A neologism in simulation: skillary

We have all been students and we have all frequented that place, almost mystical, mysterious and at the same time fascinating, where books and magazines are collected for study purpose, the library. From the Latin liber “book”, the term library identifies that physical space, indeed that fundamental service, which is aimed at the entire community of students and professionals to provide books, magazines, newspapers, audiovisual media so that everyone is able to keep informed and updated. The book is (perhaps it was) the heart of the service. Often linked within universities, the library provides teachers and learners with the necessary support for university studies with the aim of democratizing training by making expensive volumes and journals subscription accessible. The library is therefore an essential service of any university.

Today, simulation represents another invaluable resource that medical education is increasingly using, especially in recent years. The simulation has as its objective the faithful reproduction of anatomical parts, physiological or pathological functions, clinical situations of real life in which clinical and decisional actions are carried out. The awareness has grown that the competence of health professionals, either current or in training, cannot be guaranteed by proven theoretical knowledge only but also by procedural skills (the “know-how”) and social and relational skills (the ” knowing how to be “). More and more universities, training institutes and hospitals have invested huge economic resources to equip themselves with ultra-modern task trainers for the development or maintenance of procedural skills with the aim of improving the quality of training and, at the same time, not exposing patients in the places of care and learning at any kind of risk. However, these powerful training tools are too often only available in courses or educational workshops, and remain unused for the rest of the time. I see in this context a similarity with the nineteenth-century concept of the library according to which the library had the main task of keeping documents rather than making them available to as many people as possible. I believe the time has come to go further and create training spaces accessible as needed to practice the procedures in order to achieve and maintain quality standards. Here, then, is the new concept of the skillary. With a neologism from the term “skill”, that is the maneuver aimed at allowing the correct execution of a medical act according to international guidelines, I want to indicate that place of collection of task trainers where everyone can undertake self-education and permanent education journeys. To achieve an adequate level of performance it is necessary to ensure that our students can perform and repeat a given activity continuously and, at the same time, receive adequate feedback. Fortunately, more and more simulators are equipped with electronic performance detection systems and intuitive feedback. However, these training venues will need to ensure the presence of an expert. As the librarian makes available his own preparation to help users in bibliographic searches and also coordinates the use of the stored documents, so it will be necessary that theskillary is equipped with a professional figure with adequate clinical and teaching experience in simulation who can enhance the repetition of the procedural act through restitution and critical reflection.

The hope is that the skillary will not remain a simple dialectical attempt to coin a new term but become a widespread reality in any university as an essential service for students and professionals with the same dignity as the library.