Simulation Learning

Ongoing education and training are paramount to delivering high-quality simulation-based education (SBE). Simulationists must adhere to professional SBE standards, which include a commitment to foundational, ongoing professional development and assessment of competence.

According to the Healthcare Simulation Standards of Best Practice™ standard on professional development (2021), simulationists should perform an educational needs assessment as the initial stage of simulation professional development. Doing so will provide the basis for a well-designed professional development plan by identifying:

• baseline knowledge
• perceived competency
• and gaps in SBE

©2021 INACSL. Used with permission.

Simulationists should participate in professional development activities that address desired learning outcomes and align with the individual’s role and workplace priorities. Individual professional development plans should be reevaluated regularly for continuous simulation competency improvement (Hallmark et al., 2021).     

The Simulation Educator Needs Assessment Tool (SENAT) is a useful tool for simulation educators to identify and prioritize their simulation professional development needs (Britt et al., 2023).

Simulation facilitators and educators may need time to become comfortable with simulation pedagogy. Ongoing professional development will help facilitators support learners during simulations. To minimize challenges and maximize success, facilitators and educators should prepare by:  

• Understanding what experiential learning and simulation pedagogy is, including:
  • prebriefing
  • facilitation
  • debriefing
• Creating clear learning objectives  for the simulation and seeking input from others. 
• Identifying and outlining specific SBE design details that will support the educator in facilitating learning (rather than telling the learner what to do). 
• Selecting and using the appropriate tools required to operationalize simulation. 
• Understanding how to use tools to document assessment and evaluation such as competency and IPE educator development, if this is being considered. 
• Planning adequate time for learners to experience, reflect and make meaning of the SBE experience.

(Jeffries et al., 2016) 

Theories, Conceptual Frameworks and Models 

Using theory, conceptual frameworks and models is recommended when planning for facilitators’ professional development. One example is Benner’s Novice-to-Expert theory. It describes a professional growth model which progresses through core stages:

1. Novice
2. Advanced beginner
3. Competent
4. Proficient
5. Expert

(Thomas & Kellgren, 2017).  

Cheng and colleagues (2020) modified the Dreyfus and Dreyfus model of skill development to create another conceptual framework for developing debriefing skills. They divide debriefers into 3 stages by highlighting their characteristics, knowledge, and skills at each stage. Based on this conceptual framework, educators are provided scaffolding for self-reflective activities to help identify opportunities and strategies for improvement (Cheng et al., 2020).   

1. The discovery stage (novice to advanced beginners): Debriefers gain fundamental knowledge of debriefing concepts such as:
   • evidence-based frameworks
   • educational pedagogy
   • psychological safety
2. The growth stage (competent): Debriefers continue to add to their growing toolbox of strategies to manage more complex debriefing situations. These may include:
   • co-debriefing skills
   • strategies to manage difficult discussions
   • incorporating equity, diversity and inclusion principles 
   • improving authenticity and standardized elements for discussion 
3. The maturity stage (proficient to expert): Debriefers can adapt to a variety of different debriefing contexts by applying their comprehensive knowledge, deep understanding and experience. They can adapt and problem solve new challenges using past experiences and intuition, even if they have not been exposed to that specific challenge previously (Cheng et al., 2020; Kumar et al., 2021).

Steinhart (2010) outlines a variety of professional development opportunities to consider based on formality and the context of learning. These range from informal individual opportunities to learn by observing or doing, to formal group opportunities, such as seminars or fellowship programs.

In addition to being trained in aspects of simulation such as design, implementation, and evaluation, it is important that simulation facilitators receive professional development on equity, diversity and inclusion (EDI) (Jeffries, 2020). They should have the skills to provide learning experiences that incorporate EDI principles into all aspects of SBE (Hallmark et al., 2021).

EDI professional development enables facilitators to:

• effectively embed EDI into simulation scenarios.
• conduct prebriefing, facilitation and debriefing in a psychologically safe manner.

EDI professional development for simulation facilitators could include topics such as:

• the components of EDI
• the importance of EDI in health care training
• how to embed EDI in simulation
• how to incorporate EDI in simulation-based education

(Nakajima et al., 2022)

Consider consulting EDI experts and mentors. Experienced faculty mentors can provide guidance, support, and feedback on cueing, scenario scripting and the selected debriefing and evaluation methods for EDI simulation-based experiences (Williams et al., 2023).  

Now that you’ve reviewed the simulation guide, please ensure you complete the SENAT tool or another tool to reflect on your simulation experiences and to determine your own simulation learning goals.