Simulation en pédagogie médicale: état des lieux.

Training methodology having emerged primarily over the last two decades, simulation in health care has arisen from the idea that students should never practice on the patient for their "first time". Simulation makes it possible to try out the errors and to repeat the skills over and over, in a reproducible way and in the most realistic possible environment, but with no harm to the patients, a risk socially intolerable. Simulation implies multiple methods from simple role-playing schemes to most powerful experiments on high-fidelity mannequins. In all cases, simulation implies a strictly codified structure: briefing, scenario, then debriefing. Indeed, debriefing represents the cornerstone of the teaching process allowing, both technical and non-technical skills acquisition through a work based on self-criticism. It should be noticed however that, although medical simulation has very clearly provided evidence of its effectiveness in skills acquisition, appropriate behaviours or application of algorithms, it has not demonstrated any benefit in terms of patients' care quality. Further research is therefore needed to validate this last assumption, which represents the very objective of any evolution in medicine.