Healthcare Simulation

Dictionary Second Edition (2.1)

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The Healthcare Simulation Dictionary is the intellectual property of The Society for Simulation in Healthcare (SSH). The
Agency for Healthcare Research and Quality (AHRQ) has a license to use and disseminate the work. Each user is granted a
royalty-free, non-exclusive, non-transferable license to use the dictionary in their work. The dictionary may not be changed
in any way by any user. The contents of the dictionary may be used and incorporated into other work under the condition
that no fee is charged by the developer to the user. The dictionary may not be sold for profit or incorporated into any
profit-making venture without the expressed written permission of the SSH. Citation of the source is appreciated.
Suggested Citation: Lioce L. (Ed.), Lopreiato J. (Founding Ed.), Downing D., Chang T.P., Robertson J.M., Anderson M.,
Diaz D.A., and Spain A.E. (Assoc. Eds.) and the Terminology and Concepts Working Group (2020), Healthcare Simulation
Dictionary –Second Edition. Rockville, MD: Agency for Healthcare Research and Quality; September 2020. AHRQ
Publication No. 20-0019. DOI: https://doi.org/10.23970/simulationv2.
Contributors
Editor
Lori Lioce
Society for Simulation in Healthcare

Founding Editor
Joseph O. Lopreiato MD, MPH, CHSE-A

Associate Editors
Mindi Anderson Desiree Diaz Jamie Robertson
Todd Chang Dayna Downing Andrew Spain

Terminology & Concepts Working Group

Guillaume Alinier Adam Dodson Mary Beth Mancini Ferooz Sekandarpoor
Heather Anderson Chaoyan Dong Francisco Maio Matos Vickie Slot
Krista Anderson Chad Epps William McGaghie Mary Kay Smith
Zalim Balkizov Eliana Escudero Jaume Menarini Kirrian Steer
Melanie Barlow Kirsty Freeman Maurizio Menarini Uli Strauch
Thomas Bittencourt Couto Val Fulmer Mario Alberto Juarez Millan Terri Sullivan
Jennifer Calzada Wendy Gammon Geoffrey Miller Demian Szyld
Albert Chan Roxane Gardner Amy Nakajima Deb Tauber
Louise Clark Gian Franco Gensini Cate Nicholas Callum Thirkell
Marcia Corvetto Grace Gephardt Rachel Onello Kristina Thomas Dreifuerst
Scott Crawford Teresa Gore Janice Palaganas Tonya Thompson
Linda Crelinstein David Grant Geethanjali Ramachandra John Todaro
Michael Czekajlo David Halliwell Gwenn Randall Elena Tragni
Roger Daglius Edgar Herrera Mary Anne Rizzolo Isabelle Van Herzeele
John Dean Yuma Iwamoto Keondra Rustan Karen Vergara
Sharon Decker Sabrina Koh Tonya Rutherford-Hemming Sylvonne Ward
Diane Dennis Natalia Kusheleva Jill Sanko Doris Zhao
Edgar Diaz-Soto Esther León Castelao Paola Santalucia

WI T H T H E S U P P O RT AN D INP UT O F: Asia Pacific Society for Simulation in Healthcare (APSSH) • Association for Simulated
Practice in Health care (ASPiH) • Association for Standardized Patient Educators (ASPE) • Australian Society for Simulation in
Health care (ASSH) • Brasilian Association for Simulation in Health (Abrassim) • Canadian Network for Simulation in Health
care (CNSH) • Chilean Society of Clinical Simulation (SO)• China Medical Education Association (CMEA) • Dutch Society for
Simulation in Health care (DSSH) • Federacion Latin Americana de Simulacion Clinica (FLASIC) • The Gathering of Healthcare
Simulation Technology Specialists (SimGHOSTS) • Hong Kong Society for Simulation in Healthcare (HKSSIH) • International
Nursing Association for Clinical Simulation in Learning (INACSL) • International Pediatric Simulation Society (IPSS) • Italian
Society for Simulation in Healthcare (ISSIH) • Japan Society for Instructional Systems in Health care (JSISH) • Korean Society
for Simulation in Health care (KoSSH) • Malaysian Society for Simulation in Healthcare (MaSSH) • New Zealand Association for
Simulation in Health care (NZASH) • Pan Asia Society for Simulation in Health care (PASSH) • Polish Society of Medical Simulation
(PSMS) • Portuguese Society for Simulation (SPSim) • Russian Society for Simulation Education in Medicine (ROSOMED) •
SIM-one Canada (SIM-one) • Sociedad Mexicana de Simulación en Ciencias de la Salud (SOMESICS) • Society for Healthcare in
Simulation (SSH) • Society for Simulation in Medicine in Italy (SIMMED) • Society in Europe for Simulation Applied to Medicine
(SESAM) • Spanish Society of Clinical Simulation and Patient Safety (SESSEP)

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 Preamble
In January 2013, an international group of simulation experts gathered in Orlando,
Florida, U.S.A., to form a working team whose mission was to create a dictionary of terms
used in healthcare simulation. This group recognized a need to compile terms that had
been completed by other groups in healthcare simulation and to add more terms. The
document you see represents the work of many individuals and their societies to compile
and refine the dictionary. The goal of this project is to enhance communication and clarity
for healthcare simulationists in teaching, education, assessment, research, and systems
integration activities. The Agency for Health care Research and Quality (AHRQ) has
partnered with the Society for Simulation in Healthcare (SSH) and its many affiliates to
produce this comprehensive Healthcare Simulation Dictionary and disseminate it widely
as part of SSH and AHRQ’s mission to improve patient safety, which includes simulation
research.
Since the first edition of the dictionary in 2016, SSH and international affiliate member representatives have met at the
International Meeting for Simulation in Healthcare annually to define the process for revision and to discuss advances in
simulation research, expansion of terms used in research, simulation certification, practice analysis research, and simulation
accreditation terminology. Since the first edition of the dictionary in 2016, SSH and international affiliate member representatives
have met at the International Meeting for Simulation in Healthcare annually to define the process for revision and to discuss
advances in simulation research, expansion of terms used in research, simulation certification, practice analysis research, and
simulation accreditation terminology. By 2019, a clear need for updates and additions to the Dictionary were recommended to
support the expanded terms used in healthcare simulation. Further, in 2020, there was a clear need identified to add terms specific
to simulation taking place in ways other than in-person (e.g., in a simulation center). In the second edition (v2.1), the following
changes can be found:

• A section on common abbreviations was added, and 27 abbreviations were included.

• 49 new terms were added.

• 13 terms were expanded with additional definitions as reflected in the literature.

• An additional referent of “consider also” was added for terms that are not currently in the dictionary, but would support
understanding of defined terms.

• A new section titled “Terms No Longer Recommended for Use by SSH” was added.

This is a living document and represents the sum of the work at this moment. Terms and definitions will continue to change and be
clarified, added, or deleted over time.

The intent was to be inclusive of the various definitions in use, not to exclude any definitions or areas of healthcare simulation.

The definitions show how the terms are being used in healthcare simulation. It is not intended to prescribe or dictate one particular
definition over another.

This dictionary focuses on healthcare-simulation-specific terms and meanings. Many terms that are generally used in education
(e.g., educational design) and healthcare (e.g., ventricular fibrillation or anxiety) are not defined. Please refer to standard
dictionaries and resources for these definitions.

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This list of terms is not a taxonomy, nor should it be used as such. It may inform taxonomical work.

Terms that have been identified as potentially controversial have been noted with a * prior to the word.

The terms and spellings are written in standard American English. This was to aid in reducing clutter and support translation to other languages.

The etymologies are sourced from etymologyonline.com and are provided to give insight into word origins.

To date, the first edition of the dictionary has been translated into several languages, including Chinese, Italian, Russian, and Spanish by volunteer
translators. These translations may be found at the bottom of the webpage at www.ssih.org/dictionary. If you are interested in translating the
dictionary into another language, please contact SSH at [email protected] and specify your request.

As a living document, all are encouraged to submit feedback using the form located a twww.ssih.org/dictionary. We realize there may be
better insights into other terms or definitions, additional references, etc. Citations have been included wherever possible. Should you know of
additional terms, definitions, and/or missing citations, please submit those as above via the Dictionary Feedback Form.

The Society for Simulation in Healthcare (SSH) acknowledges the participation and input of many individuals and also the International
Societies they represent. Without you, this would not have been possible! Thank you for your time and efforts in the creation and revision of this
dictionary over the last seven years. We look forward to your continued contributions.

Lori Lioce DNP, FNP-BC, CHSE-A, CHSOS, FAANP (editor, 2nd edition)

Joseph Lopreiato MD, MPH, CHSE-A, FAAP (founding editor)

September 2020

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Common Abbreviations in Healthcare Simulation

AI: Artificial Intelligence

AR: Augmented Reality

CAVE: Cave Automated Virtual Environment

CHSE®: Certified Healthcare Simulation Educator®

CHSE-A®: Certified Healthcare Simulation Educator-Advanced®

CHSOS®: Certified Healthcare Simulation Operations Specialist®

CHSOS-A™: Certified Healthcare Simulation Operations

Specialist-Advanced™

CONSORT: Consolidated Standards of Reporting Trials

GTA: Genitourinary Teaching Associates

HSTS: Healthcare Simulation Technology Specialist

IPE: Interprofessional Education

KSA: Knowledge, Skills, and Abilities (or attributes)

M&S: Modeling & Simulation

MUTA: Male Urogenital Teaching Associates

OS: Operations Specialist

OSCE: Objective Structured Clinical Examination

PETA (or PTA): Physical Exam Teaching Assistant

SBAR: Situation, Background, Assessment, and Recommendation

SBE: Simulation-based Education

SBME: Simulation-based Medical Education

SME: Subject Matter Expert

SP: Standardized Patient (or Simulated Patient)

TACSIM: Tactical Simulation

TTX: Tabletop Simulation

VR: Virtual Reality

WAVE: Wide Area Virtual Environment

XR (sometimes MR): Mixed Reality

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6
A
*Actor \ˈak-tər \ noun Definition
• A method of debriefing in which an observer states what was
Etym. late 14c., “an overseer, guardian, steward,” from Latin actor
observed or performed in a simulation activity (advocacy)
“an agent or doer,” also “theatrical player,” from past participle stem
or shares critical or appreciative insights about it explicitly
of agere. Sense of “one who performs in plays” is 1580s, originally
(advocacy) and then asks the learners for an explanation of their
applied to both men and women.
thoughts or actions (inquiry)(Rudolph et al, 2007).
Definition
• Inquiry seeks to learn what others think, know, want, or feel;
• In health care simulation, professional and/or amateur people whereas advocacy includes statements that communicate what an
trained to reproduce the components of real clinical experience, individual thinks, knows, wants or feels (Bolman & Deal, 2013).
especially involving communication between health professionals
and patients or colleagues (Australian Society for Simulation in
Healthcare).
Alpha and Beta Testing \ ˈal-fə \ ˈbā-tə \ ˈte-stiŋ \ noun
See also: EMBEDDED PARTICIPANT, ROLE PLAYER, SIMULATED
PATIENT, SIMULATED PERSON, STANDARDIZED PATIENT Etym. alpha (adj.) c. 1300, from Latin alpha, from Greek alpha,
from Hebrew or Phoenician aleph (see aleph). The Greeks added
-a because Greek words cannot end in most consonants. Sense of
“beginning of anything” is from late 14c., often paired with omega
Adaptive Learning \ ə-ˈdap-tiv \ ˈlər-niŋ \ noun (the last letter in the Greek alphabet, representing “the end”); sense of
Etym. Adapt (v.) early 15c. (implied in adapted) “to fit (something, “first in a sequence” is from 1620s.
for some purpose),” from Old French adapter (14c.), from Latin
Etym. beta (adj.) c. 1300, from Greek, from Hebrew/Phoenician
adaptare “adjust, fit to,” from ad “to” (see ad-) + aptare “to join,”
beth (see alphabet); used to designate the second of many things.
from aptus “fitted” (see apt). Intransitive meaning “to undergo
modification so as to fit new circumstances” is from 1956. Etym. test (v.) late 14c., the noun form “small vessel used in
assaying precious metals,” from Old French test, from Latin testum
Etym. Learning (n.) Old English leornung “study, action of acquiring
“earthen pot,” related to testa “piece of burned clay, earthen pot,
knowledge,” verbal noun from leornian (see learn). Meaning
shell.” Sense of “trial or examination to determine the correctness
“knowledge acquired by systematic study, extensive literary and
of something” is recorded from 1590s. The connecting notion is
scientific culture” is from mid-14c. Learning curve attested by 1907.
“ascertaining the quality of a metal by melting it in a pot.” Testing
Definition as a verb came from 1748, “to examine the correctness of,” from the
noun form.
• Adaptive learning incorporates a wide range of technologies
and techniques that observes participants and adjusts the Definition
learning experience on demand to meet the unique needs of
• Alpha- early testing of a product by the developers or
the participants and facilitate the individual/team members in
programmers, but not by potential users. The purpose of
meeting the identified objectives. (Akbulut & Cardak, 2012;
alpha-testing is to find and resolve as many ‘bugs’ or problems
Brusilovsky & Peylo, 2003; Pope, Gore, & Renfroe, 2012)
in the software that were unanticipated during the design and
development. (Lee-Jayaram et al, 2019)

• Beta – early testing of a software, program, simulation, or game,

Advocacy and Inquiry \ad-və-kə-sē \ in-ˈkwī(-ə)r-e\ noun by potential users. The purpose of beta-testing is identical to
Etym. advocate (n.) mid-14c., “one whose profession is to plead alpha-testing. (Lee-Jayaram et al, 2019)
cases in a court of justice,” a technical term from Roman law. Also in See also: DRY RUN, PILOT TEST
Middle English as “one who intercedes for another,” and “protector,
champion, patron.”

Etym. inquest (n.) mid-15c., enquery, from enquere (see ‘inquire’).

From Latin methodus “way of teaching or going,” from Greek
methodos “scientific inquiry,” method of inquiry, investigation.

*Term that has been identified as potentially controversial.

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Artificial Intelligence (AI) • Formative - a type of assessment (sometimes called an
\ ˌär-tə-ˈfi-shᵊl \ in-ˈte-lə-jən(t)s \ noun evaluation) “wherein the facilitator’s focus is on the participant’s
progress toward goal attainment through preset criteria; a process
Etym. artificial (adj.) late 14c., “not natural or spontaneous,” from for an individual or group engaged in a simulation activity for the
Old French artificial, from Latin artificialis “of or belonging to art,” purpose of providing constructive feedback for that individual
from artificium “a work of art; skill; theory, system,” from artifex or group to improve (National League for Nursing Simulation
(genitive artificis) “craftsman, artist, master of an art” (music, acting, Innovation Resource Center [NLN-SIRC], 2013; Scheckel,
sculpting, etc.), from stem of ars “art” + -fex “maker,” from facere 2016)” (INACSL Standards Committee, 2016c, p.S41). Often
“to do, make”. completed at the same time as the instruction (Hamdorf &
Davies, 2016), development of the individual is the focus for
Etym. intelligence (n.) late 14c., “the highest faculty of the mind, the simulation objectives/outcomes to be reached (INACSL
capacity for comprehending general truths;” c. 1400, “faculty of Standards Committee, 2016c).
understanding, comprehension,” from Old French intelligence (12c.)
and directly from Latin intelligentia, intellegentia “understanding, • Summative - a type of assessment (sometimes called an
knowledge, power of discerning; art, skill, taste,” from intelligentem evaluation) “at the end of a learning period or at a discrete point
(nominative intelligens) “discerning, appreciative,” present participle in time in which participants are provided with feedback about
of intelligere “to understand, comprehend, come to know,” from their achievement of outcome through preset criteria; a process
assimilated form of inter “between” (see inter-) + legere “choose, for determining the competence of a participant engaged in
pick out, read,” Artificial intelligence “the science and engineering of healthcare activity. The assessment of achievement of outcome
making intelligent machines” was coined in 1956. criteria may be associated with an assigned grade (NLN-SIRC,
2013; Scheckel, 2016)” (INACSL Standards Committee, 2016c,
Definition p. S41). Performance of the individual is compared to a specific
• A system of computerized data-gathering and prediction that standard (Hamdorf & Davies, 2016).
models human behavior and decision-making with minimal • High-stakes - a type of assessment (sometimes called an
human intervention. In healthcare simulation, AI often refers to evaluation) “associated with a simulation activity that has a major
underlying programming that provides physiological or system- academic, educational, or employment consequence (such as a
based algorithm changes based on inputs from users and learners. grading decision, including pass or fail implications; a decision
Often paired with machine learning, in which the software regarding competency, merit pay, promotion, or certification) at
is programmed to alter algorithms and predictions based on a discrete point in time (Hidden curriculum, 2014)” (INACSL
observed data and results without human intervention. Virtual Standards Committee, 2016c, p. S41).
patients use artificial intelligence to react appropriately to the user
or learner. (Bennett and Hauser, 2013) See also: OBJECTIVE STUCTURED CLINICAL EXAMINATION (OSCE)
Compare: EVALUATION
See also: VIRTUAL PATIENT
Consider also: MACHINE LEARNING

Assessor \ ə-ˈse-sər \ noun

*Assessment \ ə-ˈses-mənt \ noun Etym. late 14c., from Old French assessor “assistant judge, assessor
(in court)” (12c., Modern French assesseur) and directly from Latin
Etym. (n.) “1530s, “value of property for tax purposes,” from assess assessor “an assistant, aid; an assistant judge.”
+ -ment. Meaning “act of determining or adjusting of tax rate,
charges, damages, etc., to be paid” is from 1540s (earlier in this sense Definition
was assession, mid-15c.). General sense of “estimation” is recorded
• A person who performs assessment of individuals according to
from 1620s; in education jargon from 1956.”
pre-established criteria.
Definition
• Assessors must have specific and substantial training, expertise,
• Refers to processes that provide information about or feedback and competency in assessment (Dictionary.com).
about individual participants, groups, or programs. Specifically,
assessment refers to observations of progress related to
knowledge, skills, and attitudes (KSA). Findings of assessment
are used to improve future outcomes (Scheckel, 2016; INACSL
Standards Committee, 2016c, pp. S39-S40).

• Involves measurement of the KSAs which can be recorded

(Levine, DeMaria, Schwartz, & Sim, 2014).

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Augmented Reality \ȯg-ˈmen-təd \ rē-ˈa-lə-tē \ noun
Etym. augment (v.) c. 1400, from Old French augmenter “increase,
enhance” (14c.), from Late Latin augmentare “to increase,” from
Latin augmentum “an increase,” from augere “to increase, make big,
enlarge, enrich.” Related: Augmented; augmenting.

Etym. reality (n.) 1540s, “quality of being real,” from French réalité
and directly Medieval Latin realitatem (nominative realitas); Meaning
“real existence, all that is real.”

Definition
• A type of virtual reality in which synthetic stimuli are
superimposed on real-world objects, usually to make information
that is otherwise imperceptible to human senses perceptible
(M&S Glossary).

• A technology that overlays digital computer-generated

information on objects or places in the real world for the purpose
of enhancing the user experience.

• The combination of reality and overlay of digital information

designed to enhance the learning process.

• A spectrum of mixed-reality simulation that is part way between

the real world and the virtual world.

• A form of virtual reality that includes head-mounted displays,

overlays of computer screens, wearable computers, or displays
projected onto humans and manikins (D.R. Berryman et al; M.
Bajura et al; H. Fuchs et al).

Avatar \ˈa-və-ˌtär\ noun

Etym. 1784, “descent of a Hindu deity,” from Sanskrit. In computer
use, it seems to trace to the novel “Snowcrash” (1992) by Neal
Stephenson.

Definition
• A virtual object used to represent a physical object (e.g., a human)
in a virtual world.

• A graphical representation, typically three-dimensional, of a

person capable of relatively complex actions, including facial
expressions and physical responses, while participating in a
virtual simulation-based experience. The user controls the avatar
through the use of a mouse, keyboard, or a type of joystick to
move through the virtual simulation-based experience (Riley,
2008).

• Controlled avatars may be either 1st-person perspective or

3rd-person perspective in virtual simulations. A 3rd-person
perspective places the view and camera so the user and learner
can see the controlled avatar (e.g., the player). A 1st-person
perspective places the camera such that the user and learner views
the world through the eyes of the avatar (i.e., the controlled avatar
is never visible on the screen). These perspectives only apply to
screen-based simulations using a mouse, keyboard, or joystick.
Virtual Reality simulations are almost always 1st-person.
(Schuurink and Toet, 2010)

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B
Back Story or Backstory or Back-story Behavioral Skills \ bi-ˈhā-vyə-rəl \ ˈskils \ noun
\ ˈbak \ ˈstȯr-ē \ noun
Etym. behavior (n.) manner of behaving (whether good or bad),
Etym. back (adj.) “being behind, away from the front, in a backward conduct, manners,” late 15c., essentially from behave, but with ending
direction,” Middle English, from back (n.) and back (adv.); from Middle English havour “possession,” a word altered (by influence
often difficult to distinguish from these when the word is used in of have) from aver, noun use of Old French verb aveir “to have.”
combinations. Formerly with comparative backer (c. 1400), also
backermore. To be on the back burner in the figurative sense is from Etym. skill (n.) late 12c., “power of discernment,” from Old Norse
1960, from the image of a cook keeping a pot there to simmer while skil “distinction, ability to make out, discernment, adjustment,”
at work on another concoction at the front of the stove.” “to or toward related to skilja (v.) “to separate; discern, understand,” from Proto-
the rear or the original starting place; in the past; behind in position,” Germanic *skaljo- “divide, separate” (source also of Swedish skäl
literally or figuratively, late 14c., shortened from abak, from Old “reason,” Danish skjel “a separation, boundary, limit,” Middle Low
English on bæc “backwards, behind, aback” (see back (n.), and German schillen “to differ,” Middle Low German, Middle Dutch
compare aback). To give (something) back is to give it again, to give schele “separation, discrimination;” from PIE root *skel- (1) “to cut.”
it in the opposite direction to that in which it was formerly given. Sense of “ability, cleverness” first recorded early 13c.
Adverbial phrase back and forth is attested by 1814.”
Definition
Etym. story (n.) :”connected account or narration of some
• The range of activities encompassed within the category of
happening,” c. 1200, originally “narrative of important events or
interpersonal interaction, including bedside manner, interpersonal,
celebrated persons of the past,” from Old French estorie, estoire
teamwork, leadership and communications. (Murphy, Nestel, &
“story, chronicle, history,” from Late Latin storia, shortened from
Gormley, 2019)
Latin historia “history, account, tale, story” (see history). A story
is by derivation a short history, and by development a narrative • The decision-making and team interaction processes used during
designed to interest and please. [Century Dictionary] Meaning the team’s management of a situation. (Gaba et al, 1998)
“recital of true events” first recorded late 14c.; sense of “narrative
of fictitious events meant to entertain” is from c. 1500. Not Compare to: NONTECHNICAL SKILLS
differentiated from history until 1500s. As a euphemism for “a lie” it
dates from 1690s. Meaning “newspaper article” is from 1892. Story-
line first attested 1941. That’s another story “that requires different
treatment” is attested from 1818. Story of my life “sad truth” first Brief (Briefing) \ brēf\ noun (\ˈbrē-fiŋ\ verb )
recorded 1938, from typical title of an autobiography.”
Note: this term is often not clearly distinguished from Orientation
Definition or Prebriefing

• “A narrative, which provides a history and/or background and is Etym. “fact or situation of giving preliminary instructions.” 1910
created for a fictional character(s) and/or about a situation for a
Definition
SBE (Backstory, n.d.)” (INACSL Standards Committee, 2016c,
p.S40). (Ed note: this can include the back story provided to • An activity immediately preceding the start of a simulation
participants, standardized patients, and staff as required to support activity where the participants receive essential information about
the simulation activity) the simulation scenario, such as background information, vital
signs, instructions, or guidelines. For example, before beginning
• A method, particularly in some game-based simulations, “for a session, faculty conduct a briefing about the scenario to review
creating design prompts, dialogs, and interactions that contain the information being provided to the participants.
realistic verbal behaviors and variability for multiple avatars or
non-player characters (NPCs) . . .” (Zachary, Zachary, Cannon- • The information and guidelines given to faculty or simulated
Bowers, & Santarelli, 2016, p. 207). patients participating in a scenario to allow them to fully prepare
for interactions with the participants. Briefing materials could
• Something that is developed by an author in games for characters include a handover, physician referral letter, or an ambulance call
that gives them their characteristics and memories (Fairclough & transcript. For example, at the start of the simulation scenario,
Cunningham, 2004). participants receive a notification from ambulance personnel
regarding a patient being transported to their facility with a
See also: BRIEF (BRIEFING)
gunshot wound. (Alinier, 2011; Husebø et al., 2012).

