International Journal of Healthcare Simulation
Adi Health+Wellness
116 Developing a Framework for the Integration of Skills and Simulation: The 5-Stage Approach
DOI 10.54531/KYBT8535, Volume: 1, Issue: Supplement 1, Pages: A54-A54
Article Type: Innovations, Article History

Table of Contents





In recent years, there have been many publications providing guidance on simulation-based education and frameworks for development of faculty and delivery of simulation. However, there is not a framework for the integration and delivery of skills and simulation within a pre-registration curriculum. In 2017, Woda [1] referred to a need for a ‘sequenced’ integration of simulation into programmes with increasing complexity, knowledge, and exposure to simulation. Furguson [2] also found that there was a gap in how a simulation strategy becomes effectively implemented and embedded within an existing curriculum.


The aim of the study was to create a framework that integrates clinical skills and simulation increasing in complexity that can be used for any pre-registration healthcare curriculum. Ability to effectively implement and embed within an existing or new curriculum.


We developed a framework using a five-stage approach to scaffold learning. Bringing simulation into the curriculum from the very start with the early introduction of consolidation and simulation allowing for a gradual cognitive load. Our approach builds on technical and non-technical skills alongside an understanding and exposure to simulation, by their final-year students will be debriefing their own teams in simulation and understand the use of simulation debriefing tools. This integration of skills and simulation and move away from ‘task training’ skills teaching aims to create both competence and confidence in students enhancing practice placements and ultimately improving the safety of patients. The approach consists of five stages: (1) online learning; (2) facilitated practical (task training); (3) simulation consolidation (facilitated simulation); (4) simulation days (remote facilitation); (5) clinical practice.

Implementation outline:

The framework is being applied to the 2-year Master's programmes and nursing associate programmes as well as the standard 3-year pre-registration nursing, midwifery, operating department practitioner and paramedic programmes. Skills both technical and non-technical are introduced in years 1 and 2. In year 3, the focus is on knowledge review with a higher expectation of understanding and assimilation into the simulated environments expected. Over the 3 years, facilitation will lessen until students are leading on the simulation delivery and debrief by the end of their course. The same principle is applied to the 2-year programmes. This framework has been applied to all our healthcare courses by mapping the required skills curriculum and using the framework to build the content and set the delivery. The framework has now been adopted by another university.

Browne and Phillips: 116 Developing a Framework for the Integration of Skills and Simulation: The 5-Stage Approach



Woda A, Hansen J, Paquette M, Topp R. The impact of simulation sequencing on perceived clinical decision making. Nurse Educ Practice. 2017;26:3338.


Furguson J, Astbury J, Willis S, Silverthorne J, Schafheurne E. Implementing, embedding and sustaining simulation-based education: what helps, what hinders. Med Educ. 2020;54(10):915924. Developing a Framework for the Integration of Skills and Simulation: The 5-Stage Approach&author=&keyword=&subject=Innovations,