There are several teaching methods used in simulation with role modeling and method of inquiry being the most frequently used.
In the role modeling method, an instructor demonstrates an ideal performance to the participants to observe and follow. This method is frequently used to teach procedural skills. Typically, when the role modeling method is used, participants receive feedback from the instructor during the encounter. The role modeling simulation teaching method very often used in teaching Basic Life Support (BLS)and Advanced Cardiac Life Support (ACLS). Immersive simulation to improve learners’ critical thinking uses role modeling less frequently.
Method of inquiry is an in immersive simulation teaching method with the primary goal of teaching the learners how to apply knowledge that they already have. Traditionally, a group of participants is limited to three or four learners, the simulation activity is preceded by didactic teaching and a debriefing is conducted after the activity. While using method of inquiry as a teaching method, the instructor is usually not present in the simulation theater and has no control over the course of action that the participants take during the encounter. Thus, when developing the content, the instructor needs to know the learners’ levels of expertise on the subject, their decision-making patterns, possible misconceptions that they might have, then script the simulator’s responses to all possible interventions in the scenario. While this is one of the most effective methods of teaching with the use of simulation, it has both challenges and limitations. When method of inquiry is used learners might take an action that was not anticipated by the scenario developer leading to a stalemate. To resolve this situation, a Danish educational psychologist from the University of Stavanger, Dr. Peter Dieckmann, has introduced a concept of the external and internal life-savers. The internal life-saver is a prompt that could be initiated by the simulation operator during the encounter that would be perceived as the part of the scenarioand that will guide the learners to the correct treatment pathway. For example, the patient during a scenario becomes non-responsive and requires endotracheal intubation. If learners fail to realize the need to intubation, an instructor might elicit a snoring sound that provides a hint to the learners that the patient is not protecting his or her airway and prompts them for intubation. The external life-saver is an intervention that is not perceived as a part of the scenario and that is used to re-direct the learners to the right pathway. A comment by the instructor, “How is this medication going to affect the patient’s arterial blood pressure?” is an example of the external life-saver. Time-out is a form of a life-saver and an instructor steps into the simulation theater to provide help for the learners.
The University of South Dakota Sanford School of Medicine has developed and implemented what is called the simulation-based interactive problem-solving (SBIPS) teaching method. Unlike the inquiry method, during the SBIPS the instructor is in the simulation room with the learners, and the group of learners is usually large (10-15 learners). Briefing in SBIPS is performed similarly to with the inquiry method. Then the instructor assigns one learner to manage the patient. As the learner interacts with the simulator, the instructor might facilitate a guided discussion with the learner, who handles the patient, and the rest of the group. This facilitated discussion helps the learners navigate through the scenario and overcome any possible knowledge deficits on the subject. The instructor might alternate learners who are handling the patient. This method is frequently used when the instructor knows that the learners have significant knowledge gaps and when interactive methods of teaching are preferred to didactic methods in an attempt to close these knowledge gaps. Thus, in contrast to the inquiry method, feedback is provided during the encounter, and after the encounter only if needed.