See also: BACK STORY, ORIENTATION, PREBRIEFING

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C
Cave Automated Virtual Environment (CAVE) • A detailed outline of a clinical encounter that includes: the
\ ˈkāv \ ˈȯ-tə-ˌmā-təd \ ˈvər-chə-wəl \ in-ˈvī-rə(n)-mənt \ noun participants in the event, briefing notes, goals and learning
objectives, participant instructions, patient information,
Etym. cave (n.) “a hollow place in the earth, a natural cavity of environmental conditions, manikin or standardized patient
considerable size and extending more or less horizontally,” early preparation, related equipment, props, and tools or resources for
13c., from Old French cave “a cave, vault, cellar” (12c.), from Latin assessing and managing the simulated experience.
cavea “hollow” (place)
• A progressive outline of a clinical encounter, including a
Etym. automate (v.) “to convert to automatic operation,” beginning, an ending, a debriefing, and evaluation criteria
1954, back-formation from automated (q.v.). Ancient Greek verb (Meakim et al., 2013).
automatizein meant “to act of oneself, to act unadvisedly.”
See also: SCENARIO, SCRIPT, SIMULATED-BASED LEARNING
Etym. virtual (adj.) The meaning “being something in essence or EXPERIENCE, SIMULATION ACTIVITY
effect, though not actually or in fact” is from mid-15c., probably
via sense of “capable of producing a certain effect” (early 15c.).
Computer sense of “not physically existing but made to appear by
software” is attested from 1959. Coaching \ kōch-iŋ \ verb
Etym. environment (n.) sense of “the aggregate of the conditions in Etym. Meaning “to prepare (someone) for an exam.”
which a person or thing lives” is by 1827 (used by Carlyle to render Related: Coached; coaching.
German Umgebung); specialized ecology sense first recorded 1956.
Definition
Definition
• To direct or instruct a person or group of people in order to
• Large cube wall structure inside which a participant stands; achieve goals, develop specific skills, or develop competencies.
the walls have projected images to simulate an immersive,
virtual environment, including shadows cast by the participant.
CAVE participants use specialized goggles for the illusion of
stereoscopic depth when inside the CAVE. (Cruz-Neira et al, Cognitive Load \ ˈkäg-nə-tiv \ ˈlōd \ noun
1993).
Etym. Cognitive (adv.) 1580s, “pertaining to cognition,” with -ive
Compare: WIDE AREA VIRTUAL ENVIRONMENT + Latin cognit-, past participle stem of cognoscere “to get to know,
recognize,” from assimilated form of com “together” (see co-) +
gnoscere “to know,” from PIE root *gno- “to know.” Taken over by
psychologists and sociologists after c. 1940. Cognitive dissonance
Clinical Scenario \ kli-ni-kəl \ sə-ˈner-ē-ˌō \ noun “psychological distress cause by holding contradictory beliefs or
values” (1957) apparently was coined by U.S. social psychologist
Etym. scenario (n.) 1868, “sketch of the plot of a play,” from Italian Leon Festinger, who developed the concept. Related: Cognitively.
scenario, from Late Latin scenarius “of stage scenes,” from Latin
scena “scene.” Etym, Load (n.) c. 1200, lode, lade “that which is laid upon a person
or beast, burden,” a sense extension from Old English lad “a way,
Etym. clinical (adj.) 1780, “pertaining to hospital patients or hospital a course, a carrying; a street, watercourse; maintenance, support,”
care,” from clinic + -al. from Proto-Germanic *laitho (source also of Old High German leita,
German leite, Old Norse leið “way, road, course”), from PIE root
Definition
*leit- (2) “to go forth” (see lead (v.1)).
• The plan of an expected and potential course of events for a It seems to have expanded its range of senses in early Middle
simulated clinical experience. A scenario usually includes the English, supplanting words based on lade (v.), to which it is not
context for the simulation (hospital ward, emergency room, etymologically connected. The older senses went with the spelling
operating room, clinic, out of hospital, etc.). Scenarios can vary in lode(q.v.). The spelling is modern. Meaning “amount customarily
length and complexity, depending on the learning objectives. loaded at one time” is from c. 1300; meaning “a quantity of strong
drink taken” is from 1590s. Meaning “the charge of a firearm” is
from 1690s.

11
Definition CONSORT (Consolidated Standards of Reporting
Trials) \ ˈkän-ˌsȯrt \ noun
• The amount of information the working memory of the
participant and/or facilitator can manage at any given point. The Etym. consolidated (adj.) “made firm, solid, hard, or compact,”
definition is based on the Cognitive Load Theory (CLT) proposed 1736, past-participle adjective from consolidate.
by Sweller et al. (1998) based on the working memory model
introduced by Baddeley (1992). Etym. standards (adj.) 1620s, “serving as a standard,” from standard
(adj.). Earlier it meant “upright” (1530s). Standard-bred “bred up to
some agreed-upon standard of excellence” is from 1888.

Etym. report (n.) late 14c., “to make known, tell, relate,” from Old
Computer-Based Simulation French reporter “to tell, relate; bring back, carry away, hand over,”
\ kəm-ˈpyü-tər \ bāst \ sim-yuh-ley-shuh n \ noun
from Latin reportare “carry back, bear back, bring back,” figuratively
Etym. computer (n.) 1640s, “one who calculates,” agent noun from “report,” in Medieval Latin “write (an account) for information or
compute (v.). Meaning “calculating machine” (of any type) is from record,” from re- “back” (see re-) + portare “to carry” (from PIE root
1897; in modern use, “programmable digital electronic computer” *per- (2) “to lead, pass over”).
(1945 under this name; theoretical from 1937, as Turing machine).
Etym. trial (n.) mid-15c., “act or process of testing, a putting to
ENIAC (1946) usually is considered the first.
proof by examination, experiment, etc.,” from Anglo-French trial,
Etym. simulation (n.) noun of action from past participle stem of noun formed from triet “to try” (see try (v.)). Sense of “examining
simulare “imitate,” from stem of similis “like.” Meaning “a model or and deciding of the issues between parties in a court of law” is first
mock-up for purposes of experiment or training” is from 1954. recorded 1570s; extended to any ordeal by 1590s.

Definition Definition

• The modeling of real-life processes with inputs and outputs • CONSORT is a guideline that standardizes the reporting for
exclusively confined to a computer, usually associated with any randomized control trials. First developed for clinical
a monitor and a keyboard or other simple assistive device trials, the guideline has been adopted by the simulation research
(Textbook of Simulation). Subsets of computer-based simulation community. (Cheng et al, 2016)
include virtual patients, virtual reality task trainers, and
immersive virtual reality simulation (ibid)..

See also: SCREEN-BASED SIMULATION, SIMULATOR

Cue/Cueing \ˈkyü – iŋ \ verb/noun
Etym. cue (n.) “stage direction,” 1550s, from Q, which was used
16c., 17c. in stage plays to indicate actors’ entrances, probably as an
Conceptual Fidelity \ kən-ˈsep-chə-wəl \ fə-ˈde-lə-tē, fī- \ noun abbreviation of Latin quando “when” or a similar Latin adverb.
Etym. conceptual (adj.) 1820, “pertaining to mental conception” Definition
(there is an isolated use from 1662), from Medieval Latin
• To provide information during the simulation that helps the
conceptualis, from Latin conceptus” a collecting, gathering,
participant progress through the activity to achieve stated
conceiving,” past participle of concipere. Related: Conceptualism;
objectives (modified from National League for Nursing -
conceptualist.
Simulation Innovation Resource Center, 2013).
Etym. fidelity (n.) early 15c., “faithfulness, devotion,” from Middle
• Information provided to help the learner reach the learning
French fidélité (15c.), from Latin fidelitatem (nominative fidelitas)
objectives (conceptual cues), or to help the learner interpret or
“faithfulness, adherence.”
clarify the simulated reality (reality cues). Conceptual cues help
Definition the learner reach instructional objectives through programmable
equipment, the environment, or through responses from the
• In health care simulation, ensures that all elements of the scenario
simulated patient or role player, Reality cues to help the learner
relate to each other in a realistic way so that the case makes
interpret or clarify simulated reality through information
sense as a whole to the learner(s) (For example: Vital signs are
delivered during the simulation (modified from Paige & Morin,
consistent with the diagnosis). To maximize conceptual fidelity,
2013).
cases or scenarios should be reviewed by subject matter expert(s)
and pilot-tested prior to use with learners (Rudolph et al., 2007; See also: PROMPT
Dieckmann et al., 2007).

12
D
Debrief (Debriefing) \ dēˈbrēf \ noun (\ dē ˈbrē-fiŋ\ verb) Deliberate Practice \di-ˈli-bə-rāt\ˈprak-təs\ noun
Etym. debrief “obtain information (from someone) at the end of a Etym. deliberate (adj.) 15th century Middle English, from Latin
mission,” 1945, from de- + brief (v.). Related: Debriefed; debriefing. deliberatus, past participle of deliberare to consider carefully,
perhaps alteration of *delibrare, from de- + libra scale, pound.
Definition
Etym. practice (n.) 14th century Middle English practisen, from
• (noun) A formal, collaborative, reflective process within the
Middle French practiser, from Medieval Latin practizare, alteration
simulation learning activity.
of practicare, from practica practice, noun, from Late Latin practice,
• An activity that follows a simulation experience and led by a from Greek praktikē, from feminine of praktikos.
facilitator.
Definition
• (verb) To conduct a session after a simulation event where • A theory of general psychology that states the differences
educators/instructors/facilitators and learners re-examine between expert performers and normal adults reflect a life-long
the simulation experience for the purpose of moving toward period of deliberate effort to improve performance in a specific
assimilation and accommodation of learning to future situations domain. (Ericsson, K. A).
(Johnson-Russell & Bailey, 2010; National League for Nursing -
Simulation Innovation Resource Center, 2013); debriefing should • A systematically designed activity that has been created
foster the development of clinical judgment and critical thinking specifically to improve an individual’s performance in a given
skills (Johnson-Russell & Bailey, 2010). domain (Ericsson, Krampe, & Tesch-Römer, 1993).

• To encourage participants’ reflective thinking and provide Compare: MASTERY LEARNING

feedback about their performance, while various aspects of the
completed simulation are discussed.

• To explore with participants their emotions and to question, Deterministic \ di-ˈtər-mə-ˌni- stik \ adj
reflect, and provide feedback to one another (i.e., guided
reflection). Etym. determinism (n.) 1876 in general sense of “doctrine that
everything happens by a necessary causation,” from French
Compare: ADVOCACY AND INQUIRY, FEEDBACK, GUIDED
déterminisme; deterministic (adj.) 1874, from determinist (see
REFLECTION
determinism) + -ic.

Definition
• Pertaining to a process, model, or variable whose outcome, result,
Debriefer \ dē-ˈbrēf - ur\ noun or value does not depend on chance (Department of Defense
Etym. debrief “obtain information (from someone) at the end of a Modeling and Simulation Glossary).
mission,” 1945, from de- + brief (v.). Related: Debriefed; debriefing. Compare: STOCHASTIC
Definition
• The individual who facilitates a debriefing session and is
knowledgeable and skilled in performing appropriate, structured,
and psychologically safe debriefing sessions (Fanning & Gaba,
2007).

• The person who leads participants through the debriefing.

Debriefing by competent instructors and subject matter experts is
considered important to maximize the opportunities arising from
simulation (Raemer et al, 2011).

Compare: FACILITATOR, SIMULATIONIST

*Term that has been identified as potentially controversial.

13
Discrete Simulation (Discrete-Event Simulation) Distributed Simulation
\ dis-ˈkrēt \ sim-yuh-ley-shuh n \ noun \ di-ˈstri-byüt \ sim-yuh-ley-shuh n \ noun

Etym. discrete (adj.) mid-14c., “morally discerning, prudent, Etym. distribute (v.) early 15c., “to deal out or apportion,” from
circumspect,” from Old French discret “discreet, sensible, intelligent, Latin distributus, past participle of distribuere “to divide, distribute.”
wise,” from Latin discretus “separated, distinct;” in Medieval Latin, Related: Distributable; distributed; distributing.
“discerning, careful;” past participle of discernere “distinguish.”
Meaning “separate, distinct” in English is late 14c. Etym. simulation (n.) noun of action from past participle stem of
simulare “imitate,” from stem of similis “like.” Meaning “a model or
Etym. simulation (n.) noun of action from past participle stem of mock-up for purposes of experiment or training” is from 1954.
simulare “imitate,” from stem of similis “like.” Meaning “a model or
mock-up for purposes of experiment or training” is from 1954. Definition
• The concept of simulation on-demand, made widely available
Definition
wherever and whenever it is required; DS provides an easily
• A simulation that relies on variables changed only at a countable transportable, self-contained ‘set’ for creating simulated
number of points in time; discrete event simulation (DES) is the environments, at a fraction of the cost of dedicated, static
process of codifying the behavior of a complex system as an simulation facilities (Kneebone et al, 2010).
ordered sequence of well-defined events.
• A set of simulations operating in a common environment
• The operation of a system as a discrete sequence of events in and distributed to learners; a distributed simulation may be
time. Each event occurs at a particular instant in time and marks composed of any of the three modes of simulation: live, virtual,
a change of state in the system. Between consecutive events, no and constructive, and are seamlessly integrated within a single
change in the system is assumed to occur; thus the simulation exercise (Department of Defense Modeling and Simulation
can directly jump in time from one event to the next (Robinson, Glossary).
2004).

• One or more variables that completely describe a system at any

given moment in time (Sokolowski & Banks, 2011).
Durational Simulation \ dū-rā’shŭn-ăl \ sim″u-la´shun\ noun
Compare: DURATIONAL SIMULATION, SEQUENTIAL SIMULATION
Etym. duration (n.) Late 14c. duracioun, from Old French duration,
from Medieval Latin durationem (nominative duratio), noun of action
from past-participle stem of Latin durare “to harden,” from durus
“hard,” from PIE *dru-ro-, suffixed variant form of root.
Distance Simulation \ dis-tuhns \ sim-yuh-ley-shuh n \ noun
Etym. simulation (n.) noun of action from past participle stem of
Etym. distance (adj.) Meaning “remoteness of space, extent of space
between two objects or places” is from late 14c. Also “an interval of
simulare “imitate,” from stem of similis “like”. Meaning “a model or
time” (late 14c., originally distaunce of times). Meaning “remote part mock-up for purposes of experiment or training” is from 1954.
of a field of vision” is by 1813. The figurative sense of “aloofness,
remoteness in personal intercourse” (1590s) is the same as in 
Definition
stand-offish.
• Multiple simulations that build off of one another. This can
Etym. simulation (n.) noun of action from past participle stem of include a simulation that focuses on an initial assessment of a
simulare “imitate,” from stem of similis “like”. Meaning “a model or simulated or standardized patient portraying a patient role and the
mock-up for purposes of experiment or training” is from 1954. subsequent simulations are the follow-up visit (e.g., initial visit,
one-month visit and six-month visit, etc.).
Definition
• A Durational Simulation is the opposite of a Discrete Simulation
• Implementing a simulation or training at a physical distance in that changes occur in the system between simulations.
from the participant(s) (LeFlore et al., 2014; von Lubitz et al.,
2003). This may include operating a simulator via some type Compare: DISCRETE SIMULATION, SEQUENTIAL SIMULATION
of remote access where the operator remotes into a simulator
stationed where the participants are located; otherwise known as
remote-controlled (LeFlore et al., 2014). Or, it could be where
the participants remote into something like the cameras during
a simulation where the simulator is stationed at a different site,
which may be called “distance-based high-fidelity human patient
simulation training” (von Lubitz et al., 2003, p. 379). Advantages
of this method are being able to use experts to run the simulator
(LeFlore et al., 2014) or to instruct (von Lubitz et al., 2003) if not
currently available at the site where the participants are located.

Compare: REMOTE SIMULATION,TELESIMULATION

14
Dryrun \ ˈdrī \ ˈrən \ noun
Etym.”dry run” (n): “walk-through (n.) also walkthrough, 1944, “an
easy part” (in a theatrical production), from walk (v.) + through.
Meaning “dry run, full rehearsal” is from 1959, from the notion of
“walking (someone) through” something.”

Definition

• A “planning meeting with standardized learners” is used to reveal

un-intentional problems within the scenario. A designated time to
explore the possibility of errors. (Boilat et al, 2012)

• A verification period prior to live encounters to ensure a “safe and

therapeutic” environment. (Greswell et al, 2018)

See also: ALPHA and BETA TEST, PILOT TEST

Consider also: DRESS REHEARSAL, RUN THROUGH, SIMULATION
VALIDATION, WALK THROUGH

15
E
Educator (Simulation Educator) \ ˈe-jə-ˌkā-tər \ noun Environmental Fidelity
\ en - vī-rə(n)-ˈmen-tə- l \ fə-ˈde-lə-tē \ noun
Etym. simulation (n.) noun of action from past participle stem of
simulare “imitate,” from stem of similis “like”. Meaning “a model or Etym. environmental (adj.) 1887, “environing, surrounding,” from
mock-up for purposes of experiment or training” is from 1954. environment + -al (1). Ecological sense by 1967.
Related: Environmentally.
Etym. educator (n.) “one who trains or instructs,” 1670s.
Etym. fidelity (n.) early 15c., “faithfulness, devotion,” from Middle
Definition French fidélité (15c.), from Latin fidelitatem (nominative fidelitas)
“faithfulness, adherence, trustiness,” from fidelis “faithful, true,
• Person who uses the modality of simulation to educate learners,
trusty, sincere,” from fides “faith.” From 1530s as “faithful adherence
utilizing evidence -based strategies.
to truth or reality;” specifically of sound reproduction from 1878.
• Person who supports healthcare professionals who are learning to
Definition
manage clinical situations and provide care that is safe, effective,
efficient, timely, patient-centered, and equitable. May teach an • The degree to which the simulated environment (manikin, room,
individual learner or a group of learners practicing to work as a tools, equipment, moulage, and sensory props) replicates reality
team (Lindell, Poindexter, & Hagler, 2016). and appearance of the real environment.

See also: FACILITATOR, SIMULATIONIST See also: FIDELITY, HIGH FIDELITY SIMULATION, PHYSICAL FIDELITY,
REALISM

Embedded Participant \ im-ˈbed \ id \ pär-ˈti-sə-pənt \ noun

Evaluation \ i-ˌval-yə-ˈwā-shən \ noun
Etym. embed (v.) 1778, “to lay in a bed (of surrounding matter),”
from em- (1) + bed (n.). Originally a geological term, in reference Etym. (n.) 1755, “action of appraising or valuing,” from French
to fossils in rock; figurative sense is by 1835; meaning “place (a évaluation, noun of action from évaluer “to find the value of,” from
journalist) within a military unit at war” is from 2003 and the Iraq é- “out” (see ex-) + valuer, from Latin valere “be strong, be well; be
war. Related: Embedded; embedding. of value, be worth” (from PIE root *wal- “to be strong”). Meaning
“job performance review” attested by 1947.
Etym. participant (n.) 1560s, from Middle French participant, from
Latin participantem, present participle of participare “to share in, Definition
partake of” from particeps “sharing, partaking.”
• Determination of the value, nature, character, or quality of
Definition something or someone (Merriam Webster)
• An individual who is trained or scripted to play a role in a • A broad term for appraising data or placing a value on data
simulation encounter in order to guide the scenario, and may be gathered through one or more measurements. It involves
known or unknown to the participants; guidance may be positive rendering a judgment, including strengths and weaknesses.
or negative, or a distractor based on the objectives, level of the Evaluation measures quality and productivity against a standard
participants, and the needs of the scenario. of performance. Evaluation may be formative, summative, high
stakes, or related to the simulation program or process. (INACSL
• A role assigned in a simulation encounter to help guide the
Standards Committee, Glossary, 2016c)
scenario.
Compare: ASSESSMENT
• The embedded participant’s role is part of the situation. However,
the underlying purpose of the role may not be revealed to the
participants in the scenario or simulation (INACSL, 2013).

See also: ACTOR, ROLE PLAYER, SIMULATED PATIENT, SIMULATED

PERSON, STANDARDIZED PATIENT

16
Event \ i-ˈvent \ noun
Etym. 1570s, “the consequence of anything” (as in in the event that);
1580s, “that which happens;” from Middle French event, from Latin
eventus “occurrence, accident, event, fortune, fate, lot, issue,” from
past participle stem of evenire “to come out, happen, result,” from
assimilated form of ex- “out” + venire “to come.” Meaning “a contest
or single proceeding in a public sport” is from 1865. Events as “the
course of events” is attested from 1842.

Definition
• The occurrences that cause variation or changes in the state of a
system (Sokolowski and Banks, 2009); in health care simulation,
this term is common when programming manikins and often
refers to learner actions.

• An event is described by the time it occurs and event lists can be

created to drive changes in a simulation.

See also: STATE/STATES

17
F
Facilitator (Simulation Facilitator) \fə-ˈsi-lə-ˌtā-tər\ noun Fiction Contract \ˈfik-shən\ ˈkän-ˌtrakt\ noun
Etym. 1806, agent noun in Latin form from facilitate. Etym. fiction (n.) something that is not true; something invented by
the imagination or feigned; an assumption of a possibility as a fact
Definition irrespective of the question of its truth; a useful illusion or pretense;
• An individual who is involved in the implementation and/or the action of feigning or of creating with the imagination.
delivery of simulation activities. For example, faculty, educators,
Etym. contract (n.) a binding agreement between two or more
etc.
persons or parties.
• An individual that helps to bring about an outcome (such as Definition
learning, productivity, or communication) by providing indirect
or unobtrusive assistance, guidance, or supervision. For example: • A concept which implies that an engagement in simulation is a
The debriefing facilitator kept the discussion flowing smoothly. contract between the instructor and the learner: each has to do
his or her part to make the simulation worthwhile (Rudolph,
Compare: DEBRIEFER, SIMULATIONIST Dieckmann, et al.).

