Chapter 9 Simulation-Based Education and the Challenge of Transfer

An implicit assumption of simulation is that skills learned in the simulation setting can be easily, or even automatically, transferred to the real clinical setting. A corollary to this assumption is that the more closely the simulation resembles “real life” the more likely this will occur. In this chapter we critically examine these assumptions. We invoke an extensive literature in psychology and motor learning that indicates that transfer is far from easy, and can, under some circumstances, be extraordinarily difficult. We also show that an appearance of reality is no guarantee that skills will transfer. We then explore various features of simulation and its curriculum application that increase the likelihood of successful transfer.