The Role of Fidelity in Simulation Training

Fidelity comes from the Latin word fidēlis, meaning faithful or loyal. Generally speaking, fidelity is the degree of exactness with which something is copied or reproduced.

What is Fidelity in Simulation Training?

We have always emphasized on the role and benefits of using simulation for training aspiring doctors and nurses. Simulators are devices that imitate the real-life medical environment, but in a safe way, so learners can practice with real-time feedback but without the risks involved.

In simulation, fidelity is a term that denotes the degree to which the simulator replicates reality. Simply speaking, it is how well the simulator is able to imitate a real-life medical environment, or how close it gets to a real scenario. So, a simulator that depicts a real scenario really well would be termed “high-fidelity”, and one that does not so much, “low-fidelity”. A low-fidelity simulation is less realistic than a high-fidelity one.

Levels of Fidelity in Simulation

In 1990, Miller sketched out a pyramid depicting how a person’s actions are built upon his knowledge, competence, and performance. An increased level of fidelity in simulation may correspond to a transformation from knowledge to competence, performance, and ultimately, action. 

Miller's Pyramid

We observe the following levels of fidelity in simulation:

  • Low-Fidelity Simulation: This level of simulation helps build knowledge. This may not be very realistic, but it takes away the stress of the situation and lets the learner focus on learning the skill. Take static models and 2D displays for example.
  • Mid-Fidelity Simulation: This one is a bit more realistic and helps build competence in the learner. Take, for example, full-body manikins that imitate real heart and breathing sounds. Learners can use these to train on procedures like IV insertions, injections, and NG tube insertions.
  • High-Fidelity Simulation: These are the most realistic simulations- the closest to real life. Take, for example, full-body computerized manikins that can talk and run pre-programmed scenarios.

Types of Fidelity in Simulation

Fidelity can be physical, psychological, and conceptual. Physical fidelity can be perceived by the senses. If your manikin’s skin feels like real skin, and body parts react and bleed like they would on a real patient, it increases the degree of physical fidelity. Task-trainers, or lifelike manikin simulators representing a part of the body can help train on specific skills and focus on functional fidelity. And when they allow haptic feedback, that increases the degree of physical fidelity. Moulage, or applying makeup to mock injury, can engage learners’ sensory perceptions.

If you introduce some realistic background noises to the simulated setting, you will increase the physical fidelity, consequently also increasing the psychological fidelity as it elicits an emotional response from the learner and raises stress levels. If all aspects of your simulated scenario accurately represent how they would be in a real scenario, such that it makes sense to the learner, you have high conceptual fidelity.

Beyond the three major classifications, fidelity may also be classified as functional fidelity, which is the dynamic interaction between the learner and the task at hand, and sociological fidelity, which is how the interactions between the participants affect the level of realism.

So What Degree of Fidelity Do We Really Need?

Ideally, we want all simulators to be high-fidelity, but limited procurement budgets make that hard to achieve. So, often, we must settle for a trade-off between the degree of fidelity and the cost of procurement, or “mid-fidelity”. In high-stress environments, the costs may be monetary as well as loss of human life. We will discuss various scenarios ahead in the discourse.

Scenarios to Imagine

Imagine this. A well-established gaming company comes up with an exciting idea for a new game, and the developers must build it soon. A high-fidelity videogame would be meticulous with the graphics, the gameplay, and the story. A game that would manage to ignore even one of these aspects could fail to create an immersive, realistic gaming experience. This would result in a failure of the game to launch successfully, and possibly cost the company millions of dollars, along with ruining its reputation. Here, the cost would be monetary.

In the application of aircraft or driving simulation, higher fidelity would be required. Poor training and poor decisions made under high-stress, emergency situations in real-life could result in fatal outcomes. In emergency situations on an actual plane, you would expect your pilots to make the right decisions at the right time regardless of the immense stress of an urgent, unfamiliar situation. This cannot be made possible without training in high-fidelity simulation.

If we take the military for example, soldiers may be trained for combat in a high-fidelity simulation. Such training must prepare the soldier for making resource-aware decisions and train them in dealing with a variety of unexpected situations. Training for this in low-fidelity simulations may not prepare a soldier for combat, but create the illusion of competence.

Ultimately, the degree of fidelity exercised in simulation can impact the levels of confidence and anxiety. If learners practice in low-fidelity environments, they might incorrectly assume confidence. Being met with unexpected developments in-field can render a state of disillusionment and disbelief in the training, revealing that they were, in fact, unprepared, and further leading to possibly catastrophic consequences.

However, it is also true that learners and educators are biased towards HFS (High-Fidelity Simulation), and that higher levels of fidelity may increase the cognitive load on the learner to the point of overwhelming him, effectively decreasing learning. Maybe beginners would be better off starting with low-fidelity simulation and then move up as they gain experience. Low-fidelity simulation may also be preferred when training on skills that call for repeated practice.

For More Detailed Information Contact Us on sem@semtrainers.com or +91-88495 63724 .

Sem Trainers & Systems