Comparision and Contrast between Police and Medical Simulation

To the Editor: Recently I (D.H.) had an opportunity to observe and participate in simulation exercises with the Edmonton City Police Tactical Team. The exercises were part of the regular training for new recruits into the Tactical Team program. Each recruit is a member of the Edmonton City Police force with an average of 7 years seniority. These exercises and particularly the debriefing session demonstrated many similarities with medical simulation. The group leaders are interested and dedicated officers with previous tactical experience who also oversee all other aspects of the training program. Each simulation scenario started with a prebriefing followed by the exercise. The debriefing was a group activity with all participants standing in a circle to facilitate expression of opinion. The scenario and performance was reviewed in detail step by step. When issues were identified, the group discussed alternatives and repeated key steps to ensure the learning objectives were met. The main themes throughout the debriefing session mirrored crisis resource management issues addressed in healthcare. The majority of the session was spent discussing knowledge and reasoning deficits, resource allocation, fixation errors, and problems with priority formation. I did observe several differences in the debriefing session I attended versus those in healthcare Crisis Resource Management courses I have seen. The Tactical Team leaders were more critical and less supportive of learner errors. No time was spent familiarizing the learners with the concept of simulation nor was there any discussion about the deficiencies in the simulation. In other words, complete familiarity and acceptance of simulation by the trainees is assumed by their instructors. As Edmonton City Police officer are exposed to simulated training situations throughout their career and, by the time they come to the Tactical Team, they are conditioned to automatically treat the simulation as reality. This experience reinforces that issues and themes in medical simulation cut across other professions and their simulations, not just aviation. Pioneers of simulation in medicine have widely acknowledged that they borrowed the ideas and techniques from other domains, and practitioners of simulation in healthcare should continue looking to other professionals for collaboration and ideas. Darren Hudson, BSc (Hons), MD, FRCP Dave Berry From the Department of Critical Care Medicine, University of Alberta (D.H.) and the Edmonton Police Service Tactical Team Unit (D.B.), Canada.

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