Simulation and new learning technologies

Changes in medical practice that limit patient availability and instructors ' time have resulted in poor physical diagnosis skills by learners at all l evels. Advanced simulation technology, including the use of sophisticated m ultimedia computer systems helps to address this problem. For many years 'H arvey', the Cardiology Patient Simulator, and the UMedic Multimedia Compute r system have proven to be effective tools to teach and assess bedside card iovascular skills when they are integrated into the required curriculum of medical school and postgraduate training. In the future, virtual reality te chnology, based initially on data from the Visible Human Data set, will pro vide the majority of simulation-based training. Models that provide a high level of visual fidelity and use sophisticated haptic devices that simulate the 'touch' and 'feel' of a procedure or examination are now being used in selected medical centers. The presence of these tools is not enough. Evide nce-based outcomes must show these systems to be effective instruments for teaching and assessment, and medical educators must be willing to effect ch ange in medical education to ensure the appropriate use of these systems in the next millennium.