• The degree of engagement that healthcare trainees are willing

to give the simulated event. Also known as the “suspension of
Feedback \ fēd-ˌbak \ noun disbelief”, it is a literary and theatrical concept that encourages
participants to put aside their disbelief and accept the simulated
Etym. 1920, in the electronics sense, “the return of a fraction of an exercise as being real for the duration of the scenario.
output signal to the input of an earlier stage,” from verbal phrase,
from feed (v.) + back (adv.). Transferred use, “information about the
results of a process” is attested by 1955.
*Fidelity \ fə-ˈde-lə-tē \ adj
Definition
Etym. (n.) early 15c., “faithfulness, devotion,” from Middle
• An activity where information is relayed back to a learner; French fidélité (15c.), from Latin fidelitatem (nominative fidelitas)
feedback should be constructive, address specific aspects of the “faithfulness, adherence, trustiness,” from fidelis “faithful, true,
learner’s performance, and be focused on the learning objectives trusty, sincere,” from fides “faith.” From 1530s as “faithful adherence
(Society for Simulation in Healthcare). to truth or reality;” specifically of sound reproduction from 1878.

• Information transferred between participants, facilitator, Definition

simulator, or peer with the intention of improving the
• The degree to which the simulation replicates the real event
understanding of concepts or aspects of performance (INACSL
and/or workplace; this includes physical, psychological, and
2013). Feedback can be delivered by an instructor, a machine, a
environmental elements.
computer, a patient (or a simulated person), or by other learners
as long as it is part of the learning process. • The ability of the simulation to reproduce the reactions,
interactions, and responses of the real-world counterpart. It is not
Compare: ADVOCACY AND INQUIRY, DEBRIEF/DEBRIEFING,
constrained to a certain type of simulation modality, and higher
GUIDED REFLECTION
levels of fidelity are not required for a simulation to be successful.
• The level of realism associated with a particular simulation
activity; fidelity can involve a variety of dimensions, including
(a) physical factors such as environment, equipment, and related
tools; (b) psychological factors such as emotions, beliefs,
and self-awareness of participants; (c) social factors such as
participant and instructor motivation and goals; (d) culture
of the group; and (e) degree of openness and trust, as well as
participants’ modes of thinking (INACSL, 2013);
See also: ENVIRONMENTAL FIDELITY, FUNCTIONAL FIDELITY, HIGH
FIDELITY, HIGH FIDELITY SIMULATION, IMMERSIVE SIMULATION, LOW
FIDELITY, PHYSICAL FIDELITY, PSYCHOLOGICAL FIDELITY, REALISM,
SIMULATION FIDELITY

18
Fixation Error \ fik-ˈsā-shən \ er-ər \ noun
Etym. fixation (n.) late 14c., fixacion, an alchemical word, “action
of reducing a volatile substance to a permanent bodily form,” from
Medieval Latin fixationem (nominative fixatio), noun of action
from past participle stem of Latin fixare, frequentative of figere “to
fix.” Meaning “condition of being fixed” is from 1630s. Used in the
Freudian sense since 1910.

Etym. error (n.) also, through 18c., errour; c. 1300, “a deviation from
truth made through ignorance or inadvertence, a mistake.” From late
14c. as “deviation from what is normal; abnormality, aberration.”
From 1726 as “difference between observed value and true value.”

Definition
• A principle of crisis resource management wherein humans fail
to revise a situation assessment in risky and dynamic systems or
events (Decker, 2011).

• The persistent failure to revise a diagnosis or plan in the face of

readily available evidence suggesting that a revision is necessary.

Compare: SITUATIONAL AWARENESS

Frame(s) \ frāmz \ noun

Etym. From 1660s in the meaning “particular state” (as in Frame of
mind, 1711). Frame of reference is 1897.

Definition
• The perspectives through which individuals interpret new
information and experiences for the purpose of decision-making.

• Frames are formed through previous experiences and can be

based on knowledge, attitudes, feelings, goals, rules, and/or
perceptions.

• The mindset of the internal participant or facilitator; their

knowledge, thoughts, feelings, actions (speech/body language),
attitudes (verbal/non-verbal), and perceptions (adapted from
Rudolph, J.W. et al, 2007, 2008).

Functional Fidelity \ˈfəŋ(k)-shnəl, -shə-nəl \fə-ˈde-lə-tē \ noun

Etym. functional (adj.) 1630s, “pertaining to function or office,”
from function (n.) + -al (1), or from Medieval Latin functionalis.
Meaning “utilitarian” is by 1864. Related: Functionally;
functionality.

Etym. fidelity (n) early 15c., “faithfulness, devotion,” from Middle

French fidélité (15c.), from Latin fidelitatem (nominative fidelitas)
“faithfulness, adherence, trustiness,” from fidelis “faithful, true,
trusty, sincere,” from fides “faith” (see faith). From 1530s as “faithful
adherence to truth or reality.”

Definition
• The degree in which the equipment used in the simulation
responds to the participant’s actions; e.g., a static ventilator would
offer low functional fidelity compared to a working ventilator in a
simulation requiring a ventilator alarm.

See also: FIDELITY, HIGHT FIDELITY SIMULATOR, REALISM

19
G
Gamification \ gā-mə-fə-ˈkā-shən \ noun [U] • A mentor-facilitated process that allows the learner to “integrate
the understanding gained into one’s experience in order to enable
Etym. game (n.) c. 1200, from Old English gamen “joy, fun; game, better choices or actions in the future, as well as enhance one’s
amusement,” common Germanic (cognates: Old Frisian game “joy, overall effectiveness” (Rogers, 2001).
glee,” Old Norse gaman “game, sport; pleasure, amusement,” Old
Saxon gaman, Old High German gaman “sport, merriment,” Danish Compare: ADVOCACY AND INQUIRY, DEBRIEF/DEBRIEFING,
gamen, Swedish gamman “merriment”), said to be identical with FEEDBACK
Gothic gaman “participation, communion,” from Proto-Germanic See also: REFLECTIVE THINKING
*ga- collective prefix + *mann “person,” giving a sense of “people
together.” The -en was lost perhaps through being mistaken for a
suffix. Meaning “contest for success or superiority played according
to rules” is first attested c. 1200 (of athletic contests, chess, Gynecological / Genitourinary Teaching Associate
backgammon). (GTA, GUTA, MUTA) \ˌje-nə-tō-ˈyu̇r-ə-ˌner-ē \ˈtēch ng \ə-ˈsō-
shē-ˌāt, -sē-\ noun
Definition
Etym. genitourinary (adj.) of or relating to the genital and urinary
• The application of game design elements (conceptual building organs or functions. genitals (n.) “reproductive organs,” especially
blocks integral to building successful games) to traditionally non- the external sexual organs, late 14c. Compare Genitalia.
game contexts (Rutledge et al, 2018).
Definition
• The application of the characteristics and benefits of games to
real-world processes or problems. “Gamification differs from • A Genitourinary Teaching Associate (GUTA) is an individual
serious games in terms of the design intention, with gamification trained to teach the techniques and protocol for performing the
interventions involving the application of game elements with a gender-specific physical examination to learners, using himself or
utilitarian purpose...” (Gentry et al, 2019). herself as a demonstration and practice model.

Compare: SERIOUS GAMES • A Gynecological Teaching Associate (GTA) is a female

Consider also: GAME-BASED LEARNING specifically trained to teach, assess, and provide feedback to
learners about accurate pelvic, rectal and/or breast examination
techniques. They also address the communication skills needed
to provide a comfortable exam in a standardized manner, while
Guided Reflection \ gīd – id \ ri-ˈflek-shən\ noun using their bodies as teaching tools in a supportive, non-
threatening environment (ASPE).
Etym. guide (v.) late 14c., “to lead, direct, conduct,” from Old French
guider “to guide, lead, conduct” (14c.), earlier guier, from Frankish • A Male Urogenital Teaching Associates (MUTA) is a male
*witan “show the way” or a similar Germanic source. specifically trained to teach, assess, and provide feedback
to learners about accurate urogenital and rectal examination
Etym. reflection (n.) Of the mind, from 1670s. Meaning “remark techniques. They also address the communication skills needed
made after turning back one’s thought on some subject” is from to provide a comfortable exam in a standardized manner, while
1640s. using their bodies as teaching tools in a supportive, non-
threatening environment (ASPE).
Definition
• The process encouraged by the instructor during debriefing that
reinforces the critical aspects of the experience and encourages
insightful learning, allowing the participant to link theory with
practice and research (INACSL, 2013).

• The facilitated intellectual and affective activities that allow

individuals to explore their experience in order to lead to new
understanding and appreciations (adapted from Boud et al, 1985).

20
H
Haptic (Haptics) \ˈhap-tik \ adj Etym. simulator (n.) 1835, of persons, from Latin simulator “a
copier, feigner,” agent noun from simulare “imitate,” from stem of
Etym. (adj.) “pertaining to the sense of touch,” 1890, from Greek similis “like.” In reference to training devices for complex systems,
haptikos “able to come into contact with,” from haptein “to fasten.” from 1947 (flight simulator). simulated (adj.) 1620s, “feigned,”
past participle adjective from simulate (v.). Meaning “imitative
Definition
for purposes of experiment or training” is from 1966 (agent noun
• In health care simulation, refers to devices that providing tactile simulator in the related sense dates from 1947. In commercial jargon,
feedback to the user. Haptics can be used to simulate touching, “artificial, imitation” by 1942.
palpating an organ, or body part, and the cutting, tearing, or
traction on a tissue. Definition
• A term often used to refer to the broad range of full-body
• Devices that capture and record a trainee’s ‘touch’ in terms
manikins that have the ability to mimic, at a very high level,
of location and depth of pressure at specific anatomical sites
human body functions.
(McGaghie et al, 2010; Jackson et al).
• Also known as a high-complexity simulator. Other types of
simulators can also be considered high-fidelity, and that fidelity
(realism) has other characteristics beyond a particular type of
Health Care Simulation simulator.
\ helth \ ker \ sim-yuh-ley-shuh n \ noun
See also: FIDELITY, FUNCTIONAL FIDELITY, REALISM SIMULATION
Etym. simulation (n.) noun of action from past participle stem of FIDELITY
simulare “imitate,” from stem of similis “like.” Meaning “a model or
mock-up for purposes of experiment or training” is from 1954.

Definition High-Fidelity Simulation

• A technique that creates a situation or environment to allow \ hī \ fə-ˈde-lə-tē \ sim-yuh-ley-shuh n \ noun
persons to experience a representation of a real health care event
for the purpose of practice, learning, evaluation, testing, or to Etym. fidelity (n.) early 15c., “faithfulness, devotion,” from Middle
gain understanding of systems or human actions (Society for French fidélité (15c.), from Latin fidelitatem (nominative fidelitas)
Simulation in Healthcare). “faithfulness, adherence, trustiness,” from fidelis “faithful, true,
trusty, sincere,” from fides “faith.” From 1530s as “faithful adherence
• The application of a simulation activity to training, assessment, to truth or reality;” specifically of sound reproduction from 1878.
research, or systems integration toward patient safety (Society for
Simulation in Healthcare). Etym. simulation (n.) noun of action from past participle stem of
simulare “imitate,” from stem of similis “like.” Meaning “a model or
See also: SIMULATION mock-up for purposes of experiment or training” is from 1954.

Definition
• In health care simulation, high-fidelity refers to simulation
High-Fidelity Simulator experiences that are extremely realistic and provide a high level
\ hī \ fə-ˈde-lə-tē \ ˈsim-yə-ˌlā-tər \ noun of interactivity and realism for the learner (International Nursing
Association for Clinical Simulation and Learning, 2013). It can
Etym. fidelity (n.) early 15c., “faithfulness, devotion,” from Middle apply to any mode or method of simulation; for example: human,
French fidélité (15c.), from Latin fidelitatem (nominative fidelitas) manikin, task trainer, or virtual reality.
“faithfulness, adherence, trustiness,” from fidelis “faithful, true,
trusty, sincere,” from fides “faith.” From 1530s as “faithful adherence See also: ENVIRONMENTAL FIDELITY, FIDELITY, REALISM
to truth or reality;” specifically of sound reproduction from 1878.

21
Human Factors \ hyü-mən \ fak-tərz \ noun
Etym. factor (n.) Sense of “circumstance producing a result” is
attested by 1816, from the mathematical sense.

Definition
• The discipline or science of studying the interaction between
humans and systems and technology; it includes, but is not
limited to, principles and applications in the areas of human
engineering, personnel selection, training, life support, job
performance aids, and human performance evaluation (M&S
Glossary).

• The psychological, cultural, behavioral, and other human

attributes that influence decisionmaking, the flow of information,
and the interpretation of information by individuals or groups
(Department of Defense Modeling and Simulation Glossary).

Hybrid Simulation \ hī-brəd \ sim-yuh-ley-shuh n \ noun

Etym. hybrid (n.) “a product of two heterogeneous things” emerged
c. 1850.

Etym. simulation (n.) noun of action from past participle stem of

simulare “imitate,” from stem of similis “like.” Meaning “a model or
mock-up for purposes of experiment or training” is from 1954.

Definition
• The union of two or more modalities of simulation with the aim
of providing a more realistic experience.

• In health care simulation, hybrid simulation is most commonly

applied to the situation where a part task trainer (e.g., a urinary
catheter model) is realistically affixed to a standardized/simulated
patient, allowing for the teaching and assessment of technical and
communication skills in an integrated fashion (Kneebone, Kidd et
al, 2002).

• The use of two or more simulation modalities in the same

simulation activity (Zulkepli et al, 2012).

Compare: MIXED SIMULATION/MIXED METHODS SIMULATION,

MULTIPLE MODALITY SIMULATON

22
I
Immersion \i-ˈmər-zhən \ noun • noun: A simulation session influenced by participants’
characteristics, experiences, level of training, and preparation
Etym. (n.) c. 1500, from Late Latin immersionem (nominative for the case or task,. The perceived physical, conceptual and
immersio), noun of action from past participle stem of immergere emotional fidelity, the appropriate level of challenge, and the
“to plunge in, dip into, sink, submerge,” from assimilated form of in- simulators and actors can all affect the simulation experience
“into, in, on, upon” (see in- (2)) + Latin mergere “plunge, dip” (see (Hamstra et al, 2014; Rudolph et al, 2007).
merge). Meaning “absorption in some interest or situation” is from
1640s. See also: FIDELITY, IMMERSION, REALISM

Definition
• Describes the level to which the learner becomes involved in the
simulation; a high degree of immersion indicates that the learner Incognito Standardized Patient \ in-ˌkäg-ˈnē-
is treating the simulation as if it was a real-life (or very close to \ stan-dər-ˌdīzd \ pā-shənt \ noun
real-life) event (Society for Simulation in Healthcare).
Etym. incognito (adj./adv.) 1640s as both adjective (“disguised
• A state (or situation) in which trainees dedicate most of their under an assumed name and character”) and adverb (“unknown, with
time doing something related to or thinking about a simulation, concealed identity”), from Italian incognito “unknown,” especially
and becomes involved in it; the level of immersion might vary, in connection with traveling, from Latin incognitus “unknown, not
where a high degree indicates that the trainee is fully involved; investigated.”
for example: realistic environments facilitate a participant´s full
immersion in the simulation. Etym. standard “authoritative or recognized exemplar of quality
or correctness” (late 15c.). Meaning “rule, principal or means of
• The placing of a human in a synthetic environment through judgment” is from 1560s. That of “definite level of attainment” is
physical and/or emotional means. (M&S Glossary) attested from 1711 (as in standard of living, 1903).

See also: IMMERSIVE SIMULATION Etym. patient (n.) “suffering or sick person under medical
treatment,” late 14c.

Definition
Immersive Simulation \ ɪˈmɜːsɪv\ sim-yuh-ley-shuh n \ adj • A person who plays a role as a patient in real health care
(immersive); n (simulation) situations, while the health care workers in those situations are
unaware of the fact that the person is not a real patient (Rethans
Etym. immersion . (n.) c. 1500, from Late Latin immersionem, et al., 2007).
noun of action from past participle stem of immergere “to plunge
in, dip into, sink, submerge,” from assimilated form of in- “into, in, Consider also: UNANNOUNCED STANDARDIZED PATIENTS, STEALTH
on, upon” (see in- (2)) + Latin mergere “plunge, dip” (see merge). PATIENTS, SECRET SHOPPER
Meaning “absorption in some interest or situation” is from 1640s.

Etym. simulation (n.) noun of action from past participle stem of

simulare “imitate,” from stem of similis “like.” Meaning “a model or In Silico \ in-ˈsi-li-ˌkō \ adj or adv.
mock-up for purposes of experiment or training” is from 1954.
Etym. 1980s: Latin, literally ‘in silicon’ (with reference to the use of
Definition silicon chips in computer systems); on the pattern of in vitro and in
• adj: A real-life situation that deeply involves the participants’ vivo.
senses, emotions, thinking, and behavior; creating an immersive
Definition
simulation depends on the alignment with learning objectives, the
fidelity of the simulation (physical, conceptual, and emotional), • Performed on computer or via computer simulation; the phrase
and participant´s perception of realism. was coined in 1989 as an analogy to the Latin phrases in vivo, in
vitro, and in situ (Sieburg, 1990).

Compare: IN SITU

23
In Situ/In Situ Simulation Interdisciplinary / Interdisciplinary Learning
\ in ˈsɪtju \ sim-yuh-ley-shuh n \ adj \ in-ter -ˈdi-sə-plə-ˌner-ē \ lərn-ing \ noun / adj

Etym. in situ 1740, Latin, literally “in its (original) place or position,” Etym. discipline (n.) directly from Latin disciplina “instruction
from ablative of situs “site.” given, teaching, learning, knowledge,” also “object of instruction,
knowledge, science, military discipline,” from discipulus. Meaning
Etym. simulation (n.) noun of action from past participle stem of “branch of instruction or education” is first recorded late 14c.
simulare “imitate,” from stem of similis “like.” Meaning “a model or Meaning “military training” is from late 15c.; that of “orderly
mock-up for purposes of experiment or training” is from 1954. conduct as a result of training” is from c. 1500.
Definition Etym. learning (n.) Old English leornung “learning, study,” from
• Taking place in the actual patient care setting/environment in an leornian.
effort to achieve a high level of fidelity and realism; this training
Definition
is particularly suitable for difficult work environments, due to
space constraints or noise. For example, an ambulance, a small • noun: The academic disciplines, such as psychology, or
aircraft, a dentist’s chair, a catheterization lab (Kyle & Murray, subspecialties within professions. For example, within the
2008). This training is valuable to assess, troubleshoot, or develop profession of medicine, anesthesia or cardiology (Barr, Koppel,
new system processes. Reeves, et al., 2005).

Compare: IN SILICO • adj: Working jointly, but address issues from their individual
discipline’s perspective (Gray & Connolly, 2008).

• Integrating the perspective of professionals from two or more

Interactive Model or Simulation \ in-ter-ˈak-tiv \ mä-dəl \ professions by organizing the education around a specific
or \ sim-yuh-ley-shuh n \ adj discipline, where each discipline examines the basis of their
knowledge” (Bray & Howkins, 2008).
Etym. simulation (n.) noun of action from past participle stem of
See also: INTERPROFESSIONAL EDUCATION/TRAINING/LEARNING
simulare “imitate,” from stem of similis “like.” Meaning “a model or
mock-up for purposes of experiment or training” is from 1954.

Definition
• Simulating a situation in which the outcome varies depending on Interprofessional \ in-ter - \ prə-ˈfesh-nəl \ adj
human participation (Thomas). This allows humans to practice Etym. professional (n.) “one who does it for a living,” 1798, from
different sets of actions in order to learn the correct response to professional (adj.).professional (adj.) 1747 of careers (especially of
an event. the skilled or learned trades from c. 1793). Related: profession.
• Modeling that requires human participation (Australian Definition
Department of Defense, 2011).
• Collaborating as a team with a shared purpose, goal, and mutual
respect to deliver safe, quality healthcare (Freeth, Hammick,
Reeves, Koppel, & Barr, 2005; World Health Organization
[WHO], 2010).
Interdisciplinary \ in-ter-dis-uh-pluh-ner-ee \ adj
• Interprofessional is a more contemporary term describing a
Etym. discipline (n.) directly from Latin disciplina “instruction
team effort in healthcare from two or more professions whose
given, teaching, learning, knowledge,” also “object of instruction,
members learn about, from, and with each other to improve health
knowledge, science, military discipline,” from discipulus. Meaning
outcomes (Nester, 2016).
“branch of instruction or education” is first recorded late 14c.
Meaning “military training” is from late 15c.; that of “orderly Consider also: PROFESSION
conduct as a result of training” is from c. 1500.

Definition
• Involving two or more academic, scientific, or artistic disciplines
(Merriam-Webster.com).

• The combining of two or more academic disciplines, fields of

study, professions, technologies or departments (dictionary.
reference.com).

• Of or relating to more than one branch of knowledge

(oxforddictionaries.com).

See also: MULTIDISCIPLINARY

*Term that has been identified as potentially controversial.

24
Interprofessional Education /Training/Learning
\ in-ter - prə-ˈfesh-nəl \ e-jə-ˈkā-shən\ trā-niŋ \ lərn-ing\ noun

Etym. professional (n.) “one who does it for a living,” 1798, from
professional (adj.).professional (adj.) 1747 of careers (especially of
the skilled or learned trades from c. 1793). Related: profession.

Etym. education (n.) 1530s, “childrearing,” also “the training of

animals,” from Middle French education (14c.) and directly from
Latin educationem (nominative educatio) “a rearing, training,”
noun of action from past participle stem of educare. Originally
of instruction in social codes and manners; meaning “systematic
schooling and training for work” is from 1610s.

Etym. training (n.) From 1540s as “discipline and instruction to

develop powers or skills;” 1786 as “exercise to improve bodily
vigor.”

Definition
• An educational environment where students from two or
more professions learn about, from, and with each other to
enable effective collaboration and improve health outcomes
(World Health Organization Interprofessional Education and
Collaborative Expert Panel, 2011).

• An initiative to secure learning, and promote gains through

interprofessional collaboration in professional practice
(Freeth, Hammick, Reeves, et al., 2008).

See also: INTERDISCPLINARY LEARNING

Interprofessionalism \ in-ter - \prə-ˈfesh-nəl \ ˈi-zəm\ noun

Etym. professional (n.) “one who does it for a living,” 1798, from
professional (adj.).professional (adj.) 1747 of careers (especially of
the skilled or learned trades from c. 1793). Related: profession.

Definition
• The effective integration of professionals through mutual
respect, trust, and support, from various professions, who share
a common purpose to mold their separate skills and knowledge
into collective responsibility and awareness that can be achieved
through learned processes for communication, problem solving,
conflict resolution, and conduct.

Consider also: PROFESSION

*Term that has been identified as potentially controversial.

25
J
Just-in-Time Simulation
\ jəst \ ˈin \ tīm \ sim-yuh-ley-shuh n \ noun

Etym. simulation (n.) noun of action from past participle stem of

simulare “imitate,” from stem of similis “like.” Meaning “a model or
mock-up for purposes of experiment or training” is from 1954.

Definition
• A method of training that is conducted directly prior to a potential
intervention (Palaganas, Maxworthy, Epps, & Mancini, 2015).
The training that is utilized is “just in time” at the “place near
the site of the potential intervention” (Palaganas, Maxworthy,
Epps, and Mancini, 2014).

