The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.
Evaluating Clinical Simulations for Learning Procedural Skills: A Theory-Based Approach
Abstract
Simulation-based learning is becoming widely established within medical education. It offers obvious benefits to novices learning invasive procedural skills, especially in a climate of decreasing clinical exposure. However, simulations are often accepted uncritically, with undue emphasis being placed on technological sophistication at the expense of theory-based design. The author proposes four key areas that underpin simulation-based learning, and summarizes the theoretical grounding for each. These are (1) gaining technical proficiency (psychomotor skills and learning theory, the importance of repeated practice and regular reinforcement), (2) the place of expert assistance (a Vygotskian interpretation of tutor support, where assistance is tailored to each learner's needs), (3) learning within a professional context (situated learning and contemporary apprenticeship theory), and (4) the affective component of learning (the effect of emotion on learning). The author then offers four criteria for critically evaluating new or existing simulations, based on the theoretical framework outlined above. These are: (1) Simulations should allow for sustained, deliberate practice within a safe environment, ensuring that recently-acquired skills are consolidated within a defined curriculum which assures regular reinforcement; (2) simulations should provide access to expert tutors when appropriate, ensuring that such support fades when no longer needed; (3) simulations should map onto real-life clinical experience, ensuring that learning supports the experience gained within communities of actual practice; and (4) simulation-based learning environments should provide a supportive, motivational, and learner-centered milieu which is conducive to learning.
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“Classroom role-play helps, but lacks the distinctiveness of real conversations (5).”
From Using generative AI for interview simulations to enhance student research skills in biology education (2025) · cites this paper as [5]
Citations
Cites
The role of deliberate practice in the acquisition of expert performance
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Ericsson, K. A. (2004) · Academic Medicine · doi:10.1097/00001888-200410001-00022 · Cited by 2,988
Expert performance: its structure and acquisition.
Ericsson, K. A., & Charness, N. (1994) · American Psychologist · doi:10.1037/0003-066x.49.8.725 · Cited by 2,072
A meta-analytic review of the distribution of practice effect: Now you see it, now you don’t
Donovan, J. J., & Radosevich, D. J. (1999) · Journal of Applied Psychology · doi:10.1037/0021-9010.84.5.795 · Cited by 696
Factors That Influence Skill Decay and Retention: A Quantitative Review and Analysis
Arthur Jr., W., Bennett Jr., W., Stanush, P. L., & McNelly, T. L. (1998) · Human Performance · doi:10.1207/s15327043hup1101_3 · Cited by 664
Simulation in surgical training: educational issues and practical implications
Kneebone, R. L. (2003) · Medical Education · doi:10.1046/j.1365-2923.2003.01440.x · Cited by 642
Self-citationA Comprehensive Anesthesia Simulation Environment
Gaba, D. M., & DeAnda, A. (1988) · Anesthesiology · doi:10.1097/00000542-198809000-00017 · Cited by 490
The Educational Impact of Bench Model Fidelity on the Acquisition of Technical Skill
Grober, E. D., Hamstra, S. J., Wanzel, K. R., Reznick, R. K., Matsumoto, E. D., Sidhu, R. S., & Jarvi, K. A. (2004) · Annals of Surgery · doi:10.1097/01.sla.0000133346.07434.30 · Cited by 425
Anesthesia crisis resource management: Real-life simulation training in operating room crises
Holzman, R. S., Cooper, J. B., Gaba, D. M., Philip, J. H., Small, S., & Feinstem, D. (1995) · Journal of Clinical Anesthesia · doi:10.1016/0952-8180(95)00146-8 · Cited by 312
An innovative model for teaching and learning clinical procedures
Kneebone, R. L., Kidd, J. M., Nestel, D., Asvall, S., Paraskeva, P. A., & Darzi, A. W. (2002) · Medical Education · doi:10.1046/j.1365-2923.2002.01261.x · Cited by 289
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Cited by
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Simulation‐based learning in nurse education: systematic review
Cant, R. P., & Cooper, S. J. (2010) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2009.05240.x · Cited by 984
“These findings concur with the four key facets of simulation education that assist learning listed earlier (Kneebone 2005).”
Reconsidering Fidelity in Simulation-Based Training
Hamstra, S. J., Brydges, R., Hatala, R. A., Zendejas, B., & Cook, D. A. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000130 · Cited by 662
Clinical virtual simulation in nursing education: randomized controlled trial
Padilha, J. M., Machado, P. P., Ribeiro, A., Ramos, J., & Costa, P. (2019) · Journal of Medical Internet Research · doi:10.2196/11529 · Cited by 550
“The use of high-fidelity simulators has improved the acquisition of knowledge and skills and strengthened quality and safety in clinical practice [3,9-15].”
Web-based learning: pros, cons and controversies
Cook, D. A. (2007) · Clinical Medicine · doi:10.7861/clinmedicine.7-1-37 · Cited by 437
Role-play for medical students learning about communication: guidelines for maximising benefits
Nestel, D., & Tierney, T. (2007) · BMC Medical Education · doi:10.1186/1472-6920-7-3 · Cited by 441
“These role-play guidelines also complement the criteria that Kneebone (2005) sets out to evaluate simulations [26].”
BackgroundInfluential
Metadata
- Authors
- Kneebone, R.
- Affiliations
- St Mary's Hospital (GB)
- Corresponding author
- Kneebone, Roger
- ORCID
- Kneebone, Roger
- Venue
- Academic Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-06
- Volume
- 80
- Issue
- 6
- Pages
- 549-553
- ISSN
- 1040-2446 (ISSN-L)
- OpenAlex
- W2054537285
- Cited by
- 423
- References
- 18
- Citations by year
- 2026: 17 · 2025: 17 · 2024: 17 · 2023: 14 · 2022: 14 · 2021: 19 · 2020: 19 · 2019: 26 · 2018: 25 · 2017: 21 · 2016: 26 · 2015: 31 · 2014: 31 · 2013: 23 · 2012: 26
- FWCI
- 2.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Academic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Education › Simulation-Based Education in Healthcare
- Health Sciences › Medicine › Surgery › Surgical Simulation and Training
- Social Sciences › Education › Innovations in Medical Education
- Keywords
- simulation-based training, procedural training, medical education, psychomotor skill acquisition, deliberate practice, situated learning, affective learning, student-centered learning environment, skill consolidation
- MeSH terms
- Computer-Assisted Instruction, Computer Simulation, Education, Medical, Evaluation Studies as Topic, Humans
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