By Lesley McKarney

Recently, I had the privilege of attending the International Meeting for Simulation in Healthcare (IMSH) in San Diego, CA in January 2016. This is the annual conference of the Society for Simulation in Healthcare (SSIH) and it was held over four days (plus three days of pre-conference activities) and attracted more than 2500 delegates from around 75 countries. It’s a key event in the calendar of healthcare simulation offerings.

Celebrating its sixteenth year, IMSH 2016 brought together practitioners, simulation educators, academics, innovators and developers from a wide spectrum of simulation-based healthcare disciplines. Attendees gathered to learn, network and share in everything exciting and new in the burgeoning field of simulation-based medical education and healthcare simulation training tools.

Faculty development, support and turnover were common issues cited in several sessions focussed on getting started on, or expanding simulation programs. There are many challenges associated with recruiting and retaining clinicians to be simulation faculty, particularly in regional areas of Australia. It follows that there’s a growing need for simulation programs to create an incentive for recruiting and retaining clinician partners by formalising their simulation efforts into promotable scholarly activities.

The key to keeping your simulation educator staff, it would seem, is to first define faculty needs in simulation education and provide the necessary support to enable that to happen; and secondly, provide some assurance to simulation faculty that their activities are recognised and appropriately incorporated into the fabric of the organisation.

As for professional development, there is an increasing offering of faculty development courses in simulation but it can quickly become a costly venture to send staff offsite (often interstate) for such training. For some organisations, a more sustainable model may be to design and deliver their own simulation instructor training, perhaps in collaboration with other sites.  

I took the opportunity to attend a pre-conference workshop at IMSH 2016, Build a Simulation Instructor Course.  It was run by the friendly folk at PennState University Clinical Simulation Center, who’ve had a good deal of experience at developing simulation instructor courses and helping others to do so. Effective use of simulation, they say, is part science, part art, part experience and a large part practice after reflective instruction.

Below are some of the take-home messages from the workshop:

1. Conduct a needs assessment for simulation gaps in your organisation. Understanding the needs of your audience is obviously key to getting the right balance in content and creating something useful and that senior management sees the value in
2. Who are your learners? Have a good understanding of your faculty experience using simulation when you are designing a course. Few trainees will have background in education and simulation theory
3. You can’t teach everything in one course
4. Keep the course coherent and focused. Know what you what to teach and what you don’t want to teach
5. Be aware of the diversity of learners and learning styles and follow adult learning theoretical frameworks
6. Set clear course expectations before and during the course
7. Use a crawl, walk, run approach to build learner confidence. Be mindful of the level of your students and teach to that.
8. Remind learners that debriefing is difficult and requires practice
9. Use watchmen to assess flow, presentations and learner engagement
10. Use smaller learner groups for collaborative, hands-on work
11. Learner satisfaction and comfort is crucial: pay attention to room temperature, provide adequate space and food
12. Finally, create the course knowing you will change it often. Simulation instructor courses should evolve over time but they will never be perfect in the experience of the PennState educators. Collecting and incorporating feedback from participants at the end of each day is vital for improving any course. Be prepared to cover off any ‘grey’ areas in the evaluation as your course goes along, if possible.  Accept that you’ll need to change the course before, during and after each rendition according to learner and instructor feedback.

The workshop highlighted for participants the complexity of designing a fit-for-purpose educational program, as we were tasked with deciding on content for a 1-day, 2-day, 3-day or 5-day course curriculum. Deciding on what topics should be given greatest weight and how should they be ordered was not an easy task, given the breadth of possible content. The workshop emphasized effective debriefing as the key to learning in simulation-based education. Overall, the workshop participants decided on the following list of the top ten topics for a simulation instructor course, ranked in order of importance.

1. Debriefing
2. Standards and guidelines
3. Conducting needs assessments and gap analyses
4. Evaluation (at the learner, instructor and program levels)
5. Developing learning objectives
6. Simulation modalities and methodology
7. Scenario design
8. Facilitator roles and responsibilities
9. Learning theories
10. Curriculum integration and program design

For more information on designing a simulation instructor course, check out the Resources below.

Resources

The University of Washington CHSIERP has produced a series of e-learning modules for simulation faculty development, which can be accessed for free (but with registration)

PennState have published a suggested reading list for simulation instructors

Zigmont J et al. (2015) Chapter 8.1: Educator Training and Simulation Methodology Courses. In Defining Excellence in Simulation Programs. Edited by J. Palaganas, JC Maxworthy, CA Epps and ME Mancini. Published by Wolters Kluwer.

Jeffries PR et al. (2015) Faculty Development When Initiating Simulation Programs: Lessons Learned From the National Simulation Study. Journal of Nursing Regulation 5(4):17–23. Available athttp://www.journalofnursingregulation.com/article/S2155-8256%2815%2930037-5/pdf

Sinz e et al. (2014) Teaching Simulation Literacy in Adult Healthcare Education: A Qualitative Action Research Study. Available at http://www.adulterc.org/Proceedings/2014/papers/Sinz.pdf

Cheng A et al. (2015) Faculty Development for Simulation Programs: Five Issues for the Future of Debriefing Training. Simulation in Healthcare 10(4):217-22.

Paige JT et al. (2015) Debriefing 101: training faculty to promote learning in simulation-based training.  American Journal of Surgery 209(1):126-31.

Kim S et al. (2011) Halting the revolving door of faculty turnover: recruiting and retaining clinician educators in an academic medical simulation center. Simulation in Healthcare 6(3):168-75