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G. and McTighe, J. [ 4 , 5 ] and the current “Standards for Educational and
Psychological Testing” which was produced by collaborative efforts of a committee
from the Educational Research Association, the National Council on Measurement
in Education, and the American Psychological Association [ 6 ], as well as the
Guidelines for Simulation Development which was developed by the Technology
and Simulation Committee of the Accredited Education Institutes Consortium [ 7 ].
Theory of Simulators Design and Development
According to the Standards for Educational and Psychological Testing 2014, test/
simulator development is defined as “the process of producing a measure of some
aspects of individual’s knowledge, skills, abilities, attitudes, or other characteristics
by developing tasks and combining them to form a test/simulator, according to a
specific plan”. A simulator-specific design/development plan should include all
steps and considerations in this process. The design/development plan is guided by
the expected interpretation of simulator scores for an intended use(s). Simulator
development is a multidisciplinary and interprofessional process that occurs through
collaboration of physicians, engineers, and industry. This process has four phases:
first involves assessment of the requirements from the physicians’ perspective, sec-
ond is translating physicians’ requirements to engineers’ requirements, third
involves the development of a prototype(s), and fourth is a validation process. The
transition to a manufactural product is an additional critical step but is beyond the
scope of this chapter.
Phase I: Assessing the Requirements from the Physicians’ Perspective Identifying
a training gap or unmet training need is considered an “opportunity” whereby simu-
lators can fill or satisfy. According to “backward design” principles, the desired
training objectives and outcomes should be firstly identified to guide the develop-
ment process. Training objectives and desired outcomes should be delineated in
collaboration with authoritative societies. During the needs assessment process, the
following questions must be considered: What will the desired simulator replace
(e.g., live patient, expensive teaching technology, or animals)? What are the curricu-
lar needs? What are the educational objectives to address? Will this simulator be the
most effective educational tool from a cost perspective? Is a demonstration of pro-
ficiency necessary and/or required for credentialing or certification? Will the data
derived from a simulation-based curriculum improve the quality of care and patient
safety? What is the required level of fidelity broken down into anatomic, physio-
logic, tissue and affective aspects of fidelity. and what learning objective domains
are predominant (cognitive, psychomotor, communication, or affective)?
Given the fact that the design and development of simulators are usually led by
engineers, it is the responsibility of the physicians to give a clear and detailed
answers about all aspects of the surgical procedure such as the indications, purpose,
how is it performed, and what is considered success and what is considered failure.
This is considered an excellent opportunity for engineers (developers) to interact
Y.A. Noureldin and R.M. Sweet