• A learning approach that meets the learner’s needs during or just

before it is needed to maximize an educational outcome
(Barnes, 1998).

• A cost-reduction method that is derived originally from the

Japanese car manufacturing industry where it was a strategy that
was utilized to reduce flow times in both production and response
time costs (Ohno, 1978).

*Term that has been identified as potentially controversial.

26
L
Learning Goal \ ˈlər-niŋ \ ˈgōl \ noun Learning Outcome \ ˈlər-niŋ \ ˈau̇t-ˌkəm \ noun
Etym. learning (n.) Old English leornung “study, action of acquiring Etym. learning (n.) Old English leornung “study, action of acquiring
knowledge,” verbal noun from leornian (see learn). Meaning knowledge,” verbal noun from leornian (see learn). Meaning
“knowledge acquired by systematic study, extensive literary and “knowledge acquired by systematic study, extensive literary and
scientific culture” is from mid-14c. Learning curve attested by 1907. scientific culture” is from mid-14c. Learning curve attested by 1907.

Etym. goal (n.) 1530s, “end point of a race,” of uncertain origin. It Etym. outcome (n.)1788, “that which results from something,”
appears once before this (as gol), in a poem from early 14c. and with originally Scottish, from the verbal phrase; see out (adv.) + come (v.).
an apparent sense of “boundary, limit.” Perhaps from Old English Popularized in English by Carlyle (c. 1830s). It was used in Middle
*gal”obstacle, barrier,” a word implied by gælan “to hinder” and also English in sense of “an emergence, act or fact of coming out” (c.
found in compounds (singal, widgal). 1200), and the gerund, outcoming, was used as “an issue, a result.”
Old English had utancumen (n.) “stranger, foreigner.”
Definition
Definition
• Higher order ambitions for the learners.
• A result of an activity the learners demonstrate by the end of an
• Broad, general statements of what is desired for students to learn, educational activity in terms of knowledge, skills, and attributes
and provide direction, focus, and cohesion. (KSAs) acquired.
Compare: LEARNING OBJECTIVES; LEARNING OUTCOMES • “Measurable results of the participants’ progress toward meeting
a set of objectives.” (INACSL Standards Committee, 2016c,
December).

• “Outcomes include: knowledge, skill performance, learner

Learning Objective \ ˈlər-niŋ \ əb-ˈjek-tiv \ noun
satisfaction, critical thinking and self-confidence” (Ironside,
Etym. learning (n.) Old English leornung “study, action of acquiring Jeffries, & Martin, 2009, p.333)
knowledge,” verbal noun from leornian (see learn). Meaning
• Outcomes are a measurable judgement (Cooke, Stroup, &
“knowledge acquired by systematic study, extensive literary and
Harrington, 2019).
scientific culture” is from mid-14c. Learning curve attested by 1907.
• Learning outcomes “measure the effect on learning: psychomotor,
Etym. objective (n.) 1738, “something objective to the mind,” from
affective and cognitive skills” (Cant & Cooper, 2017, p.69).
objective (adj.). Meaning “goal, aim” (1881) is from military term
objective point (1852), reflecting a sense evolution in French. Compare: LEARNING GOALS; LEARNING OBJECTIVES

Definition

• Expected goal of a curriculum, course, lesson or activity in terms

of demonstrable skills or knowledge that will be acquired by a
student as a result of instruction.

• Measurable results which can be knowledge, skills, or attitudes

(KSAs). (INACSL Standards Committee, 2016c, December).

• A learning objective guides the debrief activity by supporting

what content should be covered or avoided (Szyld & Rudolph,
2014).

Compare: LEARNING GOALS; LEARNING OUTCOME

*Term that has been identified as potentially controversial.

27
Live, virtual, and constructed (LVC) simulation
\ˈliv\‘vər-chə-wəl, -chəl; ˈvərch-wəl\kən-ˈstrək-tiv\ noun

Etym. live 1540s, “having life,” later (1610s) “burning, glowing,”

a shortening of alive. Meaning “in-person” (of performance) is first
attested 1934.

Etym. virtual The meaning “being something in essence or effect,

though not actually or in fact” is from mid-15c., probably via sense
of “capable of producing a certain effect” (early 15c.). Computer
sense of “not physically existing but made to appear by software” is
attested from 1959.

Etym. constructed early 15c., “derived by interpretation,” from

Middle French constructif or from Medieval Latin constructivus,
from Latin construct-, past participle stem of construere “to heap up.”

Definition
• A broadly used taxonomy describing a mixture of simulation
modalities; a live simulation involves real people operating real
systems; a virtual simulation is where a real person operates
simulated systems; and a constructed simulation does not involve
real people or real systems, but instead consists of computer
programs that create an environment. (Sokolowski & Banks,
2011).

Logistics \ lō-ˈji-stiks \ noun

Etym. (n.) “art of moving, quartering, and supplying troops,” 1846,
from French (l’art) logistique “(art) of quartering troops,” which
apparently is from Middle French logis “lodging” (from Old French
logeiz “shelter for an army, encampment,” from loge; see lodge (n.))
+ Greek-derived suffix -istique (see -istic). The form in French was
influenced by logistique, from the Latin source of English logistic.
Related: Logistical.

Definition

• Details of an entire process. (Merriam Webster)

• Ensuring the details, in simulation-based education, such as

scheduling of learners, facilitators, moulage, props, scenario
preparation and design are all complete.

Low-Fidelity \ ˈlō \ fə-ˈde-lə-tē \ adj

Etym. fidelity (n.) early 15c., “faithfulness, devotion,” from Middle
French fidélité (15c.), from Latin fidelitatem (nominative fidelitas)
“faithfulness, adherence, trustiness,” from fidelis “faithful, true,
trusty, sincere,” from fides “faith.” From 1530s as “faithful adherence
to truth or reality;” specifically of sound reproduction from 1878.

Definition
• Not needing to be controlled or programmed externally for the
learner to participate (Palaganas, Maxworthy, Epps, & Mancini,
2015); examples include case studies, role playing, or task
trainers used to support students or professionals in learning a
clinical situation or practice (Adapted from National League for
Nursing - Simulation Innovation Resource Center, 2013).

See also: FIDELITY

28
M
*Manikin \ ma-ni-kən\ (also Mannequin) noun Manual Input \ˈman-yə-wəl \ ˈin-ˌpu̇t\ noun
Etym. 1560s, “jointed figure used by artists,” from Dutch manneken, Etym. manual (adj.) c. 1400, from Latin manualis “of or belonging to
literally “little man,” diminutive of Middle Dutch man. the hand; that can be thrown by hand,” from manus “hand, strength,
power over; armed force; handwriting.”
Definition
Etym. input Middle English verb (late 14c.) meaning “to put in,
• A life-sized human like simulator representing a patient for health
place, set.”
care simulation and education (Palaganas, Maxworthy, Epps, &
Mancini, 2015). Definition
• Full or partial body representation of a patient for practice. • The method of operation in which an operator inputs a value
to a given parameter regardless of how it would affect any
• Full or partial body simulators that can have varying levels of other parameter. The input of the parameter does not adjust the
physiologic function and fidelity. variables in any physiological manner (Palaganas, Maxworthy,
See also: SIMULATOR Epps, & Mancini, 2015).

Compare: PHYSIOLOGIC MODELING, PREPACKAGE SCENARIO,

“RUNNING ON THE FLY”

Manikin-based Simulation \ ma-ni-kən \ bāst \ sim-yuh-ley-

shuh n \ noun
Mastery Learning \ˈmas-t(ə-)rē\ \ˈlərn- iŋ\ noun
Etym. manikin. 1560s, “jointed figure used by artists,” from Dutch
manneken, literally “little man,” diminutive of Middle Dutch man. Etym. mastery (adj.) early 13c., mesterie, “condition of being a
master,” also “superiority, victory;” from Old French maistrie, from
Etym. simulation (n.) noun of action from past participle stem of
maistre “master” (n.). Meaning “intellectual command” (of a topic,
simulare “imitate,” from stem of similis “like.” Meaning “a model or
etc.) is from 1660s.
mock-up for purposes of experiment or training” is from 1954.
Etym. learning (n.) Old English leornung “learning, study,” from
Definition
leornian.
• The use of manikins to represent a patient using heart and lung
sounds, palpable pulses, voice interaction, movement (e.g., Definition
seizures, eye blinking), bleeding, and other human capabilities • An instructional philosophy originally proposed by Benjamin
that may be controlled by a simulationist using computers and Bloom that stated a student must first practice and study to meet
software. the predetermined level criteria (>90%) through the formative
assessment of a prerequisite domain prior to advancing in subject
• The life-like aspects of people and situations generated by a
matter. If the learner does not achieve the level of mastery,
manikin.
information from the test is used to diagnose areas of deficiency
necessary for additional prescriptive support. The student is later
tested again. This cycle of feedback and corrective procedures is
repeated until mastery is achieved, at which point the student will
*Mannequin \ ma-ni-kən \ (also Manikin) noun move on to the next level (Guskey, 2010).
Etym. 1902, “model to display clothes,” from French mannequin. A • An instructional philosophy that highlights individualized
French form of the same word that yielded manikin, and sometimes feedback and adequate time, allowing the learner to progress
mannequin was used in English in a sense “artificial man” (especially through the subject in a customized manner, generally in smaller
in translations of Hugo). Originally of persons, in a sense where we units, to master the subject matter. This concept states that nearly
might use “model.” all learners can achieve subject or skill mastery utilizing this
See: MANIKIN method (Palaganas, Maxworthy, Epps, & Mancini, 2015).
See also: SIMULATOR Compare: DELIBERATE PRACTICE

29
Mental Simulation \ ˈmen-tᵊl \ n sim-yuh-ley-shuh n \ noun Mixed Reality Human \ mikst \ rē-ˈa-lə-tē \ hyü-mən \ noun
Etym. mental (adj.) early 15c., “in, of, or pertaining to the mind; Etym. mixed (adj.) mid-15c., also mixte, “consisting of different
characteristic of the intellect,” from Late Latin mentalis “of the elements or parts,” from Latin mixtus, past participle of miscēre “to
mind,” from Latin mens (genitive mentis) “mind,” from PIE root mix, mingle, blend”
*men- (1) “to think.”
Etym. reality (n.) 1540s, “quality of being real,” from French réalité
Etym. simulation (n.) noun of action from past participle stem of and directly Medieval Latin realitatem (nominative realitas), from
simulare “imitate,” from stem of similis “like”. Meaning “a model or Late Latin realis. Meaning “real existence, all that is real” is from
mock-up for purposes of experiment or training” is from 1954. 1640s; that of “the real state (of something)” is from 1680s.

Definition Definition

• Mentally rehearsing an action to enhance performance. (Van Meer • The use of a technology such as video, augmented reality, or
P., 2009). virtual reality in conjunction with a physical manikin to simulate
a human. (Costanza, Kunz, and Fjeld, 2009); for example,
• Cognitive rehearsal of a task in the absence of overt physical in team-based training, using TV monitors in portrait mode
movement that can be used to learn cognitive, kinesthetic, with interactive videos as a stand-in for a real team member
psychomotor, or technical skills. (Driskell, 1994 and Rao, 2015). (Palaganas, Maxworthy, Epps, & Mancini, 2015).

• Activities that take place in the brain such as “mental imagery,

imagination, thought flow, narrative transportation, fantasizing,
and counterfactual thinking.”  These are “specific processes that Mixed Simulation (Mixed Methods Simulation)
occur in the brain when an individual is mentally simulating \ mikst \ sim-yuh-ley-shuh n \ noun
an action or forming a mental image,” or are “focused on
the consequences of mental simulation processes for affect, Etym. mixed (adj.) mid-15c., also mixte, “consisting of different
cognition, motivation, and behavior” (Markman, Klein, & Suhr, elements or parts,” from Latin mixtus, past participle of miscēre “to
2009). mix, mingle, blend”

Etym. simulation (n.) noun of action from past participle stem of

simulare “imitate,” from stem of similis “like.” Meaning “a model or
Mixed Reality (XR) \ ‘mikst \ rē-ˈa-lə-tē \ noun [U] mock-up for purposes of experiment or training” is from 1954.

Etym. mixed (adj.) mid-15c., also mixte, “consisting of different Etym. method (n.) early 15c., “regular, systematic treatment of
elements or parts,” from Latin mixtus, past participle of miscēre “to disease,” from Latin methodus “way of teaching or going,” from
mix, mingle, blend” Greek methodos “scientific inquiry, method of inquiry, investigation,”
originally “pursuit, a following after.” Meaning “way of doing
Etym. reality (n.) 1540s, “quality of being real,” from French réalité anything” is from 1580s; that of “orderliness, regularity” is
and directly Medieval Latin realitatem (nominative realitas), from from 1610s.
Late Latin realis (see real (adj.)). Meaning “real existence, all that
is real” is from 1640s; that of “the real state (of something)” is from Definition
1680s. • The use of a variety of different simulation modalities; this is
differentiated from hybrid simulation in that it is not characterized
Definition by the combining of one type of simulation to enhance another,
• A category that encompasses the hybrid combination of virtual but rather the use of multiple types of simulation in the same
reality environments and reality (e.g., real environment, scenario or place. For example, a standardized patient (SP) and a
standardized patient, normal manikin simulator). Often mannequin are used in a scenario or a task trainer paired with an
encompasses the definition of Augmented Reality (AR), but SP for venipuncture, etc. (SSH).
has more virtual features than typical AR. The blend of what See also: MULTIPLE MODALITY SIMULATION
is physically present to what is 100% computer-generated Compare: HYBRID SIMULATION
is expressed in this continuum: Reality——— Augmented
Reality——— Mixed Reality——— Virtual Reality (Hsieh and
Lee, 2017).

• A simulator that combines virtual and physical components

(Robinson et al, 2014).

See also: AUGMENTED REALITY, VIRTUAL REALITY

*Term that has been identified as potentially controversial.

30
Mobile Simulation/Mobile Simulator Modeling and Simulation (M&S) (also Modeling
\ˈmō-bəl \ sim-yuh-ley-shuh n \ noun and Simulation) \ˈmä-dəl – iŋ \ and \ sim-yuh-ley-shuh n \ noun
Etym. mobile (adj.) late 15c., from Middle French mobile (14c.), Etym model sense of “thing or person to be imitated” is 1630s.
from Latin mobilis “movable, easy to move; loose, not firm,”
“pliable, flexible. contraction of *movibilis, from movere “to move.” Etym. simulation (n.) noun of action from past participle stem of
simulare “imitate,” from stem of similis “like.” Meaning “a model or
Etym. simulation (n.) noun of action from past participle stem of mock-up for purposes of experiment or training” is from 1954.
simulare “imitate,” from stem of similis “like.” Meaning “a model or
mock-up for purposes of experiment or training” is from 1954. Definition
• The terms modeling and simulation are often used
Definition
interchangeably.
• A simulator that can be transported relatively easily. Often refers
to digital simulations with minimal equipment, without manikins • An academic discipline focused on the study, development, and
(Mladenovic et al, 2019). use of live, virtual, and constructive models, including simulators,
emulators, and prototypes to investigate, understand, or provide
See also: PORTABLE SIMULATOR data.

• The use of models, including emulators, prototypes, simulators,

and stimulators, to develop data as a basis for making managerial
*Modality \ mō-ˈda-lə-tē\ noun or technical decisions.

Etym. 1610s, from Old French modalité or directly from Medieval

Latin modalitatem (nominative modalitas) “a being modal,” from
modalis. 1560s, term in logic, from Middle French modal and directly Monte Carlo Simulation
from Medieval Latin modalis “of or pertaining to a mode,” from \ män-tē-ˈkär-(ˌ)lō \ sim-yuh-ley-shuh n \ noun
Latin modus “measure, manner, mode.”
Etym. Monte Carlo fallacy 1957, named for resort in Monaco famous
Definition for its gambling casinos. The fallacy of thinking that the probability
• A term used to refer to the type(s) of simulation being used as part of a particular outcome rises with the successive number of opposite
of the simulation activity, for example, task trainers, manikin- outcomes.
based, standardized/simulated patients, computer-based, virtual
Etym. simulation (n.) noun of action from past participle stem of
reality, and hybrid (SSH).
simulare “imitate,” from stem of similis “like.” Meaning “a model or
• A selected type or types of simulation equipment, concept, mock-up for purposes of experiment or training” is from 1954.
or technique that constitutes a method of simulation use
Definition
(Rutherford-Hemming et all, 2019).
• A simulation in which random statistical sampling techniques are
• Broad description of the simulation experience, consisting of one employed such that the result determines estimates for unknown
or more of the following: Computer- or Digital-based simulation; values (Department of Defense Modeling and Simulation
Simulated Patient (SP); Simulated clinical immersion; Procedural Glossary).
simulation (Chiniara et al, 2013).
• A mathematical model using probability distributions to calculate
See also: SIMULATED/SYNTHETIC LEARNING METHODS, TYPOLOGY the possible outcomes for a given choice of action. Such a
simulation involves many calculations and re-calculations to yield
a range of possible outcomes.

Model (as in Modeling and Simulation)

\ mä-dəl \ noun

Etym. Sense of “thing or person to be imitated” is 1630s.

Definition
• A representation of an object, concept, event, or system; models
can be physical models, computational models, or theories of
function (Sokolowski, 2011).

31
Moulage \mü-ˈläzh\ noun • A mixture of textual, audio, and visual modes in combination
with media and materiality with the aim of enhancing the realism
Etym. (n.) From the French: casting/moulding. of the simulation encounter (Lutkewitte).

Definition See also: MIXED SIMULATION/MIXED METHODS SIMULATION

Compare: HYBRID SIMULATION
• The makeup and molds applied to humans or manikins used to
portray lesions, skin findings, bleeding, and traumatized areas
(Levine et al).

• The application of makeup and molds to a human or simulator’s

limbs, chest, head, etc. to provide elements of realism (such as
blood, vomitus, open fractures, etc.) to the training simulation.

• Techniques used to simulate injury, disease, aging, and other

physical characteristics specific to a scenario; moulage supports
the sensory perceptions of participants and supports the fidelity
of the simulation scenario through the use of makeup, attachable
artifacts (e.g. penetrating objects), and smells (INACSL, 2013).

Multidisciplinary \ mʌltɪ \ di-sə-plə-ˌner-ē \ noun

Etym. discipline (n.) directly from Latin disciplina “instruction
given, teaching, learning, knowledge,” also “object of instruction,
knowledge, science, military discipline,” from discipulus. The Latin
word is glossed in Old English by þeodscipe. Meaning “branch of
instruction or education” is first recorded late 14c. Meaning “military
training” is from late 15c.; that of “orderly conduct as a result of
training” is from c. 1500.

Definition
• The combining of professionals with different perspectives to
provide a wider understanding of a particular problem (Bray &
Hawkins, 2008).

Compare: INTERPROFESSIONAL
See also: INTERDISCIPLINARY

*Multiple Modality (Multi-modal) Simulation

\ˈmʌltɪpl \ moʊˈdæləti \ sim-yuh-ley-shuh n \ noun

Etym. modality. 1610s, from Old French modalité or directly from

Medieval Latin modalitatem (nominative modalitas) “a being modal,”
from modalis. 1560s, term in logic, from Middle French modal and
directly from Medieval Latin modalis “of or pertaining to a mode,”
from Latin modus “measure, manner, mode.”

Etym. simulation (n.) noun of action from past participle stem of

simulare “imitate,” from stem of similis “like.” Meaning “a model or
mock-up for purposes of experiment or training” is from 1954.

Definition
• The use of multiple modalities of simulation in the same
simulation activity; differentiated from hybrid simulation in that it
is not characterized by the combining of one type of simulation to
enhance another, but rather the use of multiple types of simulation
in the same scenario or place, e.g., SP and manikin used in a
scenario or a task trainer paired with an SP for venipunture, etc.
(SSH).

32
N
Negative Learning \ ˈne-gə-tiv \ ˈlər-niŋ \ noun body part is operated on (Agency for Healthcare Research and
Quality [AHRQ], 2019; CMS, 2006).
Etym. (adj.) c. 1400, negatif, “expressing denial” (a sense now rare or
obsolete), from Anglo-French negatif(early 14c.), Old French negatif • The term has expanded to mean other serious and most often,
(13c.) and directly from Latin negativus “that which denies,” from preventable errors (AHRQ, 2019).
negat-, past-participle stem of negare “deny, say no” (see deny).
• In relation to simulation-based education, avoidance of such
Etym. (adj.) Old English leornung “study, action of acquiring errors is the basis for training and/or assessment.
knowledge,” verbal noun from leornian (see learn). Meaning
Consider also: ADVERSE EVENT, ERROR, NEAR MISS
“knowledge acquired by systematic study, extensive literary and
scientific culture” is from mid-14c. Learning curve attested by 1907.

Definition
Non-technical Skills \ non \ˈtek-ni-kəl \ skilz \ noun
• “When stress among students occurs, and when knowledge and
abilities are not properly developed” (Dormann, Demerouti, & Etym. techno word-forming element meaning “art, craft, skill,”
Bakker, 2017). later “technical, technology,” from Latinized form of Greek tekhno-,
combining form of tekhne “art, skill, craft in work; method, system,
• “The acquisition of erroneous conceptual and procedural an art, a system or method of making or doing.”
knowledge and understanding from unwarranted information,
which leads to faulty mental models and reasoning…” (Zlatkin- Etym. skill (n.) late 12c., “power of discernment,” from Old Norse
Troitschanskaia, & Brückner, 2017). skil “distinction, ability to make out, discernment, adjustment,”
related to skilja (v.) “to separate; discern, understand,” from Proto-
Compare to: TRAINING SCARS
Germanic *skaljo. Sense of “ability, cleverness” first recorded early
13c.

