<s>
Medical	B-Application
simulation	I-Application
,	O
or	O
more	O
broadly	O
,	O
healthcare	B-Application
simulation	I-Application
,	O
is	O
a	O
branch	O
of	O
simulation	O
related	O
to	O
education	O
and	O
training	O
in	O
medical	O
fields	O
of	O
various	O
industries	O
.	O
</s>
<s>
Medical	B-Application
simulation	I-Application
was	O
not	O
immediately	O
accepted	O
as	O
a	O
useful	O
training	O
technique	O
,	O
both	O
because	O
of	O
technological	O
limitations	O
and	O
because	O
of	O
the	O
limited	O
availability	O
of	O
medical	O
expertise	O
at	O
the	O
time	O
.	O
</s>
<s>
However	O
,	O
extensive	O
military	O
use	O
demonstrated	O
that	O
medical	B-Application
simulation	I-Application
could	O
be	O
cost-effective	O
.	O
</s>
<s>
Gradually	O
,	O
medical	B-Application
simulation	I-Application
became	O
affordable	O
,	O
although	O
it	O
remained	O
un-standardized	O
.	O
</s>
<s>
With	O
the	O
help	O
of	O
a	O
UCSD	O
School	O
of	O
Medicine	O
student	O
,	O
Computer	O
Gaming	O
World	O
reported	O
that	O
a	O
Surgeon	O
(	O
1986	O
)	O
for	O
the	O
Apple	B-Device
Macintosh	I-Device
very	O
accurately	O
simulated	O
operating	O
on	O
an	O
aortic	O
aneurysm	O
.	O
</s>
<s>
Others	O
followed	O
,	O
such	O
as	O
Life	B-Device
&	I-Device
Death	I-Device
(	O
1988	O
)	O
.	O
</s>
<s>
In	O
2004	O
,	O
the	O
Society	O
for	O
Simulation	O
in	O
Healthcare	O
(	O
SSH	O
)	O
was	O
formed	O
to	O
assist	O
in	O
collaboration	O
between	O
associations	O
interested	O
in	O
medical	B-Application
simulation	I-Application
in	O
healthcare	O
.	O
</s>
<s>
The	O
American	O
Board	O
of	O
Emergency	O
Medicine	O
employs	O
the	O
use	O
of	O
medical	B-Application
simulation	I-Application
technology	O
in	O
order	O
to	O
accurately	O
judge	O
students	O
by	O
using	O
"	O
patient	O
scenarios	O
"	O
during	O
oral	O
board	O
examinations	O
.	O
</s>
<s>
That	O
said	O
,	O
successful	O
strides	O
are	O
being	O
made	O
in	O
terms	O
of	O
medical	O
education	O
and	O
training	O
,	O
although	O
a	O
number	O
of	O
studies	O
have	O
shown	O
that	O
students	O
engaged	O
in	O
medical	B-Application
simulation	I-Application
training	O
have	O
overall	O
higher	O
scores	O
and	O
retention	O
rates	O
than	O
those	O
trained	O
through	O
traditional	O
means	O
.	O
</s>
<s>
The	O
two	O
main	O
types	O
of	O
medical	O
institutions	O
that	O
train	O
people	O
through	O
medical	B-Application
simulations	I-Application
are	O
medical	O
schools	O
and	O
teaching	O
hospitals	O
.	O
</s>
<s>
A	O
medical	B-Application
simulation	I-Application
centre	O
is	O
an	O
educational	O
centre	O
in	O
a	O
clinical	O
setting	O
.	O
</s>
<s>
However	O
,	O
the	O
technology	O
that	O
has	O
emerged	O
within	O
medical	B-Application
simulation	I-Application
has	O
become	O
complex	O
and	O
can	O
benefit	O
from	O
the	O
utilization	O
of	O
specialists	O
.	O
</s>
<s>
In	O
2014	O
,	O
Society	O
for	O
Simulation	O
in	O
Healthcare	O
introduced	O
the	O
Certified	O
Healthcare	B-Application
Simulation	I-Application
Operations	O
Specialist	O
(	O
CHSOS	O
)	O
certification	O
.	O
</s>
<s>
More	O
specific	O
