| Domain | Relevant ASPiH standards for mapping |
| Pedagogy | An introductory course (or courses) should expose and orientate novice simulation faculty to the principles of adult learning theory and explore underpinning educational theories/pedagogy relevant to the spectrum of simulation. The introductory course (or courses) should provide a definition of simulation, clarify terminology used and describe the simulation process and how scenarios are developed. Simulation-based education programmes are developed in alignment with formal curriculum mapping or learning/training needs analysis undertaken in clinical or educational practice. Domains (cognitive/affective/psychomotor) of learning involved in the activity should be described using educational theory (Bloom’s taxonomy or higher). This encourages faculty to aim to provide holistic teaching of the skill or task set for learners. |
| Human Factors | Faculty delivering human factors training should have undergone bespoke training in systems engineering, human factors or other systematic approaches to tackling workplace error and patient safety concerns. Debriefing should include relevant technical and non-technical aspects of performance as well as the human factors approach to patient safety. Consideration should be given to the incorporation of the human factors approach in SBE programmes to develop better healthcare practitioners with an improved understanding of the role of human factors. This will help build resilience in individual practice, increase team performance and produce systems improvement. Sufficient time needs to be allocated to debriefing immediately following the simulation in the clinical setting to gain the maximum benefit. A multidisciplinary approach to evaluating team interactions should be undertaken, with a focus on human factors approach to evaluate the impact of latent errors and to identify remedial steps to overcome such errors. Chartered Institute of Ergonomics and Human Factors Competency Checklist Human factors competencies have been adapted from the CIEHF Competency Checklist. |
| Course Creation and Development | The design & planning of SBE programmes is vital to ensure learners obtain the optimal benefit. Specific attention should be paid to describing how the use of simulation enhances existing educational/training interventions or provides learning opportunities to address current or anticipated gaps in curriculum & /or training. Simulation-based education programmes are developed in alignment with formal curriculum mapping or learning/training needs analysis undertaken in clinical or educational practice. A faculty member with expertise in simulation-based education oversees the simulation programme design & ensures that it is regularly peer reviewed, kept up to date & relevant to the organisation goals, clinical needs & curriculum to which it is mapped. Consultation with learners, managers & patient groups, as appropriate, should assist in identifying training needs. A learning needs assessment of all stakeholders should be used to develop the learning objectives. Learning objectives should be appropriate to the level of the learner &, at the same time, designed to be challenging but achievable. Objectives will need to be linked where applicable to individual technical or procedural skills, team working, non-technical skills & to organisational goals & requirements. Incorporate up-to-date, evidence-based practice in course content. A manual should be maintained to ensure consistency between design & delivery of the programme & reproducibility between faculty. A faculty member with expertise in SBE should oversee the simulation programme design & ensure that it is regularly peer reviewed & kept up to date & relevant to the organisational goals, clinical needs & curriculum to which it is mapped. The simulation lead oversees appropriate & responsive programme design, develops & retains faculty & sustains SBE programmes. |
| Simulated Patients | Simulated Patient (SP) involvement, as a specialist group of faculty, should be supported with the same considerations as other faculty members. Content should adhere to best practice when engaging with SPs, such that the four principles of biomedical ethics are adhered to: autonomy, beneficence, non-maleficence & justice. Where appropriate SPs should acquire specific training provided by a formal course, a Continuing Professional Development (CPD) opportunity, or targeted work with an experienced faculty member. Facilitators should engage with SPs to access, enable & incorporate their feedback. SPs should be competent in the process of debriefing & feedback from their perspective – as agreed on with the facilitator – in role, in neutral or out of role. Facilitators, SPs & technical personnel benefit from an additional debrief after the simulation session as & when required, without learner presence, to reflect & develop self-awareness. |