Definition
Never Event \ ˈne-vər \ i-ˈvent \ noun • In the healthcare field, the skills of communication, (patient-
Etym. never (adv.) “Middle English never, from Old English næfre provider, team) leadership, teamwork, situational awareness,
“not ever, at no time,” a compound of ne “not, no” (from PIE root decision-making, resource management, safe practice, adverse
*ne- “not”) + æfre “ever” (see ever). Early used as an emphatic event minimization/mitigation, and professionalism; also known
form of not (as still in never mind). Old English, unlike its modern as behavioral skills or teamwork skills (ASSH).
descendant, had the useful custom of attaching ne to words to create • Interpersonal skills that include: communication skills; leadership
their negatives, as in nabban for na habban “not to have.” “Italian skills; teamwork skills; decision-making skills; and situation-
giammai, French jamais, Spanish jamas are from Latin iam “already” awareness skills (Australian Radiation Protection and Nuclear
+ magis “more;” thus literally “at any time, ever,” originally with a Safety Agency, n.d.)
negative, but this has been so thoroughly absorbed in sense as to be
formally omitted.” • Social, cognitive and personal skills that can enhance the way you
or your staff carry out technical skills, tasks, and procedures. By
Etym. event (n.) “1570s, “the consequence of anything” (as in in
developing these skills, people in safety-critical roles can learn
the event that); 1580s, “that which happens;” from Middle French how to deal with a range of different situations (Rail Safety and
event, from Latin eventus “occurrence, accident, event, fortune, Standards Board, 2019).
fate, lot, issue,” from past participle stem of evenire “to come out,
happen, result,” from assimilated form of ex- “out” (see ex-) + venire • Non-technical skills are the cognitive (decision-making, situation
“to come,” from a suffixed form of PIE root *gwa- “to go, come.” awareness) and interpersonal (communication, teamwork,
“Meaning “a contest or single proceeding in a public sport” is from leadership) skills that underpin technical proficiency, and
1865. Events as “the course of events” is attested from 1842. Event are considered particularly important for preventing errors.
horizon in astrophysics is from 1969.” Non-technical skills include communication, leadership and
followership, decision-making, situation awareness, and task-
Definition
management (Pires et al., 2017).
• “A serious and costly” error “in the provision of healthcare Compare: BEHAVIORAL SKILLS
services that should never happen” (Centers for Medicare &
Medicaid Services [CMS], 2006); an example is when the wrong

33
O
Objective Structured Clinical Examination (OSCE) Operations Specialist
\ əb-ˈjek-tiv \ strək-chərd \ kli-ni-kəl \ ig-ˌza-mə-ˈnā-shən \ noun \ op-uh-rey-shuh nz \ spesh-uh-list \ noun

Etym. objective (n.) 1738, “something objective to the mind,” from Etym. operation (n.) late 14c., “action, performance, work,” also
objective (adj.). Meaning “goal, aim” (1881) is from military term “the performance of some science or art,” from Old French operacion
objective point (1852), reflecting a sense evolution in French. “operation, working, proceedings,” from Latin operationem
(nominative operatio) “a working, operation,” from past participle
Etym. structured (adj.) 1810, past-participle adjective from structure
stem of operari “to work, labor.” Military sense of “series of
(v.). Meaning “organized so as to produce results” is from 1959.
movements and acts” is from 1749.
Etym. clinical (adj.) 1780, “pertaining to hospital patients or hospital
care,” from clinic + -al. Etym. specialty (n.) From early 15c. as unusual, or extraordinary
thing; specialized branch of learning; peculiar quality, distinctive
Etym. examination (n.) late 14c., “action of testing or judging;
characteristic.
judicial inquiry,” from Old French examinacion, from Latin
examinationem (nominative examinatio), noun of action from past- Definition
participle stem of examinare “to weigh; to ponder, consider” (see
examine). Sense of “test of knowledge” is attested from 1610s. • An individual whose primary role is the implementation and
delivery of a simulation activity through the application of
Definition simulation technologies such as, computers, audio-visual (AV), or
• An approach to the assessment of clinical or professional networking technologies.
competence in which the components of competence are assessed
• An inclusive “umbrella” term that embodies many different roles
in a planned or structured way with attention being paid to the
within health care simulation operations, including simulation
objectivity of the examination (Harden, 1988).
technician, simulation technology specialist, simulation specialist,
• A station or series of stations designed to assess performance simulation coordinator, and simulation AV specialist. While many
competency in individual clinical or other professional skills. of these individuals also design simulation activities, this term
Learners are evaluated via direct observation, checklists, learner refers to the functional role related to the implementation of the
presentation, or written follow-up exercises. The examinations simulation activities (SSH).
may be formative and offer feedback or summative and be used
See also: SIMULATIONIST, SIMULATION TECHNOLOGY SPECIALIST
for making high stakes educational decisions (Lewis et al, 2017).

• A method of assessment where learners perform specific skills

and behaviors in a simulated work environment.
Orientation \ȯr-ē-ən-ˈtā-shən,-ˌen- \ noun
Etym. (n.) 1839, originally “arrangement of a building, etc., to face
east or any other specified direction,” noun of action from orient
Online Simulation on-lahyn \ sim-yuh-ley-shx n \noun (v.). Sense of “action of determining one’s bearings” is from 1868.
Etym. online (adj.) also on-line, in reference to computers, “directly Meaning “introduction to a situation” is from 1942.
connected to a peripheral device,” 1950; see on+ line (n.).
Definition
Etym. simulation (n.) noun of action from past participle stem of • The process of giving participants information prior to a
simulare “imitate,” from stem of similis “like”. Meaning “a model or simulation event to familiarize them with a simulation activity or
mock-up for purposes of experiment or training” is from 1954. environment, such as center rules, timing, and how the simulation
modalities work, with the intent of preparing the participants.
Defnition
• An activity that occurs prior to a simulation activity in order
• Interactive simulation experience offered through an online to prepare the faculty/instructors or learners; for example, a
platform that connects participants with other learners in a virtual PowerPoint presentation that all participants must review to
world to complete assessment, diagnosis, and treatment tasks for understand how the center operates, or how the activity is being
virtual patients (Dikshit et al., 2005; Duff et al., 2016).  conducted.
• Online, often multiplayer, simulation exercises involving care for See also: BRIEF/BRIEFING, PREBRIEF/PREBRIEFING
a single patient or multiple patients. Often utilizes gamification
concepts to engage and incentivize learners (Evans et al., 2015;
Kusumoto et al., 2007).

34
P
Participant \ pahr-tis-uh-puh nt \ noun Physical Examination Teaching Associates (PETAs
or PTAs)
Etym. 1560s, from Middle French participant, from Latin \ ˈfi-zi-kəl \ ig-ˌza-mə-ˈnā-shən \ ˈtē-chiŋ \ ə-ˈsō-shē-ˌāt-sē- \ noun
participantem (nominative participans), present participle of
participare “to share in, partake of” from particeps “sharing, Etym. physical (n.) (adj.)
partaking.” n. ““a physical examination,” by 1934, from physical (adj.).””
adj. “early 15c., “of or pertaining to material nature” (in medicine,
Definition opposed to surgical), from Medieval Latin physicalis “of nature,
• In health care simulation, a person who engages in a simulation natural,” from Latin physica “study of nature” (see physic). Meaning
activity for the purpose of gaining or demonstrating mastery “pertaining to matter” is from 1590s; meaning “having to do with
of knowledge, skills, and/or attitudes of professional practice the body, corporeal” is attested from 1780. Meaning “characterized
(INACSL, 2013). by bodily attributes or activities” is attested from 1970. Physical
education first recorded 1838; abbreviated form phys ed is from 1955.
• A person engaged in a simulation activity or event and for those Physical therapy is from 1922. Related: Physically
involved in simulation research.
Etym. examination (n.) “late 14c., “action of testing or judging;
judicial inquiry,” from Old French examinacion, from Latin
examinationem (nominative examinatio), noun of action from past-
Patient Simulator \ pey-shuh nt \ sim-yuh-ley-ter \ noun participle stem of examinare “to weigh; to ponder, consider” (see
examine). Sense of “test of knowledge” is attested from 1610s.”
Etym. patient (n.) “suffering or sick person under medical
treatment,” late 14c. Etym. teaching (n.) “Old English tecunge “act of teaching,” verbal
noun from teach (v.). As “that which is taught” from c. 1300.”
Etym. simulator (n.) 1835, of persons, from Latin simulator “a
copier, feigner,” agent noun from simulare “imitate,” from stem of Etym. associates (n.) associate “1530s, “a partner in interest or
similis “like”. In reference to training devices for complex systems, business,” from associate (adj.). Meaning “one admitted to a
from 1947 (flight simulator). simulated (adj.) 1620s, “feigned,” subordinate degree of membership” is from 1812.”
past participle adjective from simulate (v.). Meaning “imitative
for purposes of experiment or training” is from 1966 (agent noun Definition
simulator in the related sense dates from 1947. In commercial jargon,
“artificial, imitation” by 1942. • Standardized patients who are specifically trained to teach, assess,
and provide feedback to learners about physical examination
Definition techniques. They also address the communication skills needed
to provide a comfortable exam in a standardized manner, while
• Life-like, anatomically correct, computer-driven manikin with using their bodies to instruct in a supportive, non-threatening
physiologic responses that mimic real patients (Ober, 2009). environment (Lewis et al, 2017).
• High- or low-fidelity full-body manikins controlled by instructors • An individual who is trained to teach and provide feedback on
to create a structured learning environment in a clinically realistic basic physical exam techniques and process; serves as coach
setting where learning can take precedence over patient care and as a model (is the instructor and patient) (The John Hopkins
(Good, 2003). University, 2019).
• Ed note: while these definitions are manikin-oriented, the reader • The person may also serve in the role as evaluator and is
should consider other simulators as meeting the concepts of these considered under the larger category of simulated participants
definitions. (Lewis et al., 2017).
See also: MANIKIN, SIMULATOR • Also referred to at some institutions as PTA (Physical Training
Assistants) or PI (Patient Instructors) (East Carolina University,
2019).

35
Physical Fidelity \ˈfi-zi-kəl\ fə-ˈde-lə-tē, fī-\ noun Pilot Test \ ˈpī-lət \ ‘test\ verb
Etym. physical early 15c., “of or pertaining to material nature” (in Etym. pilot (v.) 1640s, “to guide, lead;” 1690s, “to conduct as a
medicine, opposed to surgical), from Medieval Latin physicalis “of pilot,” from pilot (n.) or from French piloter.
nature, natural,” from Latin physica “study of nature” (see physic).
Meaning “pertaining to matter” is from 1590s; meaning “having Etym. test (v.) 1748, “to examine the correctness of,” from test (n.),
to do with the body, corporeal” is attested from 1780. Meaning on the notion of “put to the proof.” Earlier “assay gold or silver” in a
“characterized by bodily attributes or activities” is attested from test (c. 1600). Meaning “to administer a test” is from 1939; sense of
1970. Physical education first recorded 1838; abbreviated form phys “undergo a test” is from 1934.
ed is from 1955. Physical therapy is from 1922. Related: Physically.
Definition
Etym. fidelity early 15c., “faithfulness, devotion,” from Middle
• A small-scale, short-term effort designed to provide data about
French fidélité (15c.), from Latin fidelitatem (nominative fidelitas)
the feasibility of a simulation prior to large-scale implementation.
“faithfulness, adherence, trustiness,” from fidelis “faithful, true,
trusty, sincere,” from fides “faith” (see faith). From 1530s as “faithful • Trial of simulation operations, scenarios, procedures, and
adherence to truth or reality;” specifically of sound reproduction teaching methods on a smaller scale to determine acceptability,
from 1878. identify feasibility concerns, and refine processes prior to full
implementation.
Definition
• A level of realism associated with a particular simulation activity. • A phase that includes review of the scenario to gain “clarification
from experts and participants” (Rizzolo, 2014, p .114).
• The degree to which the simulation looks, sounds, and feels like
the actual task (Alexander, Brunyé, Sidman, & Weil, 2005). • Explores the feasibility of the proposed application pertaining
to such things as: recruitment, methods, and procedures (Leon,
See also: ENVIRONMENTAL FIDELITY, FIDELITY, REALISM Davis, & Kraemer, 2010).

• An assessment of the feasibility and acceptability of the proposed

design and procedure (Feeley et al, 2009).
Physiologic Modeling \ fiz-ee-uh-loj-i-k \ mod-l-ing \ noun
See also: ALPHA and BETA TESTING, DRY RUN
Etym. physiology (n.) 1560s, “study and description of natural Consider also: DRESS REHEARSAL, RUN THROUGH, SIMULATION
objects,” from Middle French physiologie or directly from Latin VALIDATION, WALK THROUGH
physiologia “natural science, study of nature,” from Greek
physiologia “natural science, inquiry into nature,” from physio-
“nature” + logia “study.” Meaning “science of the normal function
of living things” is attested from 1610s. Related: Physiologic; Portable Simulator \pawr-tuh-buh l \ sim-yuh-ley-ter \ noun
physiologist.
Etym. portable (adj.) Early 15c., from French portable “that can be
Etym model. Sense of “thing or person to be imitated” is 1630s. carried,” from Late Latin portabilis “that can be carried,” from Latin
portare “to carry.” Related: Portability.
Definition
• The mathematical computer models governing complex human Etym. simulator (n.) 1835, of persons, from Latin simulator “a
physiology in a simulated patient case so that reasonable copier, feigner,” agent noun from simulare “imitate,” from stem of
responses occur automatically to events inputted into the similis “like.” In reference to training devices for complex systems,
program. For example: a pharmacodynamic model could predict from 1947 (flight simulator); simulated (adj.) 1620s, “feigned,”
effects of drugs on heart rate, cardiac output, or blood pressure past participle adjective from simulate (v.). Meaning “imitative
and display them on a simulated clinical monitor. (Howard for purposes of experiment or training” is from 1966 (agent noun
Schwid, Rosen, 2013). simulator in the related sense dates from 1947). In commercial
jargon, “artificial, imitation” by 1942.
• A computer model that allows for a method of operation in
which an operator inputs a value to a given parameter, and it Definition
automatically adjusts the other variables in a physiologically • A simulator that has the capabilities of being moved, and may
realistic manner (Palaganas, Maxworthy, Epps, and Mancini, also be able to operate independently of tethers such as power
2015). cords or communication cables.
Compare: MANUAL INPUT, PREPACKAGED SCENARIO, See also: MOBILE SIMULATOR
“RUNNING ON THE FLY”

36
*Prebrief (Prebriefing) \ pri’brēf \ noun (\priˈbrē-fiŋ\ verb ) • A simulation that incorporates cognitive knowledge and technical
skill into a precise sequence of actions that are safe and efficient,
Etym. brief “fact or situation of giving preliminary instructions,” targeting any level of learner (Palaganas, Maxworthy, Epps, &
1910 (but popularized by World War II pre-flight conferences). Mancini, 2015).

Definition Compare: PROCESS-ORIENTED SIMULATION

• An information or orientation session held prior to the start
of a simulation activity in which instructions or preparatory
information is given to the participants. The purpose of the
prebriefing is to set the stage for a scenario, and assist participants Process-Oriented Simulation \ pros-es \ awr-ee-uh nt-id \
in achieving scenario objectives. sim-yuh-ley-shuh n \ noun

• The time used by educators, researchers, facilitators, or staff to Etym. simulation (n.) noun of action from past participle stem of
plan their roles prior to the simulation. Suggested activities in a simulare “imitate,” from stem of similis “like.” Meaning “a model or
prebriefing include an orientation to the equipment, environment, mock-up for purposes of experiment or training” is from 1954.
manikin, roles, time allotment, objectives, and patient situation.
Definition
For example: Before starting the simulation session, there is a
prebriefing where the equipment and its capabilities are reviewed • A simulation in which the process is considered more important
and they are reminded of the equipment available to them in the than the outcome. For example, a model of a radar system in
room (INACSL, 2013). which the objective is to replicate exactly the radar’s operation,
and duplication of its results is a lesser concern (M&S Glossary).
• The collaboration and planning of co-facilitators/co-debriefers
prior to the simulation activity. • In health care, the use of simulation to examine the process
of care rather than the outcome of care. For example: using
See also: BACK STORY, BRIEF/BRIEFING, ORIENTATION simulation to re-create an emergency in a patient area to see
what latent safety threats exist, such as poor availability of
patient equipment, inadequate emergency call buttons, or unsafe
Prepackaged / Preprogrammed Scenario \ pree - pak- obstacles.
ijd \ si-nair-ee-oh \ noun
Compare: PROCEDURAL SIMULATION
Etym. scenario (n.) 1868, “sketch of the plot of a play,” from Italian
scenario, from Late Latin scenarius “of stage scenes,” from Latin
scena “scene.” Meaning “imagined situation” is first recorded 1960,
in reference to hypothetical nuclear wars. Prompt \ präm(p)t \ noun
Definition Etym: (n.) mid-14c., prompten, from Latin promptus, past participle
• A method of operation in which the simulator is programmed to of promere “to bring forth,” from pro”forward” (from PIE root
be in one state and to respond to an input and transition to another *per- (1) “forward”) + emere “to take” (from PIE root *em- “to take,
state based on a script or algorithm. distribute”). Theatrical sense of “to assist a speaker with lines” is first
recorded early 15c. Related: Prompted; prompting.
• A scenario where a script will assign initial values (such as heart
rate, blood pressure, emotional state, or concern) at the start of Definition
the scenario that will require specific actions by the participant or
• (noun) A cue given to a participant in a scenario (Meakim et al
certain time frames, for the scenario to transition to the next state
2013).
(Palaganas, Maxworthy, Epps, and Mancini, 2015).

Compare: MANUAL INPUT, PHYSIOLOGIC MODELING, “RUNNING ON • (noun) A word or phrase spoken as a reminder to an actor of a
THE FLY” forgotten word or line (Dictionary.com).

• (verb) (of an event or fact) cause or bring about (an action or

feeling) (Dictionary.com).
Procedural Simulation
\ pruh-see-jer-uh l \ sim-yuh-ley-shuh n \ noun • (verb) Assist or encourage (a hesitating speaker) to say something
(Dictionary.com).
Etym. simulation (n.) noun of action from past participle stem of
simulare “imitate,” from stem of similis “like.” Meaning “a model or See also: CUE/CUEING
mock-up for purposes of experiment or training” is from 1954.

Definition
• The use of a simulation modality (for example, task trainer,
manikin, computer) to assist in the process of learning to
complete a technical skill(s), or a procedure, which is a series of
steps taken to accomplish an end (INACSL).

37
Prop \ prop \ noun Etym. risk (n.) “1660s, risque, from French risque (16c.), from Italian
risco, riscio (modern rischio), from riscare “run into danger,” of
Etym. prop (n.) “object used in a play,” 1898, from props (1841), uncertain origin. The Englished spelling first recorded 1728. Spanish
shortened form of properties (which was in theatrical use from early riesgo and German Risiko are Italian loan-words. With run (v.) from
15c.). 1660s. Risk aversion is recorded from 1942; risk factor from 1906;
risk management from 1963; risk taker from 1892.”
Definition
• In simulation, an element or accessory used in a given scenario to Definition
enhance realism, or to provide a cue to learners. • A perceived or actual feeling of mental threat as a result of
• A physical object used as an interface to a virtual world; a prop participation in a simulation which can mean feeling unsafe.
may be embodied by a virtual object and might have physical Examples include feelings of shame or humiliation (Rudolph et
controllers mounted on it (Australian Department of Defense). al., 2014).

Compare: PSYCHOLOGICAL SAFETY

Psychological Fidelity
\ sahy-kuh-loj-i-kuh l \ fə-ˈde-lə-tē \ noun Psychological Safety \ sahy-kuh-loj-i-kuh l \ seyf-tee \ noun
Etym. psychology (n.) 1650s, “study of the soul,” from Modern Latin Etym. psychology (n.) 1650s, “study of the soul,” from Modern Latin
psychologia, probably coined mid-16c. in Germany by Melanchthon psychologia, probably coined mid-16c. in Germany by Melanchthon
from Latinized form of Greek psykhe- “breath, spirit, soul” + logia from Latinized form of Greek psykhe- “breath, spirit, soul” + logia
“study of.” Meaning “study of the mind” first recorded 1748, from “study of.” Meaning “study of the mind” first recorded 1748, from
Christian Wolff’s “Psychologia empirica” (1732); main modern Christian Wolff’s “Psychologia empirica” (1732); main modern
behavioral sense is from early 1890s. behavioral sense is from early 1890s.
Etym. fidelity (n.) early 15c., “faithfulness, devotion,” from Middle Etym. safety (n.) early 14c., from Old French sauvete “safety,
French fidélité (15c.), from Latin fidelitatem (nominative fidelitas) safeguard; salvation; security, surety,” earlier salvetet (11c., Modern
“faithfulness, adherence, trustiness,” from fidelis “faithful, true, French sauveté), from Medieval Latin salvitatem (nominative
trusty, sincere,” from fides “faith.” From 1530s as “faithful adherence salvitas) “safety,” from Latin salvus.
to truth or reality;” specifically of sound reproduction from 1878.
Definition
Definition
• A feeling (explicit or implicit) within a simulation-based activity
• A level of realism associated with a particular simulation activity. that participants are comfortable participating, speaking up,
sharing thoughts, and asking for help as needed without concern
• The extent to which the simulated environment evokes the
for retribution or embarrassment.
underlying psychological processes necessary in the real-world
setting (Dieckmann et al., 2008). • The perception of members of the team that the team is safe
for risk taking, and mistakes will be considered learning
• The degree of perceived realism, including psychological factors
opportunities rather than there being embarrassment or punitive
such as emotions, beliefs, and self-awareness of participants in
consequences (Edmondson, 1999; Higgins et al, 2012).
simulation scenarios (Dieckmann et al., 2008).
See also: SAFE LEARNING ENVIRONMENT, SIMULATION
See also: FIDELITY, REALISM
ENVIRONMENT
Compare: PSYCHOLOGICAL RISK

Psychological Risk \ sahy-kuh-loj-i-kuh l \ ‘risk \ noun

Etym. psychological (adj.) “1680s; see psychology + -ical. Related:
Psychologically. Psychological warfare recorded from 1940.
Psychological moment was in vogue from 1871, from French moment
psychologique “moment of immediate expectation of something
about to happen.””
“The original German phrase, misinterpreted by the French &
imported together with its false sense into English, meant the psychic
factor, the mental effect, the influence exerted by a state of mind, &
not a point of time at all, das Moment in German corresponding to
our momentum, not our moment. [Fowler]”

38
R
Realism \ rēəˌlizəm \ noun • The conscious consideration of the meanings and implications
of the events of the simulation; this process allows participants
Note: this term often used synonymously with fidelity but not all agree these
to make meaning out of the experience, to identify questions
are the same
generated by the experience, and ultimately, to assimilate the
Etym. realism (n.) 1794, from real (adj.) + -ism; after French knowledge, skills, and attitudes uncovered through the experience
réalisme or German Realismus; from Late Latin realis “real.” with pre-existing knowledge.
Meaning “close resemblance to the scene” (in art, literature, etc.,
• A process to assist learners in identifying their knowledge gaps
often with reference to unpleasant details) is attested from 1856.
and demonstrating the areas in which they may need further
Definition improvement; this reflection requires conscious self-evaluation to
deal with unique patient situations (INACSL, 2013).
• The ability to impart the suspension of disbelief to the learner by
creating an environment that mimics that of the learner’s work See also: GUIDED REFLECTION
environment; realism includes the environment, simulated patient,
and activities of the educators, assessors, and/or facilitators
(SSH).
Reliability \ ri-lahy-uh-bil-i-tee \ noun
• A statement about the similarity of something (a ‘copy’) to
See: SIMULATION RELIABILITY
something else (the ‘original’) (Dieckmann, Gaba, & Rall, 2007).

• The quality or fact of representing a person, thing, or situation

accurately in a way true to life; this enables participants to act “as
if” the situation or problem was real.
Remote Simulation \ ri-moht \ sim-yuh-ley-shuh n \ noun
Etym. remote (adj.) mid-15c., from Middle French remot or directly
• Refers to the physical characteristics of the activity, semantical
from Latin remotus “afar off, remote, distant in place,” past participle
aspects of the activity (theories and conceptual relations – if A
of removere “move back or away, take away, put out of view,
happens then B occurs), and/or the phenomenal aspects of the
subtract,” from re- “back, away” (see re-) + movere “to move” (from
activity (emotions, beliefs, and thoughts experienced).
PIE root *meue- “to push away”)
See also: FIDELITY, FUNCTIONAL FIDELITY, HIGH FIDELITY
SIMULATION, HIGH FIDELITY SIMULATOR, IMMERSIVE SIMULATION, Etym. simulation (n.) noun of action from past participle stem of
PHYSICAL FIDELITY, PSYCHOLOGICAL FIDELITY, SIMULATION simulare “imitate,” from stem of similis “like”. Meaning “a model or
FIDELITY mock-up for purposes of experiment or training” is from 1954.

