January 5, 2024By Kirk Atkinson

Boosting Healthcare Simulation Outcomes Through Attention to Detail

In observing a medical simulation, what is seen differs depending on the person watching. To a healthcare simulationist, a medical simulation can appear seemingly mundane. Conversely, to a non-healthcare professional or civilian, a medical simulation may look similar to an active movie set or a theater stage mid-production. This is partly based on the simulationist’s attention to detail in making a healthcare simulation setting look as close to reality as possible. The more attention paid to small details, the more realistic a medical simulation will appear. However, in some medical simulations, high attention to detail is not always necessary and can be a hindrance. This HealthySimulation.com article by Kirk Atkinson, Senior Clinical Simulation Operations Specialist at UT Southwestern, will discuss when attention to detail in healthcare simulation is necessary and when can a medical simulationist “phone it in”.

In healthcare simulation, regarding the argument concerning attention to detail, there are two sides to consider. Much like any good well-developed Socratic argument, there is a for and a against argument for attention to detail in a medical simulation setting. However, these arguments are unable to be completely for or completely against a healthcare simulationist’s attention to detail. There will always be a need for some attention to detail in healthcare simulation. Attention to detail in a healthcare simulation setting is already controversially one step removed from reality, while simultaneously being closer to reality than just pure imagination alone.

As in any good Socratic argument, the two opposing terms or mindsets should be defined to know where the borders of one side stop and the other side starts. There is the side where a high level of attention is paid to the detail of a medical simulation (i.e. every detail in the environment of the medical simulation is necessary or not) and the side that only focuses enough on the necessary details of the medical simulation environment to get by, also called “phoning it in” (on attention to detail).

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Argument for High Attention to Detail in Clinical Simulation

In the argument for the attention to detail, an enthusiastic medical simulation practitioner could insist on the attention to detail being needed at the highest level for all medical simulation activities. A scrutiny of the human anatomy in real medical situations is the standard of practice, so one would assume transversely a scenario mimicking an actual medical situation should appear as close to reality as possible. A spruced-up and highly detailed simulation environment that gives a realistic ambiance in all aspects can aid in the medical simulation participant’s acceptance of the pretend situation and help suspend their disbelief.

In the long life of a medical simulation program, there will be a few participants who are highly attuned to their surroundings and tend to notice just about every detail. The argument for the highest level or just a high level of attention to detail in all medical simulations is tailored almost entirely to preparing for these types of healthcare simulation participants. It is commonplace for any healthcare simulation program to encounter these attentive types of individuals who either refuse to or have a difficult time suspending their disbelief in the face of what they may consider to be a lump of silicone. The focus and treatment shown to all details can aid such an individual in the learning process that medical simulation aims to improve.

On a sliding scale of preparedness, the curious types are right alongside the highly attuned-to-detail individuals. Medical simulations can be and are often highly engaging, however, some medical practitioners will find themselves more curious than engaged and begin exploring the borders of realism in healthcare simulation. In some instances, a healthcare simulationist will encounter a curious type of person who appeases that curiosity by poking around for anything out of the ordinary. The rationale behind a high level of attention to detail is to help steer some of the curious back into the medical simulation mindset.

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Argument Against High Attention to Detail or “Phoning it In”

On the opposite side of the medical simulation coin is what could be interpreted as a lack of attention to detail. This is not necessarily the case, as attention is paid only to the simulated aspects necessary to complete the healthcare simulation session. In some cases, the attention to detail can be overlooked altogether.

A recent situation where the level of attention paid to the intricate details of a medical simulation scenario was allowed to slip was during the era of COVID-19. During the lockdowns, medical simulations continued in some medical simulation programs but were completed from a distance. Many finer points that would increase a setting’s realism became prosaic and almost too extravagant for a distance medical simulation. In this scenario, the argument for paying less attention to the finer details of the healthcare simulation could be considered appropriate, as the finer details would not even be noticed from a distance or from over a virtual meeting platform. Time spent on details that will not even be seen is time that could be spent elsewhere.

The focus of a healthcare simulation scenario tends to focus on one main objective. While the objective has important details required for learner understanding, if the required details are bundled with too many other minor details that are not required, this can be a hindrance for the medical simulationist. The argument for less attention to detail focuses on those minor details that could technically be placed in the healthcare simulation setting but do nothing to help achieve the main objective. The time and attention paid to the truly unnecessary details for no added learning benefit can be argued to have been wasted.

The realism aspect of simulation can only ever truly get so close to reality that an argument can be made that trying to pay attention to every detail to achieve hyper-realism may be too difficult. While this is not necessarily “phoning it in” on the attention to detail, not attempting to focus in on the smallest of details on a wound moulage or a medical simulation scenario setup is a decision every healthcare simulationist needs to think about. As long as the main learning point that is trying to be conveyed by the setup is conveyed, the argument for less than hyper-focus on the attention to detail can be made.

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The debate over the necessity of attention to detail in medical simulation remains a nuanced and ongoing discussion. On one hand, proponents argue for a meticulous focus on every aspect, contending that a hyper-realistic environment enhances the participant’s engagement and suspension of disbelief. This meticulous approach is particularly valuable when catering to individuals highly attuned to their surroundings, ensuring their immersion in the learning process.

Conversely, there is a pragmatic case for a more restrained attention to detail, especially in scenarios where the finer points may not contribute significantly to the main learning objectives. The era of COVID-19 presented a unique context where remote simulations minimized the visibility of intricate details, prompting a reconsideration of the time and effort spent on elements that might go unnoticed.

Navigating this dichotomy requires a discerning approach, recognizing that the level of detail may vary depending on the specific goals of a simulation. The realism achieved in a simulation is not solely determined by the meticulous recreation of every detail but by the effective communication of key learning points. Striking the right balance involves acknowledging the diverse perspectives of simulationists and non-simulationists alike.

Ultimately, the degree of attention to detail in medical simulation rests with each healthcare simulation program and practitioner. In a field where unexpected challenges are inherent, adaptability and thoughtful consideration of the learning objectives should guide the healthcare simulationist in determining when to meticulously craft every detail and when to prioritize efficiency and practicality. As medical simulation continues to evolve, finding this equilibrium will be crucial for ensuring effective and impactful training experiences.

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