Part 2

(Aligned with: Textbook Ch. 1  – Technological Shifts)

1. KEY IDEAS

• Modern medical simulation owes much of its structure and logic to the aviation industry.

• Aviation faced similar problems to healthcare: high stakes, complex systems, and human error risk.

• To reduce accidents, aviation developed standardized training, crew communication methods, and structured debriefing.

• Healthcare adopted these principles to improve safety and team performance.

• Today’s simulation workflows (pre-brief → scenario → debrief → reset) originate from aviation.

• Understanding this migration explains why SimOps work looks the way it does.

2. FOUNDATIONAL CONCEPTS EXPLAINED (Level 1)

2.1 Why Aviation?

Aviation developed structured training earlier than healthcare because:

• Errors had catastrophic consequences.

• Aircraft systems grew increasingly complex.

• Teams needed consistent communication structures.

• Training environments needed safe, repeatable practice conditions.

This parallels modern healthcare challenges.

2.2 Early Flight Simulators

Early flight simulators allowed pilots to:

• Practice emergency procedures

• Learn instrument reading

• Build muscle memory

• Develop decision-making skills under pressure

These tools emphasized:

• Safety before performance

• Repetition of high-risk tasks

• Feedback after each attempt

2.3 Crew Resource Management (CRM)

CRM emerged when aviation realized many accidents were due to:

• Poor communication

• Hierarchy barriers

• Inconsistent situational awareness

CRM introduced:

• Closed-loop communication

• Role clarity

• Shared mental models

• Mutual support

• Debriefing after every flight

These ideas became the foundation for team-based healthcare simulation.

2.4 Migration to Healthcare

Healthcare began adopting aviation strategies in the late 20th century.

Key migrations:

• Scenario-based training: structured, repeatable, predictable progression

• Debriefing: essential reflective practice

• Checklist use: reduces errors

• Simulation centers: modeled after aviation training academies

• Integrated AV systems: for review and performance feedback

Thus, modern SimOps practice is shaped directly by aviation’s methods.

3. CONNECTIONS & SYSTEMS THINKING (Level 2)

3.1 Why Simulation Workflows Follow the Aviation Model

In both fields:

• Teams must function under pressure

• Errors often arise from miscommunication

• Practice cannot rely on real-life emergencies (too risky)

• Performance improves with structured feedback

So, the aviation workflow became the healthcare simulation workflow:

3.2 Safety Culture: From Cockpit → Operating Room

Aviation discovered that technology alone cannot prevent errors.
Culture and communication matter more.

Healthcare adopted this philosophy:

• Communication training → reduces patient harm

• Team simulation → reduces adverse events

• Debriefing → improves reflection and performance

SimOps professionals are essential to this safety culture because they maintain:

• Scenario stability

• AV recording quality

• Technical support

• Workflow reliability

3.3 Digital Control Systems

Aviation created the concept of simulated systems responding to trainee actions.
Modern manikins behave similarly:

• Vitals change based on interventions

• Physiologic models respond dynamically

• Educators and technicians guide the scenario flow

This connection explains why SimOps must understand:

• logic-based programming

• timing of events

• physiological patterns

• scenario structure

4. APPLIED REASONING FOR SOS PRACTICE (Level 3)

4.1 Example Scenario: Team Communication Failure

A scenario collapses when learners miss a vital cue.
Understanding CRM allows an SOS to:

• anticipate communication stressors

• support the educator with AV markers

• highlight communication breakdowns for debrief

• maintain scenario pacing to ensure learning

4.2 Competency and OPA Integration

STEPS Competencies

• Technical Operations: Ensure stability of the digital simulation.

• Systems Thinking: Understand how human and technical systems interact.

• Debriefing Support: Provide AV and timing support for reflective learning.

Relevant OPAs

• OPA 2.1: AV setup and capture

• OPA 3.1: Manikin programming

• OPA 4.1: Scenario flow execution

5. COMMON MISCONCEPTIONS

❌ “Aviation and healthcare have nothing in common.”

Truth: Both involve complex, high-stakes, error-prone environments requiring structured training.

❌ “Manikin-based simulation is a healthcare invention.”

Truth: Scenario-based training originates from aviation.

❌ “Debriefing is optional.”

Truth: Debriefing is the primary learning mechanism in aviation and healthcare.

6. CHECK YOUR UNDERSTANDING