Definition

Reflective Thinking \ ri-flek-tiv \ thing-king \ noun • Simulation performed with either the facilitator, learners, or both
in an offsite location separate from other members to complete
Etym. reflection (n.) Of the mind, from 1670s. Meaning “remark educational or assessment activities (Laurent et al., 2014; Shao
made after turning back one’s thought on some subject” is from et al., 2018). Facilitation and assessment can be performed
1640s. either synchronously or asynchronously using video or web
conferencing tools. 
Definition
Compare: DISTANCE SIMULATION, TELESIMULATION
• The engagement of self-monitoring that occurs during or after
a simulation experience; this self-monitoring is performed by
participants during or after a simulation experience.

• A process to assist learners in identifying their knowledge gaps

and demonstrating the areas in which they may need further
improvement; it requires active involvement in the simulation and
facilitator guidance to aid in this process (Rodgers, 2002; Decker
et al., 2008; Kuiper & Pesut, 2004).

39
Remote-controlled Simulation (also Remote-facilitated Role Player \ rohl-pley- r \ noun
simulation) \ ri-moht \ kuh n-trohld \ sim-yuh-ley-shuh n \ noun
Etym. role (n.) “part or character one takes,” c. 1600, from French
Etym. remote (adj.) mid-15c., from Middle French remot or directly rôle “part played by a person in life,” literally “roll (of paper) on
from Latin remotus “afar off, remote, distant in place,” past participle which an actor’s part is written,” from Old French rolle.
of removere “move back or away, take away, put out of view,
subtract,” from re- “back, away” (see re-) + movere “to move” (from Etym. player (n.) Old English plegere, agent noun from play (v.).
PIE root *meue- “to push away”) Stage sense is from mid-15c.

Etym. controlled (adj.) “held in check, restrained,” 1580s, past- Definition

participle adjective from control (v.). Of rent, from 1930. • One who assumes the attitudes, actions, and discourse of
(another), especially in a make-believe situation, in an effort
Etym. simulation (n.) noun of action from past participle stem of
to understand a differing point of view or social interaction.
simulare “imitate,” from stem of similis “like”. Meaning “a model or For example: Nursing students were given a chance to role
mock-up for purposes of experiment or training” is from 1954. play a patient or a surgeon. This term is sometimes used
Definition interchangeably with the terms ‘simulated’ and ‘standardized
patient’ and may include medical, nursing, or other health
• Simulation sessions conducted by an instructor who is in a professionals. (Victorian Simulated Patient Network).
location separate from the learners for a given session. The
See also: ACTOR, EMBEDDED PARTICIPANT, SIMULATED PATIENT,
remote facilitator introduces the simulation environment and
SIMULATED PERSON, STANDARDIZED PATIENT.
session, runs scenarios and debriefs with (Ohta et al., 2017) or
without an onsite facilitator (Ikeyama et al., 2012; Shao et al.,
2018). 
“Running on the Fly” \ ruhn-ing \ on \ th uh \ flahy \ noun
• A simulation-based session where mannequins are operated by
remote control and instructors facilitate in real time via Web Definition
or videoconferencing, as an alternative method to face-to-face
simulation-based training (Christensen et al., 2015).  • The method of operation for running a simulation whereby the
operator changes the parameters of the scene, the standardized
patient, or the simulator as the scenario unfolds; the changes are
dependent on the observations and knowledge of the instructor or
Risk Management \ ‘risk \ ˈma-nij-mənt \ noun the operator, which is based on the actions of the participant.

Etym. risk (n.) 1660s, risque, from French risque (16c.), from Italian • Running a simulation with minimal planning and preparation; a
risco, riscio (modern rischio), from riscare “run into danger,” of more impromptu type of simulation experience.
uncertain origin. The Englished spelling first recorded 1728. Spanish
Compare to: MANUAL INPUT, PHYSIOLOGIC MODELING,
riesgo and German Risiko are Italian loan-words. With run (v.) from
PREPACKAGE SCENARIO
1660s. Risk aversion is recorded from 1942; risk factor from 1906;
risk management from 1963; risk taker from 1892.

Etym. management (n.) 1590s, “act of managing by direction or

manipulation,” from manage + -ment. Sense of “act of man aging by
physical manipulation” is from 1670s. Meaning “governing body,
directors of an undertaking collectively” (originally of a theater) is
from 1739.

Definition

• “Proactive management of risk” that increases the rate of

successful implementation. (Zakari et al, 2017).

• Managing factors that can result in success or loss within a

project. (Sonchan & Ramingwong, 2015).

40
S
Safe Learning Environment Screen - based Simulation /
\ˈsāf\ \ˈlərn\ng\ en·vi·ron·ment \in-ˈvī-rə(n)-mənt \ noun Screen - based Simulator
\ skreen \ bāst \ sim-yuh-ley-shuh n \ noun
Etym. safe (adj.) not able or likely to be hurt or harmed in any way;
not in danger. Etym. screen (n.) Meaning “flat vertical surface for reception of
projected images” is from 1810, originally in reference to magic
Etym. environment (n.) the conditions that surround someone or lantern shows; later of movies. Related screenshot (n.) by 1991, from
something; the conditions and influences that affect the growth, (computer) screen (n.) + shot (n.) in the photograph sense.
health, progress, etc., of someone or something.
Etym. simulation (n.) noun of action from past participle stem of
Definition simulare “imitate,” from stem of similis “like.” Meaning “a model or
• A learning environment where it is clarified that learners feel mock-up for purposes of experiment or training” is from 1954.
physically and psychologically safe to make decisions, take
Etym. simulator (n.) 1835, of persons, from Latin simulator “a
actions, and interact in the simulation.
copier, feigner,” agent noun from simulare “imitate,” from stem of
• A learning environment of mutual respect, support, and respectful similis “like.” In reference to training devices for complex systems,
communication among leaders and learners; open communication from 1947 (flight simulator); simulated (adj.) 1620s, “feigned,”
and mutual respect for thought and action encouraged and past participle adjective from simulate (v.). Meaning “imitative
practiced. for purposes of experiment or training” is from 1966 (agent noun
simulator in the related sense dates from 1947). In commercial
See also: PSYCHOLOGICAL SAFETY jargon, “artificial, imitation” by 1942.

Definition
• A simulation presented on a computer screen using graphical
Scenario \si-nair-ee-oh \ noun images and text, similar to popular gaming format, where the
operator interacts with the interface using keyboard, mouse,
Etym. (n.) 1868, “sketch of the plot of a play,” from Italian scenario,
joystick, or other input device.
from Late Latin scenarius “of stage scenes,” from Latin scena
“scene.” Meaning “imagined situation” is first recorded 1960, in • The programs can provide feedback to, and track actions of
reference to hypothetical nuclear wars. learners for assessment, eliminating the need for an instructor
(Ventre & Schwid, in Levine Chapter 14).
Definition
• In healthcare simulation, a description of a simulation that • A computer-generated video game simulator that can create
includes the goals, objectives, debriefing points, narrative scenarios that require real-time decisionmaking (Bonnetain,
description of the clinical simulation, staff requirements, Biese, et al., 2009).
simulation room set up, simulators, props, simulator operation,
See also: COMPUTER-BASED SIMULATION, SIMULATOR
and instructions for standardized patients (Alinier, 2011).

• The scripts, stories, or algorithms created for instructing the

participants, including the simulators (human or robotic), on how
to interact with the students. Scribe / Scribing \ˈskrīb\ noun / verb \’skribiNG\
• The description of an exercise (including initial conditions) of Etym. special use of Latin scriba “keeper of accounts, secretary,
events for a simulation that includes details for everyone taking writer,” from past participle stem of scribere “to write.” Sense “one
part. who writes, official or public writer” in English is from late 14c.

• An initial set of conditions and timeline of significant events Definition

imposed on trainees or systems to achieve exercise objectives • The act of making notes about a scenario and documenting the
(M&S Glossary). actions taken or not taken.
See also: CLINICAL SCENARIO, SCRIPT SIMULATED-BASED LEARNING
EXPERIENCE, SIMULATION ACTIVITY

41
Script \ skript \ noun Serious Games \ seer-ee-uh s \ geymz \ noun
Etym. (n.) late 14c., “something written.” Meaning “handwriting” is Etym. serious (adj.) mid-15c., “expressing earnest purpose or
recorded from 1860. Theatrical use, short for manuscript, is attested thought” (of persons), from Middle French sérieux “grave, earnest”
from 1884. (14c.), from Late Latin seriosus, from Latin serius “weighty,
important, grave.” Gothic…..”honored, esteemed,” literally
Definition “weighty.” Meaning “attended with danger” is from 1800.
• The written plan for a simulation event that includes various
Etym. games (n.) 1200, from Old English gamen “joy, fun; game,
sets of topics, subtopics, skills, and triggers that will create
amusement,” “participation, communion.” “contest for success or
the situation to induce the desired observable behaviors by the
superiority played according to rules” is first attested c. 1200 (of
participant(s).
athletic contests, chess, backgammon).
• A preordained series of actions based on the time and sequence of
Definition
specific events.
• A mental contest played with a computer in accordance with
• A written set of instructions providing a detailed plan of action specific rules, which uses entertainment to further training,
for a simulation case; similar to a theatrical play. education, health, public policy, and strategic communication
objectives (Zyda, 2005).
• The lines to be spoken by operators, embedded actors, or
simulated patients during a simulation event. • A game designed for a primary purpose other than pure
entertainment. Serious games have an explicit and carefully
• A computer script is a list of commands that are executed by
thought out educational purpose, and are not intended to be
a certain program or scripting engine. Scripts may be used to
played primarily for amusement (Michael and Chen, 2006).
automate processes on a local computer or to generate web pages
Serious games are simulations of real-world events, or processes
on the Web. (https://techterms.com/definition/script)
designed for the purpose of solving a problem.
See also: CLINICAL SCENARIO, SCENARIO SIMULATED-BASED
LEARNING EXPERIENCE, SIMULATION ACTIVITY • In the defense context, serious games are used to rehearse, train,
or explore military options in a simulation of real-world events or
processes (Australian Dept. of Defense).

• The “serious” adjective is generally appended to refer to products

Sequential Simulation used by industries like defense, education, scientific exploration,
\ si-ˈkwen(t)-shəl \ sim-yuh-ley-shuh n \ noun healthcare, emergency management, city planning, engineering,
religion, and politics.
Etym. sequential (adj.) “1816, from Late Latin sequentia (see
sequence) + -al (1). Related: Sequentially.” See also: GAMEIFICATION, SIMULATOR

Etym. simulation (n.) noun of action from past participle stem of

simulare “imitate,” from stem of similis “like”. Meaning “a model or
mock-up for purposes of experiment or training” is from 1954.
Shared Mental Model \ shaird \ men-tl] \ mod-l] \ noun
Definition
Etym. share (n.) (v.) 1580s, “to apportion to someone as his share; to
• A concept defined as “physically simulated trajectories of apportion out to others; to enjoy or suffer (something) with others,”
care” (Weldon, Kneebone, & Bello, 2016, p. 78); in this type from share. Meaning “to divide one’s own and give part to others” is
of simulation, “elements of a patient’s care pathway” are recorded from 1590s. Related: Shared, sharer, sharing
incorporated “into a scenario-based simulation using real
Etym. mental (adj.) early 15c., “pertaining to the mind,” from Middle
clinicians and simulated patients in order to create a simulated
experience from a patient’s perspective” (Weldon, Kneebone, & French mental, from Late Latin mentalis “of the mind,” from Latin
Bello, 2016, p. 78-79). mens (genitive mentis) “mind;” cognates: Sanskrit matih “thought,
mind;” Old English gemynd “memory, remembrance.”
• Where the different components of care are re-created; may
Etym. model. Sense of “thing or person to be imitated” is 1630s.
include transitions of time and different scenes (Weil et al, 2018).
The focus is on the patient’s journey and the effect of the care on Definition
the patient (Weil et al, 2018).
• A means of describing that each participant in a simulation has a
Compare: DISCRETE SIMULATION, DURATIONAL SIMULATION shared understanding of the purpose and process of the simulation
activity and participants’ roles.

• The knowledge framework of the relationships between the task

the team is engaged in and how the team members will interact.
For example: this framework facilitates a team’s ability to predict
what team members will do when faced with a task, and what they
will need to do it.

42
 • A framework whereby an individual team member develops Definition
a perception of the situation, it is shared, allowing the team to • A person who has been carefully coached to simulate an actual
reflect on the information and revise their situational awareness patient so accurately that the simulation cannot be detected by a
and their own mental model based on new information. For skilled clinician. In performing the simulation, the SP presents
example: Sharing can be done by vocalizing observations, calling the gestalt of the patient being simulated; not just the history,
out information, using a structured time-out to communicate but the body language, the physical findings, and the emotional
new information, and thinking out loud to allow others to relate and personality characteristics as well (Barrows, 1987). Often
and appreciate the associations, assessments, and plans. Shared used interchangeably with standardized patients in the USA and
mental models facilitate collaboration, and are crucial when Canada, but in other countries simulated patient is considered a
team communication in a situation is difficult (due to time broader term than standardized patient, because the simulated
pressure, etc.). patient scenario can be designed to vary the SP role in order to
Compare: SITUATIONAL AWARENESS meet the needs of the learner.

• An individual who is trained to portray a real patient in order

to simulate a set of symptoms or problems used for health care
education, evaluation, and research (Society for Simulaton in
Simulated-Based Learning Experience Healthcare).
\ sim-yuh-leyt –id \ bāst \ lur-ning \ ik-speer-ee-uh ns \ noun
• SPs can be used for teaching and assessment of learners,
Etym. simulated (adj.) 1620s, “feigned,” past participle adjective including but not limited to history/consultation, physical
from simulate (v.). Meaning “imitative for purposes of experiment or examination, and other clinical skills in simulated clinical
training” is from 1966; commercial jargon, “artificial, imitation” by environments. SPs can also be used to give feedback and
1942. evaluate learner performance (Lewis et al, 2017).
Etym. learning (n.) Old English leornung “learning, study,” from See also: ACTOR, EMBEDDED PARTICIPANT, ROLE PLAYER,
leornian. Learning curve attested by 1907. SIMULATED PERSON, STANDARDIZED PATIENT.

Etym. experience (v.) 1530s, “to test, try, learn by practical trial or
proof;” (n.). Sense of “feel, undergo” first recorded 1580s. Related:
Experienced; experiences; experiencing.
Simulated Person \ sim-yuh-leyt -id \ pur-suh n \ noun
Etym. experience (n.) late 14c., “observation as the source of
Etym. simulated (adj.) 1620s, “feigned,” past participle adjective
knowledge; actual observation; an event which has affected one,”
from simulate (v.). Meaning “imitative for purposes of experiment or
from Old French esperience “experiment, proof, experience” (13c.),
training” is from 1966; commercial jargon, “artificial, imitation” by
from Latin experientia “a trial, proof, experiment; knowledge gained
1942.
by repeated trials;” Meaning “state of having done something and
gotten handy at it” is from late 15c. Definition
Definition • A person who portrays a patient (simulated patient), family
member, or health care provider in order to meet the objectives
• An array of structured activities that represent actual or potential
of the simulation; a simulated person may also be referred to as a
situations in education and practice. These activities allow
standardized patient/family/health care provider if they have been
participants to develop or enhance their knowledge, skills, and
formally trained to act as real patients in order to simulate a set of
attitudes, or to analyze and respond to realistic situations in a
simulated environment. (Pilcher, Goodall, Jensen, et al., 2012). symptoms or problems used for health care education, evaluation,
and research. Simulated persons often engage in assessment by
See also: CLINICAL SCENARIO, SCENARIO, SIMULATION ACTIVITY providing feedback to the learner (Palaganas, et al., 2012).

See also: EMBEDDED PARTICIPANT, ROLE PLAYER, SIMULATED

PATIENT, STANDARDIZED PATIENT, STANDARDIZED/SIMULATED
PARTICIPANT
Simulated Patient (SP) \ sim-yuh-leyt -id \ pey-shuh nt \ noun
Note: this term is often synonymous with Standardized Patient

Etym. simulated (adj.) 1620s, “feigned,” past participle adjective Simulated/Synthetic Learning Methods
from simulate (v.). Meaning “imitative for purposes of experiment or \ sim-yuh-leyt –id \ sin-thet-ik \lur-ning \ meth-uh dz noun
training” is from 1966; commercial jargon, “artificial, imitation” by
1942. Etym. simulated (adj.) 1620s, “feigned,” past participle adjective
from simulate (v.). Meaning “imitative for purposes of experiment or
Etym. patient (n.) “suffering or sick person under medical training” is from 1966; commercial jargon, “artificial, imitation”
treatment,” late 14c., from Old French pacient (n.), from the by 1942.
adjective, from Latin patientem.
Etym. synthetic (adj.) 1690s, as a term in logic, “deductive,”
from French synthétique (17c.) and directly from Modern
Latin syntheticus, from Greek synthetikos “skilled in putting

43
together, constructive,” from synthetos “put together, constructed, purpose of practice, learning, evaluation, testing, or to gain
compounded,” past participle of syntithenai “to put together” (see understanding of systems or human actions.
synthesis). Related: Synthetical (1620s in logic).
• An educational technique that replaces or amplifies real
Etym. learning (n.) Old English leornung “learning, study,” from experiences with guided experiences that evoke or replicate
leornian. substantial aspects of the real world in a fully interactive manner
(Gaba, 2004).
Etym. method (n.) from Latin methodus “way of teaching or
going,” from Greek methodos “scientific inquiry, method of inquiry, • A pedagogy using one or more typologies to promote, improve,
investigation,” originally “pursuit, a following after,” from meta- or validate a participant’s progression from novice to expert
“after” + hodos “a traveling, way.” Meaning “way of doing anything” (INACSL, 2013).
is from 1580s; that of “orderliness, regularity” is from 1610s.
• The application of a simulator to training and/or assessment
Definition (SSH).
The principles, pedagogies, and educational strategies used in health • A method for implementing a model over time.
care simulation. They include:
See also: HEALTHCARE SIMULATION
• Case-based learning - written and oral presentations used to
present and review clinical scenarios but do not involve hands-on
learning, e.g., table-top simulation.

• Computer simulation – see Computer Simulation. Simulation Activity \ sim-yuh-ley-shuh n \ ak-tiv-i-tee \ noun

• Procedural or Partial Task Training - see Part-task Trainer or Etym. simulation (n.) noun of action from past participle stem of
Task Trainer. simulare “imitate,” from stem of similis “like.” Meaning “a model or
mock-up for purposes of experiment or training” is from 1954.
• Hybrid Simulation- see Hybrid Simulation.
Definition
• Integrated procedural training (psychomotor focus) - Combines • The entire set of actions and events from initiation to termination
a series of discrete tasks that are conducted simultaneously or of an individual simulation event; in the learning setting, this is
in sequence to form a complex clinical task (e.g., endotracheal often considered to begin with the briefing (prebriefing) and end
intubation and cervical spine immobilization in a trauma patient). with the debriefing.
• Integrated procedural training (whole procedure) - Integrates • All the elements in a simulation session, including the design and
task training with role play (actors) to enable procedural and setup required.
communication tasks to be practiced simultaneously.
See also: CLINICAL SCENARIO, SCENARIO SIMULATED-BASED
• Mixed simulation- see Mixed Simulation. LEARNING EXPERIENCE

• Simulation / Scenario-based learning - Learners interact with

people, simulators, computers, or task trainers to accomplish
learning goals that are representative of the learner’s real-world
responsibilities. The environment may resemble the workplace. Simulation-Enhanced Interprofessional
Depending on the learning objectives, realism can be built into Education / (Sim-IPE)
the equipment or the environment. \ sim-yuh-ley-shuh n \ in-ˈhan(t)st \ in-ˈtər\ prə-ˈfesh-nəl
\ e-jə-ˈkā-shən\ noun
• Standardized/Simulated Patient - see Standardized/Simulated
Etym. simulation (n.) noun of action from past participle stem of
Patient. Role play - see Role Play.
simulare “imitate,” from stem of similis “like.” Meaning “a model or
• Debriefing – see Debriefing. mock-up for purposes of experiment or training” is from 1954.

• Multimodal formats – see Multiple Modality. Etym. education (n.) the action or process of teaching someone
especially in a school, college, or university; the knowledge, skill,
See also: MODALITY, TYPOLOGY and understanding that you get from attending a school, college, or
university; a field of study that deals with the methods and problems
of teaching.

Simulation \ sim-yuh-ley-shuh n \ noun Definition

• The education of health care professionals with different but
Etym. simulation (n.) noun of action from past participle stem of
complementary knowledge and skills in a simulation environment
simulare “imitate,” from stem of similis “like.” Meaning “a model or
that promotes a collaborative team approach. Simulation-
mock-up for purposes of experiment or training” is from 1954.
enhanced interprofessional education (Sim-IPE)occurs when
Definition participants and facilitators from two or more professions are
engaged in a simulated health care experience to achieve shared
• A technique that creates a situation or environment to allow or linked objectives and outcomes (Decker, et al., 2015). It is
persons to experience a representation of a real event for the designed for the individuals involved to “learn about, from and

44
 with each other to enable effective collaboration and improve Simulation Ethics \ sim-yuh-ley-shuh n \ ˈe-thiks \ noun
health outcomes” (WHO, 2010, p.13).
Etym. simulation (n.) . noun of action from past participle stem of
• A collaborative educational approach that brings together simulare “imitate,” from stem of similis “like”. Meaning “a model or
health care professionals of varying specialties in a simulation mock-up for purposes of experiment or training” is from 1954.
environment engaging learners in an interprofessional teamwork
model (Decker et. al., 2008). Etym. ethic (n.) character or pertaining to the character, from Latin
(ethica), and is from the Ancient Greek (êthicos). “late 14c., ethik
• A simulation environment of equal and mutual respect and “study of morals,” from Old French etique “ethics, moral philosophy”
recognition of each team member’s knowledge and skills. (13c.), from Late Latin ethica, from Greek ēthike philosophia “moral
philosophy,” fem. of ēthikos “ethical, pertaining to character,” from
ēthos “moral character,” related to ēthos “custom” (see ethos).
Meaning “moral principles of a person or group” is attested from
Simulation Environment / 1650s.” ethics (n.) ““the science of morals,” c. 1600, plural of Middle
Simulation Learning Environment / English ethik “study of morals” (see ethic). The word also traces to Ta
Synthetic Learning Environment (SLE) Ethika, title of Aristotle’s work. Related: Ethicist.
\ sim-yuh-ley-shuh n \ lur-ning \ en-vahy-ruh n-muh nt
\ sin-ˈthe-tik\ ˈlərn-ing \ in-ˈvī-rə(n)-mənt \ noun Definition

Etym. simulation (n.) noun of action from past participle stem of • A self-imposed formalized code for all simulationists that includes
simulare “imitate,” from stem of similis “like.” Meaning “a model or the following values: “Integrity, Transparency, Mutual Respect,
mock-up for purposes of experiment or training” is from 1954. Professionalism, Accountability, and Results Orientation” (Park,
Murphy, & Code of Ethics Working Group, 2018).
Etym. synthetic (adj.) 1690s, as a term in logic, “deductive,” from
French synthétique (17c.) and directly from Modern Latin syntheticus, • Is applicable for both simulation facilitators and the participants
from Greek synthetikos “skilled in putting together, constructive,” (learners); based on frameworks and values; includes one’s
from synthetos “put together, constructed, compounded,” past behaviors and conduct during a simulation-based experience
participle of syntithenai “to put together” (see synthesis). Related: (Lioce, Graham, & Young, 2018).
Synthetical (1620s in logic).
• A basis for simulations which is to promote patient safety and
Etym. learning (n.) Old English leornung “learning, study,” from engage learners/participants (Pinar & Peksoy, 2016).
leornian.