| Evaluation/Research | Consideration should be given to the incorporation of the human factors approach in SBE programmes to develop better healthcare practitioners with an improved understanding of the role of human factors. This will help build resilience in individual practice, increase team performance & produce systems improvement. A faculty member with expertise in SBE should oversee the simulation programme design & ensure that it is regularly peer reviewed & kept up to date & relevant to the organisational goals, clinical needs & curriculum to which it is mapped. Regular evaluation of programmes should be undertaken to ensure that content & relevance is maintained. This should be achieved at a minimum through feedback from learners & other simulation faculty. A formal evaluation by learners at the end of each session should be undertaken & the results of this evaluation should be acted upon to continuously improve & optimise the course. Faculty should evaluate ISS activity by using appropriate measurement tools, which demonstrate not only improvement of knowledge but also transfer of learning to a clinical environment. Observational tools should be designed to capture system improvements through the identification of latent errors during ISS activity. Programmes should aspire to act as a Quality & Risk Management resource for organisations to help achieve the goals of improved patient safety & quality. |
| Centre based delivery | New faculty should observe or co-facilitate existing courses alongside a more experienced faculty member & receive feedback using validated tools. Faculty should acquire specific training provided by a formal course, a Continuing Professional Development (CPD) opportunity, or targeted work with an experienced faculty member. Ensure that a pre-simulation brief takes place where learning objectives are set beforehand & discussed as part of the debriefing process which takes place after completing a simulated scenario, or in feedback on completing a practical skill. The pre-simulation brief should include elements such as expectations regarding professionalism, etiquette, confidentiality & roles, together with an introduction to the simulated environment. A manual should be maintained to ensure consistency between design & delivery of the programme & reproducibility between faculty. The expertise of faculty should be appropriate to the needs of the learners & content of the programme. The course delivery, if appropriate. A designated individual oversees the strategic delivery of SBE programmes & ensures that appropriate maintenance of simulation equipment is undertaken. Ensure mentoring of novice SBE faculty. |
| In-situ Simulation | Every ISS exercise has clearly defined learning objectives that achieve individual, team, unit level and/or organisational competencies. Local processes and procedures are carefully reviewed to deliver ISS activity authentically. Faculty delivering the ISS activity are proficient in SBE and have the required expertise on a given topic (Refer to Standards on faculty development above). |
| Technical | Simulation technicians and technologists, whose primary role is to support delivery of SBE, have gained or are working towards professional registration with the Science Council. |
| Debriefing | Faculty ensure that a safe learning environment is maintained for learners & encourages self-reflection on learning. Faculty engage in continuing professional development with regular evaluation of performance by both learner & fellow faculty. Faculty are competent in the process of debriefing. Specific training in debriefing should be provided to faculty as effective debriefing is recognised to be the most important element of learning in the simulated environment. New faculty should observe or co-facilitate existing courses alongside a more experienced faculty member & receive feedback using validated tools. The faculty & where appropriate, the SPs should acquire specific training provided by a formal course, a Continuing Professional Development (CPD) opportunity, or targeted work with an experienced faculty member. The process of becoming faculty should be streamlined as much as possible, keeping faculty training to an effective minimum as a lengthy process requiring multiple days of study leave could deter potential new faculty. Faculty development is a lifelong process & faculty should engage in CPD activities recognised by the individual’s professional body such as (but not restricted to) courses, conferences, e-learning, academic activities & regular appraisal of literature. Regular evaluation of faculty (of all levels of experience) performance by both learners & fellow faculty should be integral to the SBE exercise & could be achieved using a peer observation process. The facilitator should be a faculty member competent in the process of debriefing. Evidence from research suggests that the perceived skills of the debriefer have the highest independent correlation to the perceived overall quality of the simulation experience. The facilitator must identify pertinent elements of the simulation to discuss & relate to the objectives. This should include relevant technical & non-technical aspects of performance as well as the human factors approach to patient safety. Debriefing should be conducted in an environment that is safe, positive & non-threatening. An environment of trust, respect & confidentiality is necessary for all participants to feel sufficiently comfortable to share experiences & feelings. Duration & timing of debriefing is crucial but should be flexible enough to allow progression through phases of debriefing (e.g. reaction, analysis & summary). Debriefing should occur immediately (less than 5 minutes) after simulation so that thoughts, feeling & actions are captured without degradation or distortion. There are several popular models of debriefing, which the facilitator may wish to use as a structure for the process such as the advocacy enquiry model, the 3D Model of debriefing, the Mayo clinic model or the Lederman model. However, it is recognised that there is currently no standardised process or model of debriefing. |