descriptions	O
of	O
debriefing	O
can	O
be	O
found	O
,	O
such	O
as	O
the	O
following	O
in	O
relation	O
to	O
debriefing	O
in	O
healthcare	B-Application
simulations	I-Application
,	O
described	O
by	O
Cheng	O
et	O
al	O
.	O
</s>
<s>
Medical	B-Application
simulation	I-Application
is	O
often	O
defined	O
as	O
,	O
“	O
a	O
technique	O
(	O
not	O
a	O
technology	O
)	O
to	O
replace	O
and	O
amplify	O
real	O
life	O
experiences	O
with	O
guided	O
ones	O
,	O
often	O
“	O
immersive	O
”	O
in	O
nature	O
,	O
that	O
evoke	O
or	O
replicate	O
substantial	O
aspects	O
of	O
the	O
real	O
world	O
in	O
a	O
fully	O
interactive	O
fashion	O
”	O
.	O
</s>
<s>
A	O
debate	O
in	O
the	O
healthcare	B-Application
simulation	I-Application
community	O
exists	O
regarding	O
the	O
exploration	O
of	O
feelings	O
in	O
the	O
descriptive	O
phase	O
.	O
</s>
<s>
There	O
exists	O
a	O
framework	O
for	O
questioning	O
named	O
“	O
Advocacy-Inquiry	O
,	O
”	O
or	O
the	O
“	O
debriefing	O
with	O
good	O
judgment	O
”	O
approach	O
,	O
which	O
aims	O
to	O
reduce	O
negative	O
experiences	O
in	O
medical	B-Application
simulation	I-Application
debriefing	O
.	O
</s>
<s>
Examples	O
of	O
multi-phase	O
debriefing	O
structures	O
include	O
the	O
Promoting	O
Excellence	O
and	O
Reflective	O
Learning	O
in	O
Simulation	O
(	O
PEARLS	O
)	O
framework	O
,	O
TeamGAINS	O
,	O
and	O
Healthcare	B-Application
Simulation	I-Application
After-Action	O
Review	O
(	O
AAR	O
)	O
.	O
</s>
<s>
It	O
is	O
recommended	O
that	O
establishing	O
safety	O
begin	O
in	O
the	O
pre-brief	O
phase	O
by	O
alerting	O
participants	O
to	O
the	O
“	O
basic	O
assumption.	O
”	O
The	O
basic	O
assumption	O
,	O
derived	O
from	O
the	O
Centre	O
for	O
Medical	B-Application
Simulation	I-Application
at	O
Harvard	O
University	O
(	O
n.d.	O
)	O
,	O
is	O
an	O
agreed	O
upon	O
,	O
predetermined	O
mental	O
model	O
whereby	O
everyone	O
involved	O
in	O
the	O
simulation	O
&	O
debrief	O
believe	O
that	O
all	O
participants	O
are	O
intelligent	O
,	O
well-trained	O
,	O
want	O
to	O
do	O
their	O
best	O
,	O
and	O
are	O
participating	O
to	O
learn	O
and	O
promote	O
development	O
.	O
</s>
<s>
There	O
exists	O
a	O
paucity	O
of	O
quantitative	O
data	O
regarding	O
the	O
effectiveness	O
of	O
debriefing	O
in	O
medical	B-Application
simulation	I-Application
,	O
despite	O
Lederman	O
's	O
1992	O
seminal	O
Model	O
for	O
the	O
Systematic	O
Assessment	O
of	O
Debriefing	O
.	O
</s>
<s>
More	O
positive	O
information	O
is	O
found	O
in	O
the	O
article	O
entitled	O
,	O
"	O
The	O
role	O
of	O
medical	B-Application
simulation	I-Application
:	O
an	O
overview	O
,	O
"	O
by	O
Kevin	O
Kunkler	O
.	O
</s>
<s>
The	O
main	O
purpose	O
of	O
medical	B-Application
simulation	I-Application
is	O
to	O
properly	O
educate	O
students	O
in	O
various	O
fields	O
through	O
the	O
use	O
of	O
high	O
technology	O
simulators	O
.	O
</s>
<s>
Anything	O
that	O
can	O
assist	O
in	O
bringing	O
this	O
number	O
down	O
is	O
highly	O
recommended	O
and	O
medical	B-Application
simulation	I-Application
has	O
proven	O
to	O
be	O
the	O
key	O
assistant	O
.	O
</s>
