Contextualized simulation and procedural skills: a view from medical education.

Simulation offers an attractive solution to the profound changes affecting traditional approaches to learning clinical procedural skills. Technical developments in physical models and virtual-reality computing make it possible to practice an increasing range of procedures "in vitro." However, too narrow a focus on technical skill can overlook crucial elements of clinical care such as communication and professionalism. Patient-focused simulation (the combination of a simulated patient with an inanimate simulator or item of medical equipment) allows clinical procedures to be practiced and assessed within realistic scenarios that recreate clinical challenges by placing a real person at the center of the encounter. This paper draws on work with human clinical procedures, exploring the parallels with veterinary practice and highlighting possible developments in client-focused simulation. The paper concludes by arguing for closer collaboration and dialogue between the medical and veterinary professions, for the benefit of both.