator. Anesthesia and Analgesia, 95(1), 62–66. (Table of contents).CrossRefGoogle Scholar
  24. Sadeghi, S., Brooks, D., & Goldstein, R. S. (2013). Patients’ and providers’ perceptions of the impact of health literacy on communication in pulmonary rehabilitation. Chronic Respiratory Disease, 10(2), 65–76.
  25. Salas, E., Klein, C., King, H., Salisbury, M., Augenstein, J. S., Birnbach, D. J., et al. (2008). Debriefing medical teams: 12 Evidence-based best practices and tips. Joint Commission Journal on Quality and Patient Safety/Joint Commission Resources, 34(9), 518–527.CrossRefGoogle Scholar
  26. Salas, E., Wilson, K. A., Burke, C. S., & Priest, H. A. (2005). Using simulation-based training to improve patient safety: What does it take? Joint Commission Journal on Quality and Patient Safety/Joint Commission Resources, 31(7), 363–371.CrossRefGoogle Scholar
  27. Sampalli, T., Fox, R. A., Dickson, R., & Fox, J. (2012). Proposed model of integrated care to improve health outcomes for individuals with multimorbidities. Patient Preference and Adherence, 6, 757–764.
  28. Savoldelli, G. L., Naik, V. N., Joo, H. S., Houston, P. L., Graham, M., Yee, B., et al. (2006). Evaluation of patient simulator performance as an adjunct to the oral examination for senior anesthesia residents. Anesthesiology, 104(3), 475–481.CrossRefGoogle Scholar
  29. Shapiro, M. J., Morey, J. C., Small, S. D., Langford, V., Kaylor, C. J., Jagminas, L., Jay, G. D. (2004). Simulation based teamwork training for emergency department staff: Does it improve clinical team performance when added to an existing didactic teamwork curriculum? Quality & Safety in Health Care, 13(6), 417–421.
  30. Smith, S. M., Soubhi, H., Fortin, M., Hudon, C., & O’Dowd, T. (2012). Managing patients with multimorbidity: Systematic review of interventions in primary care and community settings. BMJ (Clinical Research Ed.), 345, e5205.Google Scholar
  31. Snyder, H., & Engström, J. (2016). The antecedents, forms and consequences of patient involvement: A narrative review of the literature. Int J Nurs Stud, 53, 351–78.  10.1016/j.ijnurstu.2015.09.008
  32. Townsend, A., Hunt, K., & Wyke, S. (2003). Managing multiple morbidity in mid-life: A qualitative study of attitudes to drug use. BMJ (Clinical Research Ed.), 327(7419), 837.
  33. Vogeli, C., Shields, A. E., Lee, T. A., Gibson, T. B., Marder, W. D., Weiss, K. B., & Blumenthal, D. (2007). Multiple chronic conditions: Prevalence, health consequences, and implications for quality, care management, and costs. Journal of General Internal Medicine, 22 Suppl 3, 391–395.
  34. Wayne, D. B., Didwania, A., Feinglass, J., Fudala, M. J., Barsuk, J. H., & McGaghie, W. C. (2008). Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: A case-control study. Chest, 133(1), 56–61.
  35. Ziv, A., Wolpe, P. R., Small, S. D., & Glick, S. (2006). Simulation-based medical education: An ethical imperative. Simulation in Healthcare: Journal of the Society for Simulation in Healthcare, 1(4), 252–256.

Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Department of Forensic MedicineHôpital Jean-Verdier (AP-HP)BondyFrance
  2. 2.Health Education and Practices Laboratory–LEPS (EA 3412)Université Paris13-Sorbonne Paris CitéBobignyFrance
  3. 3.Health Simulation Center SimUSanté®Amiens University HospitalAmiensFrance

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