Immersion and Fidelity
Fidelity is the level to which a simulated training event replicates a real event and refers to the reproduction of the reactions, interactions, and responses of three elements –
Physical or environment factors include the training room or facilities, equipment and instruments.
Conceptual fidelity ensures the content of the scenario is authentic, realistic and occurs in a logical sequence.
Psychological elements of fidelity include 'buy-in' with team members and the simulated patient; replicating the noises, lighting and smells consistent with the clinical environment; and escalation of the scenario to apply appropriate pressures to participants to impose timelines and decision making.1, 2
Fiction Contract
In order to create an immersive learning environment and a successful simulation experience, an agreement, or a fiction contract, needs to be established to outline the expectations of the trainer and the participants prior to commencing the simulation.
The trainer is responsible for providing participants with an orientation of the simulated environment to clarify what aspects are genuine, address any limitations where participants will be required to suspend disbelief, and accept that the specified conditions during the scenario are real. Trainers also need to provide a safe learning space where participants don’t feel vulnerable in front of peers, and observations and assessment of participants’ performance during the simulation remain confidential.
The participants need to accept the conditions set by the trainer, understanding that while the simulation is not real that they will be given adequate tools, equipment, time and opportunity to perform the necessary tasks and assessment to the required level.
1. Dede C. Immersive interfaces for engagement and learning. Science. 2009;323:66–9
2. INACSL Standards of Best Practice: SimulationSM Simulation Design Clinical Simulation In Nursing, Volume 12 , S5 – S12