Etym. environment (n.) 1887, “environing, surrounding,” Ecological

sense by 1967. Simulation Fidelity \ sim-yuh-ley-shuh n \ fə-ˈde-lə-tē \ noun
Definition Note: the term fidelity is often used synonymously with realism but not all agree
these are the same
• The physical setting where simulation activities may take place,
inclusive of the people and equipment that form part of the Etym. simulation (n.) noun of action from past participle stem of
simulation experience. simulare “imitate,” from stem of similis “like.” Meaning “a model or
mock-up for purposes of experiment or training” is from 1954.
• A location where a simulation-based learning experience takes
place, and where a safe atmosphere is created by the facilitator to Etym. fidelity (n.) early 15c., “faithfulness, devotion,” from Middle
foster sharing and discussion of participant experiences without French fidélité (15c.), from Latin fidelitatem (nominative fidelitas)
negative consequences. “faithfulness, adherence, trustiness,” from fidelis “faithful, true, trusty,
sincere,” from fides “faith”. From 1530s as “faithful adherence to truth
• A context for learning that consists of a controlled and shielded
or reality;” specifically of sound reproduction from 1878.
representation of real-world situations, and a set of educational
methods and procedures in which trainees feel simultaneously Definition
challenged and psychologically safe to practice and reflect on their
performance (Rudolph et al., 2007). • The level of realism associated with a particular simulation
activity.
• An atmosphere that is created by the facilitator to allow for
sharing and discussion of participant experiences without fear of • The physical, semantic, emotional, and experiential accuracy that
humiliation or punitive action. allows persons to experience a simulation as if they were operating
in an actual activity (SSH).
• A setting, surrounding, or conditions that reproduce components or
aspects of the real-world environment, for the purpose of learning • The believability, or the degree to which a simulated experience
and related activities, and/or research (ASSH). approaches reality. Fidelity can involve a variety of dimensions,
including (a) physical factors such as environment, equipment, and
See also: PSYCHOLOGICAL SAFETY related tools; (b) psychological factors such as emotions, beliefs,
and self-awareness of participants; (c) social factors such as
participant and instructor motivation and goals; (d) culture of the
group; and (e) degree of openness and trust, as well as participants’
modes of thinking (Rudolph et al., 2007).

See also: FIDELITY

45
Simulation Guideline Simulation Operations
\ sim-yuh-ley-shuh n \ gahyd-lahyn \ noun \ sim-yuh-ley-shuh n \ op-uh-rey-shuh nz \ noun

Etym. simulation (n.) noun of action from past participle stem of Etym. simulation (n.) noun of action from past participle stem of
simulare “imitate,” from stem of similis “like.” Meaning “a model or simulare “imitate,” from stem of similis “like”. Meaning “a model or
mock-up for purposes of experiment or training” is from 1954. mock-up for purposes of experiment or training” is from 1954.

Etym. guideline (n.)1785, “line marked on a surface before cutting,” Etym. operations (n.) only singular form (operation) - “late 14c.,
from guide + line (n.). Meaning “rope for steering a hot-air balloon” is “action, performance, work,” also “the performance of some
from 1846. In figurative use by 1948. science or art,” from Old French operacion “operation, working,
proceedings,” from Latin operationem (nominative operatio) “a
Definition working, operation,” noun of action from past-participle stem of
• A recommendation of the qualities for simulation fidelity, operari “to work, labor” (in Late Latin “to have effect, be active,
simulation validity, simulation program, or for formative or cause”), from opera “work, effort,” related to opus (genitive operis) “a
summative evaluation (SSH). work” (from PIE root *op- “to work, produce in abundance”).”

• A set of procedures or principles that are recommended to assist in Definition

meeting standards. Guidelines are not necessarily comprehensive.
• “The infrastructure, people, and processes necessary for
They provide a framework for developing policies and procedures
implementation of an effective and efficient simulation-based
based on best practice.
education (SBE) program” (The INACSL Standards Committee,
• A set of recommendations, incorporating currently known best 2017, p. 681).
practice, based on research and/or expert opinion.
• A term that encompasses “the job duties related to the overall
Compare: SIMULATION STANDARD management, delivery, and function of simulation-based
education” (Crawford, Bailey, & Steer, 2019, p. 148).

Simulationist \ sim-yuh-ley-shuh n - ist \ noun

Simulation Reliability
Etym. simulation (n.) noun of action from past participle stem of \ sim-yuh-ley-shuh n \ ri-lahy-uh-bil-i-tee \ noun
simulare “imitate,” from stem of similis “like.” Meaning “a model or
mock-up for purposes of experiment or training” is from 1954. Etym. simulation (n.) noun of action from past participle stem of
simulare “imitate,” from stem of similis “like.” Meaning “a model or
Definition mock-up for purposes of experiment or training” is from 1954.
• A modeling and simulation professional (Tucker, 2010).
Etym. reliable (adj.) 1560s, raliabill, Scottish; see rely + -able.
• A person “who is involved, full-time or part-time, in modeling or
Definition
simulation activities,” for example, develops models to be used
for simulation purposes; performs simulation studies; develops • The consistency of a simulation activity, or the degree to which a
simulation software; manages simulation projects; advertises simulation activity measures in the same way each time it is used
and/or markets simulation products and/or services; maintains under the same conditions with the same participants.
simulation products and/or services; promotes simulation-based
solutions to important problems; advances simulation technology; • “Consistency of performance” under the same conditions with
and advances simulation methodology and/or theory (Ören, 2000). similar participants. (Scalese & Hatala, 2014).

• A term used to describe “professionals involved in providing • The consistency is “tested by interrater, test-retest, and intra-
simulation activities, products, and services” (Kardong-Edgren, instrument“(Adamson, 2014,p.155).
2013, p. e561). This can include simulated patient educators, Compare: SIMULATION VALIDITY
trainers, and standardized or simulated patients (SPs).

• A term for “professionals involved in modelling and simulation

activities and/or with providing modelling and simulation products
and/or services” (Ören, Elzas, Smit, & Birta, 2002). Simulation Standard \ sim-yuh-ley-shuh n \ stan-derd \ noun
Compare: DEBRIEFER, FACILITATOR OPERATIONS SPECIALIST, Etym. simulation (n.) noun of action from past participle stem of
SIMULATION TECHNOLOGY SPECIALIST simulare “imitate,” from stem of similis “like.” Meaning “a model or
mock-up for purposes of experiment or training” is from 1954.

Definition
• A statement of the minimum requirements for simulation fidelity,
validity, formative or summative evaluation, or any other element
related to a simulation activity or program (SSH).

Compare: SIMULATION GUIDELINE

46
Simulation Technology Specialist \ sim-yuh-ley-shuh n \ Simulation Time \ sim-yuh-ley-shuh n \ tahym \ noun
tek-ˈnä-lə-jē \ spesh-uh-list \ noun
Etym. simulation (n.) noun of action from past participle stem of
Etym. simulation (n.) noun of action from past participle stem of simulare “imitate,” from stem of similis “like.” Meaning “a model or
simulare “imitate,” from stem of similis “like”. Meaning “a model or mock-up for purposes of experiment or training” is from 1954.
mock-up for purposes of experiment or training” is from 1954.
Definition
Etym. technology (n.) “1610s, “a discourse or treatise on an art or the
• A simulation’s internal representation of time; simulation time
arts,” from Greek tekhnologia “systematic treatment of an art, craft, or may accumulate faster, slower, or at the same pace as real time.
technique,” originally referring to grammar, from tekhno-, combining
form of tekhnē “art, skill, craft in work; method, system, an art, a • A time established by the simulation educator before the start
system or method of making or doing,” from PIE *teks-na- “craft” (of of the simulation exercise, irrespective of the actual real time
weaving or fabricating), from suffixed form of root *teks- “to weave,” (Hancock et al, 2008).
also “to fabricate.” For ending, see -logy”. “The meaning “study of
mechanical and industrial arts” (Century Dictionary, 1895, gives as
example “spinning, metal-working, or brewing”) is recorded by 1859.
High technology attested from 1964; short form high-tech is from Simulation Tool \sim-yuh-ley-shuh n \ ˈtül \ noun
1972.”
Etym. simulation (n.) mid-14c., “a false show, false profession,”
Etym. specialist (n.) “1852 (originally in the medical sense and much from Old French simulation “pretence” and directly from Latin
scorned by the GPs); see special (adj.) + -ist. Perhaps immediately simulationem (nominative simulatio) “an imitating, feigning, false
from French spécialiste (1842). In general use in English by 1862. show, hypocrisy,” noun of action from past participle stem of
Related: Specialism. simulare “imitate,” from stem of similis “like, resembling, of the same
kind” (see similar). Meaning “a model or mock-up for purposes of
Definition experiment or training” is from 1954.”
• A person, defined as someone “with a diverse set of skills Etym. tool (n.) “Old English tol “instrument, implement used by
and expertise both technical and administrative related to the a craftsman or laborer, weapon,” from Proto-Germanic *tōwalan
operation, support, and delivery of healthcare simulation” “implement” (source also of Old Norse tol), from a verb stem
(Crawford, Bailey, & Steer, 2019, p. 148). represented by Old English tawian “prepare” (see taw). The ending
is the instrumental suffix -el (1). Figurative sense of “person used by
• A person, also known as a “Sim Tech” or Simulation Technician another for his own ends” is recorded from 1660s.”
who functions as a technician for healthcare simulation technology
(Baily, 2014; Crawford, Bailey, & Steer, 2019). In addition to Definition
technical support, job duties may vary and include such duties
as preparing for simulations (mannequin programming, set-up), • A model or mock-up for purposes of experiment or training.
running of equipment during simulations (simulator, audiovisual),
• A device, including lower and higher simulation technologies,
equipment maintenance/repair, and education of others concerning
that can be used to promote participant learning (Yale University,
simulation technologies (UW Health, 2017).
n.d.). Examples include task trainers, mannequins (manikins)
• An individual who provides technological expertise, instructional and immersive environments (i.e., virtual reality). The specific
support, and advocacy in healthcare simulation. simulation tool should be chosen based on the predetermined
objectives and outcomes (INACSL Standards Committee, 2016b;
See also: OPERATIONS SPECIALIST, SIMULATIONIST Yale University, n.d.).

• The modality or “the platform for the experience” (INACSL

Standards Committee, 2016b, S7).
Simulation Testing Environment \sim-yuh-ley-shuh n \
tee-ching \ en-vahy-ruh n-muh nt \ noun • A description of what healthcare simulation is; known as “an
effective tool, technique, or method” (Barjis, 2011, p. 2).
Etym. simulation (n.) noun of action from past participle stem of
simulare “imitate,” from stem of similis “like.” Meaning “a model or • An instrument used to assess/evaluate in a simulation.
mock-up for purposes of experiment or training” is from 1954.
See also: MODALITY
Definition
• A context for formative or summative evaluation of an individual´s
or team´s performance. The goals of the simulation testing
environment are to create an equivalent activity for all participants
in order to test their knowledge, skills, and abilities in a simulated
setting (INACSL, 2013).

47
Simulation Validity \sim-yuh-ley-shuh n \ vuh-lid-i-tee\ noun Situated Learning \sich-oo-ey-tid \ lur-ning \ noun
Etym. simulation (n.) noun of action from past participle stem of Etym. situate (v.) early 15c., “to place in a particular state or
simulare “imitate,” from stem of similis “like.” Meaning “a model or condition,” from Medieval Latin situatus, past participle of situare “to
mock-up for purposes of experiment or training” is from 1954. place, locate,” from Latin situs “a place, position” (see site). Related:
Situated; situating, situation (n.).
Definition
Etym. learning (n.) Old English leornung “learning, study,” from
• The degree to which a model or simulation accurately represents
leornian (see learn). Learning curve attested by 1907.
or measures what it intends to measure. (Scalese and Hatala,
2014). Definition
• In health care simulation, the quality of a simulation or simulation • A theory that posits that learning occurs within authentic activity,
program that demonstrates that the relationship between the context, and culture. Social interaction and collaboration are
process and its intended purpose is specific, sensitive, reliable, and considered essential components (Lave and Wenger, 2008). This
reproducible (Dieckmann, 2009; SSH). is opposed to a classroom learning activity that is abstract and out
of context.
• “The degree to which a test or evaluation tool accurately measures
the intended concept of interest” (INACSL Standards Committee,
2016).

• “How well the data measures the construct it is intended to Situational Awareness
measure” (Adamson, 2014,p.155). \sich-oo-ey-shuh n-ul \ ə-ˈwer-nis\ noun

Compare: SIMULATION RELIABILITY Etym. situate (v.) early 15c., “to place in a particular state or
condition,” from Medieval Latin situatus, past participle of situare “to
place, locate,” from Latin situs “a place, position” (see site). Related:
Situated; situating, situation (n.).
Simulator \ sim-yuh-ley-ter \ noun Etym. awareness (n.) 1828, from aware + -ness. Late Old English
Etym. simulator (n.) 1835, of persons, from Latin simulator “a gewær, “wary, cautious.”
copier, feigner,” agent noun from simulare “imitate,” from stem of Definition
similis “like”. In reference to training devices for complex systems,
from 1947 (flight simulator). simulated (adj.) 1620s, “feigned,” • Situation awareness (SA) is the perception of environmental
past participle adjective from simulate (v.). Meaning “imitative elements within time and space, and a perception of their meaning;
for purposes of experiment or training” is from 1966 (agent noun it involves being aware of what is happening around you to
simulator in the related sense dates from 1947. In commercial jargon, understand how information, events, and your own actions impact
“artificial, imitation” by 1942. the outcomes and objectives.

Definition • A field of study concerned with understanding of the environment

critical to decisionmakers in complex, dynamic areas; situational
• A setting, device, computer program or system that performs awareness refers to the degree to which one’s perception of a
simulation (Hancock et al, 2008). situation matches reality.
• Any object or representation used during training or assessment • The awareness of fatigue and stress among team members
that behaves or operates like a given system and responds to the (including oneself), environmental threats to safety, immediate
user’s actions (SSH). goals, information sharing, and the deteriorating status of the crisis
• A device that duplicates the essential features of a task situation. or patient. Most commonly used in the context of crisis resource
A simulator generally has three elements – a modelled process management training (Hancock et al, 2008).
which represents, emulates, or otherwise simulates a real-world Compare: SHARED MENTAL MODEL
system; a control system; and a human-machine interface which Contrast with: FIXATION ERROR
is representative of the inputs found in the real-world system
(Australian Department of Defense). Examples include manikins
and part-task trainers.

See also: COMPUTER-BASED SIMULATION, MANIKIN, SERIOUS Standardized Patient (SP) \ stan-dər-ˌdīz-d \ pā-shənt \ noun
GAMES, SCREEN-BASED SIMULATION, SIMULATED PATIENT,
STANDARDIZED PATIENT, TASK TRAINER, VIRTUAL REALITY
[Note: this term is often synonymous with Simulated Patient]

Etym. standard - “authoritative or recognized exemplar of quality

or correctness” (late 15c.). Meaning “rule, principal or means of
judgment” is from 1560s. That of “definite level of attainment” is
attested from 1711 (as in standard of living, 1903).

Etym. patient – (n.) “suffering or sick person under medical

treatment,” late 14c.

48
Definition Standardized/Simulated Participant \ stan-dər-ˌdīz-d \
• A person who has been carefully coached to simulate an actual sim-yə-ˌlāt-id \ pär-ˈti-sə-pənt \ noun
patient so accurately that the simulation cannot be detected by a
See: SIMULATED PATIENT, STANDARDIZED PATIENT
skilled clinician. In performing the simulation, the SP presents
the gestalt of the patient being simulated; not just the history, but
the body language, the physical findings, and the emotional and
personality characteristics as well (Barrows, 1993). State/States \ stāt\ noun
• An individual trained to portray a patient with a specific condition Etym. Meaning “physical condition as regards form or structure” is
in a realistic, standardized, and repeatable way and where attested from late 13c. Meaning “mental or emotional condition” is
portrayal/presentation varies based only on learner performance; attested from 1530s (phrase state of mind first attested 1749).
this strict standardization of performance in a simulated session is
Definition
what can distinguish standardized patients from simulated patients.
• A term used when programming manikins; state variables
• SPs can be used for teaching and assessment of learners, including may include vital signs, monitor readings, body sounds, and
but not limited to history/consultation, physical examination, and verbalizations made by the simulator.
other clinical skills in simulated clinical environments Association
of Standardized Patient Educators (ASPE). SPs can also be used to • [pleural] A sequence of events that change over time. (Sokolowski
give feedback and evaluate learner performance (ASPE). & Banks, 2011). This may include psychosocial behaviors in the
simulation activities.
• An individual who is trained to portray a real patient in order
to simulate a set of symptoms or problems used for healthcare Compare to: EVENT
education, evaluation, and research (SSH). See also: TRIGGER

• •More commonly used in the USA and Canada in large part

because SPs participate in high stakes assessments in which SP Stochastic \ stə-ˈkas-tik \ adj
responses to the learner were standardized. In recent years as
SPs have been included in more formative teaching scenarios, Etym. (adj.) 1660s, “pertaining to conjecture,” from Greek
its meaning has become interchangeable with the term simulated stokhastikos “able to guess, conjecturing,” from stokhos “a guess,
patient. aim, target, mark,” literally “pointed stick set up for archers to shoot
at;” the sense of “randomly determined” is from 1934, from German
See also: ACTOR, EMBEDDED PARTICIPANT, ROLE PLAYER,
stochastik (1917).
SIMULATED OR STANDARDIZED PATIENT OR PARTICIPANT,
SIMULATED PERSON.
Definition
• Pertaining to a process, model, or variable whose outcome, result,
or value depends on chance (M&S Glossary).
Standardized Patient Simulation \ stan-dər-ˌdīz-d \ pā- Contrast with: DETERMINISTIC
shənt \ sim-yuh-ley-shuh n \ noun
Note: the term Standardized Patient is often synonymous with Simulated
Patient
Synthetic Learning Technologies \ sin-ˈthe-tik\ ˈlərn-ing \
Etym. standard (n.) “authoritative or recognized exemplar of quality tek-ˈnä-lə-jē-z \ noun
or correctness” (late 15c.). Meaning “rule, principal or means of
judgment” is from 1560s. That of “definite level of attainment” is Etym. synthetic (adj.) 1690s, as a term in logic, “deductive,” from
attested from 1711 (as in standard of living, 1903). French synthétique (17c.) and directly from Modern Latin syntheticus,
from Greek synthetikos “skilled in putting together, constructive,”
Etym. patient (n.) “suffering or sick person under medical treatment,” from synthetos “put together, constructed, compounded,” past
late 14c. participle of syntithenai “to put together” (see synthesis). Related:
Synthetical (1620s in logic).
Etym. simulation (n.) noun of action from past participle stem of
simulare “imitate,” from stem of similis “like.” Meaning “a model or Etym. learning (n.) Old English leornung “learning, study,” from
mock-up for purposes of experiment or training” is from 1954. leornian.
Definition Etym. techno - word-forming element meaning “art, craft, skill,”
• A simulation using a person or persons trained to portray a patient later “technical, technology,” from Latinized form of Greek tekhno-,
scenario or actual patient(s) for health care education (SSH). combining form of tekhne “art, skill, craft in work; method, system,
an art, a system or method of making or doing.”
• A modality used for the purpose of practice, learning, assessment,
or to gain an understanding of systems or human actions in which Definition
standardized (or simulated) patients play a central role. • The technologies used in synthetic or simulated learning
environments, including manikin; computer-based virtual reality;
haptics; actors; simulated patients; part-task / task trainers; hybrid;
and video (ASSH).

49
Systems Integration ˈsis-təmz \ ˌin-tə-ˈgrā-shən\ noun
Etym. system - (n.) 1610s, “the whole creation, the universe,” from
Late Latin systema “an arrangement, system,” from Greek systema
“organized whole, a whole compounded of parts,” from stem of
synistanai “to place together, organize, form in order,” from syn-
“together.” Meaning “set of correlated principles, facts, ideas, etc.”
first recorded 1630s.

Etym integration (n.) 1610s, from French intégration and directly

from Latin integrationem (nominative integratio) “renewal,
restoration.” Integrate - Meaning “to put together parts or elements
and combine them into a whole” is from 1802. Related: Integrated;
integrating.

Definition
• An engineering term meaning to bring together the component
subsystems into one system that functions together. In health care,
the ability to improve the quality of care and patient outcomes
through re-engineering of care delivery processes.

• A category of simulation program accreditation that recognizes

programs that demonstrate consistent, planned, collaborative,
integrated, and iterative application of simulation-based
assessment, research, and teaching activities with systems
engineering and risk management principles to achieve excellent
bedside clinical care, enhanced patient safety, and improved
outcome metrics across the health care system(s) (SSH).

50
T
Tabletop Simulation (TTX) Defnition
\ ˈtā-bəl-ˌtäp \ sim-yuh-ley-shuh n \ noun
• A combination of devices (e.g., laparoscopic box trainer),
Etym. tabletop (adj.) table- late 12c., “board, slab, plate,” from Old software, tasks, instructional videos, target performance levels,
French table “board, square panel, plank; writing table; picture; food, log sheets, and program overview materials that are provided
fare” (11c.), and late Old English tabele “writing tablet, gaming table,” to participants for use at in-home or other similar locations for
from Germanic *tabal completing simulation activities (Wilson et al., 2019).
top (adj.) “being at the top, 1590s. or (n.) highest point,” Old English
top “summit, crest, tuft,”

Etym. simulation (n.) noun of action from past participle stem of

Take-home Simulators
simulare “imitate,” from stem of similis “like”. Meaning “a model or
\ teyk \ hohm \ sim-yuh-ley-ters \ noun
mock-up for purposes of experiment or training” is from 1954.
Etym. take (v.) late Old English tacan “to take, seize,” from a
Definition
Scandinavian source (such as Old Norse taka “take, grasp, lay hold,”
• An educational tool intended to provide students/learners an past tense tok, past participle tekinn; Swedish ta, past participle tagit),
opportunity to apply knowledge through formal discussion of a from Proto-Germanic *takan- (source also of Middle Low
described scenario (Lehtola, 2007). German tacken, Middle Dutch taken, Gothic tekan “to touch”), from
Germanic root *tak- “to take,” of uncertain origin, perhaps originally
• In the context of tabletop exercise, involves key personnel meaning “to touch.
discussing simulated scenarios in an informal setting. Can be
used to assess plans, policies, and procedures (California Hospital Etym. home (n.) Old English ham “dwelling place, house, abode,
Association, 2017). fixed residence; estate; village; region, country,” from Proto-
Germanic *haimaz “home” (source also of Old Frisian hem “home,
village,” Old Norse heimr “residence, world,” heima “home,”
Danish hjem, Middle Dutch heem, German heim”home,”
Take-home Simulation Gothic haims “village”).
\ teyk \ hohm \ sim-yuh-ley-shuh n \ noun Etym. simulator (n.) 1835, of persons, from Latin simulator “a
Etym. take (v.) late Old English tacan “to take, seize,” from a copier, feigner,” agent noun from simulare “imitate,” from stem of
Scandinavian source (such as Old Norse taka “take, grasp, lay hold,” similis “like”. In reference to training devices for complex systems,
past tense tok, past participle tekinn; Swedish ta, past participle tagit), from 1947 (flight simulator). simulated (adj.) 1620s, “feigned,”
from Proto-Germanic *takan- (source also of Middle Low past participle adjective from simulate (v.). Meaning “imitative
German tacken, Middle Dutch taken, Gothic tekan “to touch”), from for purposes of experiment or training” is from 1966 (agent noun
Germanic root *tak- “to take,” of uncertain origin, perhaps originally simulator in the related sense dates from 1947. In commercial jargon,
meaning “to touch.” “artificial, imitation” by 1942.

