International Journal of Healthcare Simulation
Adi Health+Wellness
149 Updates to the Healthcare Simulation Design Standard of Best Practice
DOI 10.54531/RVDZ2686, Volume: 1, Issue: Supplement 1, Pages: A25-A26
Article Type: In Practice, Article History

Table of Contents





Offering high-quality and purposeful simulation-based educational (SBE) activities to learners requires careful planning [1]. To improve SBE practice across all healthcare professions and for learners at all levels of experience, the International Nursing Association for Clinical Simulation and Learning (INACSL) has outlined a set of standards recently rebranded as the Healthcare Simulation Standard of Best Practice Practice™ (HSSOBPTM) that were initially published in 2013 and recently revised in 2021. Involving individuals with a range of relevant expertise, revisions to these standards have occurred every few years, including expanding the topics covered as developments in this domain have occurred and the use of simulation has expanded.


The aim of this abstract was to present the changes made to the Simulation Design Standard in comparison to its previously published version [2].


From 2019 to 2021, a group of simulation educators and researchers representing multiple specialities, simulation societies and geographic areas (the authors of this abstract) met regularly via a videoconferencing platform to review and revise the Simulation Design Standard based on their review of the latest literature and their individual experiences. The team identified several aspects that would benefit from being updated to make this key standard more explicit and applicable to all types of simulation modalities. Drafts of the standard were reviewed on multiple occasions by peer reviewers and the society’s leadership until the latest version was approved for publication.


An updated version of the Simulation Design HSSOBPTM will soon be published by INACSL in the journal Clinical Simulation in Nursing. It includes the same number of criteria, 11, most of which have retained the same title whereas a few others have been slightly redefined (Table 1). The new Simulation Design Standard provides clear information and guidance to the simulationists. The updated criteria can still be matched to those from the previous edition (see colour coding in Table 1) but are now more detailed and inclusive to be applicable to various simulation modalities and healthcare professions. Advances in virtual simulation experiences, new research and knowledge regarding pre-briefing, greater integration of simulation experiences throughout the curriculum both as a clinical replacement and in the classroom, as well as integration of multipatient and inter-professional teamwork experiences create excellent opportunities for learning if designed well using the HSSOBPTM.
Table 1:
Criteria of the 2016 and 2021 HSSOBPTM for simulation design
INACLS simulation design standard20162021
Criterion 1Perform a need assessment to provide the foundational evidence of the need for a well-designed simulation-based experienceSimulation experiences should be designed in consultation with content experts as well as simulationists who are knowledgeable and competent in best practices in simulation education, pedagogy and practice
Criterion 2Construct measurable objectivesPerform a need assessment to provide the foundational evidence of the need for a well-designed simulation-based experience
Criterion 3Structure the format of a simulation based on the purpose, theory and modality for the simulation-based experienceConstruct measurable objectives that build upon the learner’s foundational knowledge
Criterion 4Design a scenario or case to provide the context for the simulation-based experienceBuild the simulation-based experience to align the modality with the objectives
Criterion 5Use various types of fidelity to create the required perception of realismDesign a scenario, case or activity to provide the context for the simulation-based experience
Criterion 6Maintain a facilitative approach that is participant-centred and driven by the objectives, participant’s knowledge or level of experience, and the expected outcomesUse various types of fidelity to create the required perception of realism
Criterion 7Begin simulation-based experiences with a pre-briefingPlan a learner-centred facilitative approach driven by the objectives, learners’ knowledge and level of experience, and the expected outcomes
Criterion 8Follow simulation-based experiences with a debriefing and/or feedback sessionCreate a pre-briefing plan that includes preparation materials and briefing to guide participant success in the simulation-based experience
Criterion 9Include an evaluation of the participant(s), facilitator(s), the simulation-based experience, the facility and the support teamCreate a debriefing or feedback session and/or a guided reflection exercise to follow the simulation-based experience
Criterion 10Provide preparation materials and resources to promote participants’ ability to meet identified objectives and achieve expected outcomes of the simulation-based experienceDevelop a plan for evaluation of the learner and of the simulation-based experience
Criterion 11Pilot test simulation-based experiences before full implementationPilot test simulation-based experiences before full implementation

Implications for practice:

It is expected that the revised Simulation Design Standard of Best Practice will be welcomed by healthcare educators and simulation technology developers. It has been designed as a guide to help educators in all the key aspects of designing SBE activities, irrespective of the modality employed. It should ultimately benefit all learners but also promote the continuing professional development of the healthcare educator with an interest in SBE. It includes an updated list of useful references readers can consult to find additional information.

Alinier, Watts, Meakim, Nawathe, McDermott, Charnetski, Ludlow, and Horsley: 149 Updates to the Healthcare Simulation Design Standard of Best Practice



INACSL Standards Committee. INACSL standards of best practice: simulation design. Clin Simul Nursing. 2016;12:S5S12.


Jeffries PR, Rodgers B, Adamson K. NLN Jeffries simulation theory: brief narrative description. Nursing Educ Perspect. 2015;36:292293. Updates to the Healthcare Simulation Design Standard of Best Practice&author=&keyword=&subject=In Practice,