Etym. home (n.) Old English ham “dwelling place, house, abode, Definition

fixed residence; estate; village; region, country,” from Proto- • Simulators that can be taken home or used in other locations (e.g.,
Germanic *haimaz “home” (source also of Old Frisian hem “home, call room). (Bokhari et al., 2010).
village,” Old Norse heimr “residence, world,” heima “home,”
Danish hjem, Middle Dutch heem, German heim “home,”
Gothic haims “village”).

Etym. simulation (n.) noun of action from past participle stem of

simulare “imitate,” from stem of similis “like”. Meaning “a model or
mock-up for purposes of experiment or training” is from 1954.

51
Task Trainer / Part-Task Trainer / Partial Task Trainer Technical skills \ˈtek-ni-kəl\ˈskil \ noun
\ tahsk \ trey-ner \ noun
Etym. technical (adj.) 1610s, “skilled in a particular art or subject,”
Etym. task (n.) early 14c., “a quantity of labor imposed as a duty,” formed in English from technic + al (1), or in part from Greek
from Old North French tasque (12c., Old French tasche, Modern tekhnikos “of art; systematic,” in reference to persons “skillful,
French tâche). General sense of “any piece of work that has to be artistic,” from tekhne “art, skill, craft.” The sense narrowed to “having
done” is first recorded 1590s. to do with the mechanical arts” (1727).

Etym. trainer (n.) c. 1600, “one who educates or instructs,”agent noun Etym. skills (n.) late 12c., “power of discernment,” from Old Norse
from train (v.). Meaning “one who prepares another for feats requiring skil “distinction, ability to make out, discernment, adjustment,” related
physical fitness” is from 1823, originally of horse trainers. to skilja (v.) “to separate; discern, understand,” from Proto-Germanic
*skaljo- “divide, separate” (cognates: Swedish skäl “reason,” Danish
Definition skjel “a separation, boundary, limit,” Middle Low German schillen
• A device designed to train in just the key elements of the “to differ,” Middle Low German, Middle Dutch schele “separation,
procedure or skill being learned, such as lumbar puncture, chest discrimination;.” Sense of “ability, cleverness” first recorded early
tube insertion, central line insertion or part of a total system, for 13c.
example, ECG simulator (Center for Immersive and Simulation
Definition
Based Learning [CISL] & Levine et al).
• A skill that is required for the accomplishment of a specific task.
• A model that represents a part or region of the human body such
as an arm, or an abdomen. Such devices may use mechanical or • In health care, the knowledge, skill, and ability to accomplish
electronic interfaces to teach and give feedback on manual skills a specific medical task; for example, inserting a chest tube or
such as IV insertion, ultrasound scanning, suturing, etc. Generally performing a physical examination.
used to support procedural skills training; however they can be
used in conjunction with other learning technologies to create
integrated clinical situations (Australian Society for Simulation in
Healthcare). Technology-Enhanced Health care Simulation
See also: PROCEDURAL SIMULATION, SIMULATOR
(encompasses high-and low-technology health
care simulation) \ tek-ˈnä-lə-jē\ in-ˈhan(t)s \ ˈhelth \ ˈker \ sim-
yuh-ley-shuh n \ noun

Etym. techno - word-forming element meaning “art, craft, skill,”

Team-based Learning \ˈtēm \ ˈbāst \ ˈlərn-ing \ noun later “technical, technology,” from Latinized form of Greek tekhno-,
combining form of tekhne “art, skill, craft in work; method, system,
Etym. team (n.) applied in Old English to groups of persons working
an art, a system or method of making or doing.”
together for some purpose, especially “group of people acting together
to bring suit;” modern sense of “persons associated in some joint Etym. simulation (n.) noun of action from past participle stem of
action” is from 1520s. Team spirit is recorded from 1928. Team player simulare “imitate,” from stem of similis “like.” Meaning “a model or
attested from 1886, originally in baseball. mock-up for purposes of experiment or training” is from 1954.
Etym. learning (n.) Old English leornung “learning, study,” from Definition
leornian.
• A group of materials and devices created or adapted to train health
Definition care professionals in a simulated environment. Examples include
such diverse products as computer-based virtual reality simulators,
• A learning method that makes use of small group discussion and high-fidelity and static mannequins, plastic models, live animals,
collaborative, self-directed study to foster new learning as opposed inert animal products, and human cadavers
to imparting information. After a period of preliminary individual (Cook et al., 2011).
accountability, teams of learners compete with each other to learn
information and solve problems, This is in distinction to traditional • An educational tool or device with which the learner physically
learning in which information is imparted from teacher to learner. interacts to mimic an aspect of clinical care for the purpose of
teaching or assessment.
• A learning method with many similarities to Problem Based
Learning (PBL). Unlike PBL, where a complex, open-ended, case
is given without the information to solve it, team-based learning
capitalizes on the use of carefully chosen learning activities based
on reading assignments (Michaelson, Parmelee, & McMahon,
2008).

52
Telepresence \ ˈtɛlɪˌprɛzəns\ noun makes telesimulation possible. Mannequin-based telesimulation is
relatively new and not well represented in the literature, but could
Etym. tele (adj.) before vowels tel-, word-forming element facilitate systems changes, providing educational experiences
meaning “far, far off, operating over distance” (also, since c. 1940, to healthcare professionals in locations not currently benefiting
“television”), from Greek tele “far off, afar, at or to a distance,” from mannequin-based simulation opportunities. Several research
related to teleos (genitive telos) “end, goal, completion, result,” from questions need to be addressed in future studies to better develop
PIE root *kwel- (2) “far” in space or time.” this educational approach, including technical feasibility, logistic
issues, a comparison of telesimulation to other simulation
Etym presence (n.): mid-14c., “fact of being present,” from Old approaches, and assessing limitations of the telesimulation
French presence (12c., Modern French présence), from Latin platform” (Hayden et al., 2018, p. 144).
praesentia “a being present,” from praesentem (see present (n.)).
Present c. 1300, “existing at the time,” from Old French present • “Telesimulation (TS) is a novel concept that uses the internet to
“evident, at hand, within reach;” as a noun, “the present time” link simulators between an instructor and a trainee in different
(11c., Modern French présent) and directly from Latin praesentem locations” (Okrainec et al., 2010, p. 417). “Telesimulation uses
(nominative praesens) “present, at hand, in sight; immediate; prompt, the Internet to link simulators between an instructor and trainee
instant; contemporary,” from present participle of præesse “be before in different locations” (Okrainec et al., 2010, p. 417). “Using two
(someone or something), Meaning “being there” is from mid-14c. in simulators, multiple computers, a series of webcams, and basic
English. video conferencing software, the instructor and trainee can see
within each other’s simulators as well as see and speak to each
Definition other” (Okrainec et al., 2010, p. 418). Telesimulation differs from
• Telepresence is the bridging of geographical separation using “telementoring or teleconferencing because it actually connects
technology that enables interaction and communication two simulators in different physical locations,” allowing teacher
approximate to being actually present. Work-from-home meeting and student to see, but not control, what the other is doing in real
software, like Cisco WebEx, Zoom, etc., is telepresence. The time (Okrainec et al., 2010, p. 418). “Telesimulation is a novel,
environment you see through the webcam of your colleague is practical, inexpensive, effective, and well-received method for
a real, non-computer generated environment (e.g., their office teaching appropriate procedural skills” (Mikrogianakis et al., 2011,
or home). Manikin-based simulations with a debriefer who is p. 427).
geographically separated but uses a telepresence robot would be Compare: DISTANCE SIMULATION, REMOTE SIMULATION
telepresence, but not virtual presence (Shaw et al., 2018).

Compare: VIRTUAL PRESENCE

Training Scars \ ˈtrā-niŋ \ ˈskär \ noun

Etym. training (adj.) mid-15c., “protraction, delay,” verbal noun from
Telesimulation \(Tele-OSCE) \ ˈtɛlɪˌ \ sim-yuh-ley-shuh n \ train (v.). From 1540s as “discipline and instruction to develop powers
noun or skills;” 1786 as “exercise to improve bodily vigor.” Training wheels
Etym. tele (adj.) before vowels tel-, word-forming element
as an attachment to a bicycle is from 1953.
meaning “far, far off, operating over distance” (also, since c. 1940, Etym. scar (n.) late 14c., from Old French escare “scab” (Modern
“television”), from Greek tele “far off, afar, at or to a distance,” French escarre), from Late Latin eschara, from Greek eskhara “scab
related to teleos (genitive telos) “end, goal, completion, result,” from formed after a burn,” literally “hearth, fireplace,” of unknown origin.
PIE root *kwel- (2) “far” in space or time.” English sense probably influenced by Middle English skar (late 14c.)
Etym. simulation (n.) noun of action from past participle stem of
“crack, cut, incision,” from Old Norse skarð, related to score (n.).
simulare “imitate,” from stem of similis “like”. Meaning “a model or Figurative sense attested from 1580s.
mock-up for purposes of experiment or training” is from 1954. Definition
Defintion • A bad habit, practice, or procedure that is taught, can result from
• “A telesimulation platform utilizes communications technology errors of commission or errors of omission in teaching.
to provide mannequin-based simulation education between • The unintentional bad habits acquired during the course of
learners and instructors located remotely from one another. training.
Specifically, the instructor controls the mannequin and moderates
the debriefing remotely. During these sessions, the instructor • The creation of obvious or latent errors in behaviors that typically
observes the learners in real time and provides immediate appear under certain conditions, especially when under stress or in
feedback during the debriefing. This platform obviates the stressful situations.
need to have instructors, learners, and mannequins in the
same place at the same time, potentially allowing simulation- • Methods in which learners have been trained that do not directly
based educational sessions to occur with greater frequency for apply to practice or operations and are not based in reality
institutions not located proximate to formal simulation centers. (Ellefritz, 2019; Grossman, 2008).
Additionally, the telesimulation platform enables an experienced
Compare: NEGATIVE LEARNING
simulation instructor to observe and directly help new simulation Consider also: STRESS INNOCULATION
instructors at remote simulation locations. Readily available Web-
conferencing, screen-sharing software, microphones, and webcams

53
Trigger(s) \ˈtri-gər \ noun
Etym. trigger (n.) “device by means of which a catch or spring is
released and a mechanism set in action.”

Definition
• An event or events that move the simulation from one state to
another.

• Anything, as an act or event, that serves as a stimulus and initiates

or precipitates a reaction (dictionary.com).

See also: STATE/STATES

Typology \tī-ˈpä-lə-jē \ noun

Etym. typology (n.) “doctrine of symbols,” 1845, from Greek typos.

Related: Typological; typologically.

Definition
• The classification of different educational methods or equipment;
for example, 3-dimensional models, computer software,
standardized patients, partial-task trainers, or high-fidelity patient
simulators (INACSL, 2013).

See also: MODALITY, SIMULATED/SYNTHETIC LEARNING METHOD

54
V
Validity \ vuh-lid-i-tee\ noun Virtual Presence \\ vur-choo-uh l \ prɛzəns \ noun
See: SIMULATION VALIDITY Etym. virtual (adj.) The meaning “being something in essence or
effect, though not actually or in fact” is from mid-15c., probably via
sense of “capable of producing a certain effect” (early 15c.). Computer
sense of “not physically existing but made to appear by software” is
Virtual Environment \ ˈvər-chə-wəl \ in-ˈvī-rə(n)-mənt \ noun attested from 1959.
[C]
Etym Presence (n.): mid-14c., “fact of being present,” from Old
Etym. virtual (adj.) The meaning “being something in essence or French presence (12c., Modern French présence), from Latin
effect, though not actually or in fact” is from mid-15c., probably via praesentia “a being present,” from praesentem (see present (n.).Present
sense of “capable of producing a certain effect” (early 15c.). Computer c. 1300, “existing at the time,” from Old French present “evident,
sense of “not physically existing but made to appear by software” is at hand, within reach;” as a noun, “the present time” (11c., Modern
attested from 1959. French présent) and directly from Latin praesentem (nominative
praesens) “present, at hand, in sight; immediate; prompt, instant;
Etym. environment (n.) sense of “the aggregate of the conditions in contemporary,” from present participle of præesse “be before
which a person or thing lives” is by 1827 (used by Carlyle to render (someone or something), Meaning “being there” is from mid-14c. in
German Umgebung); specialized ecology sense first recorded 1956. English.
Definition Definitions

• A simulated environment rendered by a computer, mobile device, • The “sense of being physically present with visual, auditory, or
or virtual reality / augmented reality / mixed reality device force displays generated by a computer” and is similar but distinct
(Schwebel, Severson, & He, 2017). from Telepresence, the “sense of being physically present with
virtual object(s) at the remote teleoperator site” (Sheridan, 1992).
Compare: VIRTUAL WORLD
See also: VIRTUAL REALITY • Virtual presence refers to the degree to which individuals
experience a computer-generated environment rather than the
physical locale (Samosorn et al., 2019).

Virtual Patient \ˈvər-chə-wəl \ pā-shənt \ noun Compare: TELEPRESENCE

Etym. virtual (adj.) The meaning “being something in essence or

effect, though not actually or in fact” is from mid-15c., probably via
sense of “capable of producing a certain effect” (early 15c.). Computer Virtual Reality \ ˈvər-chə-wəl \mrē-ˈa-lə-tē \ noun
sense of “not physically existing but made to appear by software” is
attested from 1959. Etym. virtual (adj.) The meaning “being something in essence or
effect, though not actually or in fact” is from mid-15c., probably via
Etym. patient (n.) “suffering or sick person under medical treatment,” sense of “capable of producing a certain effect” (early 15c.). Computer
late 14c. sense of “not physically existing but made to appear by software” is
attested from 1959.
Definition
• A representation of an actual patient. Virtual patients can take Etym. reality (n.) 1540s, “quality of being real,” from French
many forms such as software-based physiological simulators, réalité and directly Medieval Latin realitatem (nominative realitas),
simulated patients, physical manikins, and simulators, (Ellaway, from Late Latin realis. Meaning “real existence, all that is real” is
Poulton, Fors et al., 2008). from 1640s; that of “the real state (of something)” is from 1680s.
Sometimes 17c.-18c. also meaning “sincerity.” Reality-based attested
• A computer program that simulates real-life clinical scenarios from 1960.
in which the learner acts as a health care provider obtaining a
history and physical exam, and making diagnostic and therapeutic Definition
decisions (ASSH). • The use of computer technology to create an interactive three-
dimensional world in which the objects have a sense of spatial
See also: ARTIFICIAL INTELLIGENCE
Compare: STANDARDIZED PATIENT, SIMULATED PATIENT
presence; virtual environment and virtual world are synonyms for
virtual reality (M&S Glossary).

• A computer-generated three-dimensional environment that gives

an immersion effect.

55
 • Often refers to the three-dimensional (3D) Head-mounted Display Virtual Simulation \ˈvər-chə-wəl \ sim-yuh-ley-shuh n \ noun
VR (HMD VR) in which the Virtual World is projected using a
head-mounted display (e.g. Oculus Rift, HTC Vive Pro). (Chang Etym. virtual (adj.) The meaning “being something in essence or
and Weiner, 2016) effect, though not actually or in fact” is from mid-15c., probably via
sense of “capable of producing a certain effect” (early 15c.). Computer
• A shorthand of the HMD VR hardware, which always uses a sense of “not physically existing but made to appear by software” is
Virtual World. In that way, it is not necessarily synonymous attested from 1959.
with Virtual Environment and Virtual World, but a synecdoche /
metonymy. Etym. simulation (n.) noun of action from past participle stem of
simulare “imitate,” from stem of similis “like.” Meaning “a model or
See also: SIMULATOR mock-up for purposes of experiment or training” is from 1954.

Definition
• The recreation of reality depicted on a computer screen
Virtual Reality Environment ˈvər-chə-wəl \rē-ˈa-lə-tē \ in- (McGovern, 1994).
ˈvī-rə(n)-mənt \ noun
• A simulation involving real people operating simulated systems.
Etym. virtual (adj.) The meaning “being something in essence or Virtual simulations may include surgical simulators that are used
effect, though not actually or in fact” is from mid-15c., probably via for on-screen procedural training and are usually integrated with
sense of “capable of producing a certain effect” (early 15c.). Computer haptic device(s) (McGovern, 1994; Robles-De La Torre, 2011).
sense of “not physically existing but made to appear by software” is
attested from 1959. • A type of simulation that injects humans in a central role by
exercising motor control skills (for example, flying an airplane),
Etym. reality (n.) 1540s, “quality of being real,” from French decision skills ( committing fire control resources to action), or
réalité and directly Medieval Latin realitatem (nominative realitas), communication skills (as members of an air traffic control team)
from Late Latin realis. Meaning “real existence, all that is real” is (Hancock et al, 2008).
from 1640s; that of “the real state (of something)” is from 1680s.
Sometimes 17c.-18c. also meaning “sincerity.” Reality-based attested
from 1960.
Virtual World \ ˈvər-chə-wəl \ wurld \ noun [C]
Definition
Etym. virtual (adj.) The meaning “being something in essence or
• A wide variety of computer-based applications commonly effect, though not actually or in fact” is from mid-15c., probably via
associated with immersive, highly visual, 3D characteristics, sense of “capable of producing a certain effect” (early 15c.). Computer
that allow the participant to look about and navigate within a sense of “not physically existing but made to appear by software” is
seemingly real or physical world. It is generally defined based on attested from 1959.
the type of technology being used, such as head-mounted displays,
stereoscopic capability, input devices, and the number of sensory Etym. world (n.) Originally “life on earth, this world (as opposed
systems stimulated (ASSH). to the afterlife),” sense extended to “the known world,” then to “the
physical world in the broadest sense, the universe” (c. 1200). In Old
English gospels, the commonest word for “the physical world,” was
Virtual Reality Simulation \ ˈvər-chə-wəl \mrē-ˈa-lə-tē \ sim- Middangeard (Old Norse Midgard), literally “the middle enclosure”
yuh-ley-shuh n \ noun (see yard (n.1)), which is rooted in Germanic cosmology. Greek
kosmos in its ecclesiastical sense of “world of people” sometimes was
Etym. virtual (adj.) The meaning “being something in essence or rendered in Gothic as manaseþs, literally “seed of man.” The usual
effect, though not actually or in fact” is from mid-15c., probably via Old Norse word was heimr, literally “abode” (see home). Words for
sense of “capable of producing a certain effect” (early 15c.). Computer “world” in some other Indo-European languages derive from the root
sense of “not physically existing but made to appear by software” is for “bottom, foundation” (such as Irish domun, Old Church Slavonic
attested from 1959. duno, related to English deep); the Lithuanian word is pasaulis, from
pa- “under” + saulė “sun.”
Etym. reality (n.) 1540s, “quality of being real,” from French
réalité and directly Medieval Latin realitatem (nominative realitas), Definition
from Late Latin realis. Meaning “real existence, all that is real” is
from 1640s; that of “the real state (of something)” is from 1680s. • Similar to Virtual Environment, though implies multiple
Sometimes 17c.-18c. also meaning “sincerity.” Reality-based attested characters, learners, or participants and potentially, a larger scale
from 1960. than a virtual environment. (Chang and Weiner, 2016).

Definition • A virtual world or massively multiplayer online world (MMOW)

in a computer-based simulated environment (Change et al, 2016).
• Simulations that use a variety of immersive, highly visual, 3D
characteristics to replicate real-life situations and/or health care Compare: VIRTUAL ENVIRONMENT
procedures; virtual reality simulation is distinguished from See also: VIRTUAL REALITY
computer-based simulation in that it generally incorporates
physical or other interfaces such as a computer keyboard, a mouse,
speech and voice recognition, motion sensors, or haptic devices
(ASSH).

56
W
Wide-Area Virtual Environment (WAVE)
\ ˈwīd \ ˈā-rē-ə \ ˈvər-chə-wəl \ in-ˈvī-rə(n)-mənt \ noun

Etym. wide (adj.) “Old English wid “vast, broad, long,” also used
of time, from Proto-Germanic *widaz (source also of Old Saxon,
Old Frisian wid, Old Norse viðr, Dutch wijd, Old High German wit,
German weit), perhaps from PIE *wi-ito-, from root *wi- “apart, away,
in half.”

Etym. area (n.) “1530s, “vacant piece of ground,” from Latin area
“level ground, open space,” used of building sites, playgrounds,
threshing floors, etc.; which is of uncertain origin. Perhaps an irregular
derivation from arere “to become dry” (see arid), on notion of “bare
space cleared by burning.” The generic sense of “any particular
amount of surface (whether open or not) contained within any set of
limits” is from 1560s. Area code in the North American telephone
systems is attested from 1959.

Etym. virtual (adj.) The meaning “being something in essence or

effect, though not actually or in fact” is from mid-15c., probably via
sense of “capable of producing a certain effect” (early 15c.). Computer
sense of “not physically existing but made to appear by software” is
attested from 1959.

Etym. environment (n.) “c. 1600, “state of being environed” (see

environ (v.) + -ment); sense of “the aggregate of the conditions in
which a person or thing lives” is by 1827 (used by Carlyle to render
German Umgebung); specialized ecology sense first recorded 1956.”

Definition

• First used in the military, the Wide Area Virtual Environment is a

non-proprietary term similar to a CAVE, in which participant(s)
undergo a simulation within an area enclosed by walls with
projected images. Specialized goggles are not required for
WAVEs.

• WAVES can be very large, almost 8,000 square feet (745 square
meters) with multiple chambers, corridors, and sections. The walls
act as large movie screens with continued projected images, and
sound systems enable participants to echolocate ambient noises.

Compare: CAVE AUTOMATED VIRTUAL ENVIRONMENT

57
58
Appendix
TERMS NO LONGER RECOMMENDED
FOR USE BY SSH
Confederate \ kən-ˈfe-d(ə-)rət \ noun
Etym . late 14c., from Late Latin confoederatus “leagued together,”
past participle of confoederare “to unite by a league,” from com-
“with, together”.

Definition

• An individual(s) who, during the course of the clinical scenario,

provides assistance locating and/or troubleshooting equipment.
This individual(s) may provide support for participants in the
form of ‘help available’, e.g., ‘nurse in charge’, and/or to provide
information about the manikin that is not available in other ways,
e.g., temperature, color change, and/or to provide additional
realism by playing the role of a relative or a staff member (ASSH).

• An individual other than the patient who is scripted in a simulation

to provide realism, additional challenges or additional information
for the learner e.g., paramedic, receptionist, family member,
laboratory technician (Victorian Simulated Patient Network).

Instead, use one of the following as best fits: ACTOR, EMBEDDED

PARTICIPANT, SIMULATED PATIENT, SIMULATED PERSON,
STANDARDIZED PATIENT

59
60
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