International Journal of Healthcare Simulation

Introduction

Simulation is an effective teaching strategy that enhances critical thinking and clinical judgement, enables decision-making, promotes teamwork and improves confidence for healthcare learners [1]. As the science of simulation has grown, more and more academic and healthcare clinical educators have become interested in using simulation in their courses and practice to encourage active learning through learner engagement. While opportunities for training in simulation methodology exist (workshops, conferences and designated academic programs), not all educators have time to attend these offerings and moreover, many lack institutional, administrative and/or financial support. Faculty from across our university and educators from the healthcare system expressed interest in learning more about simulation pedagogy, and this interest increased during the COVID-19 pandemic. The International Nursing Association of Clinical Learning in Simulation (INACSL) Standards of Best Practice^SM [2] (which have recently been revised and named the Healthcare Simulation Standards of Best Practice^TM) served as our call to action to create an online simulation education course we called ‘Cultivating Simulation Champions’ for interested educators across the university and health system. The course was designed by a group of simulation experts at our university using the INACSL Standards of Best Practice^SM and served as the foundation for an evidence-based approach promote excellence in simulation from design through evaluation and professional development [2,3].

Innovation

The ‘Cultivating Simulation Champions’ course was designed by simulation educators partnering with the nursing school’s Institute for Educational Excellence (IEE). The IEE was established to meet the needs of a changing healthcare system through the facilitation of ongoing transformation of pedagogy in nursing and healthcare education. This course was well integrated with the mission of the IEE. A group of simulation experts at our university facilitated a five-session introductory simulation course for academic and clinical educators. The overall outcome for the course was to create ‘simulation champions’ to advance/enhance the use of high-quality, evidence-based simulation in education. The primary course objectives were:

1. Describe principles of utilizing simulation as an educational tool.
2. Identify best practices for healthcare simulation and role in improving patient safety.
3. Explore opportunities to integrate simulation into education, research and practice.
4. Apply strategies for managing a simulation programme/centre including effective utilization of resources.

Sessions were conducted biweekly and consisted of 1.5-hour meetings that centred around the INACSL Standards. Sessions were offered in both the morning and the evening to accommodate learners’ schedules. Biweekly sessions were chosen to allow learners 1 week in between sessions to complete readings, coursework and to self-identify areas needing additional knowledge. Each session was facilitated by volunteer simulation experts from differing disciplines across the university (nursing, medicine, physical therapy and information technology) using PowerPoint slides to present course content. Table 1 lists the session topics. Learners had access to the slides and session summary after each session. There was no cost to implement the course since the faculty facilitators volunteered their time, the sessions were conducted virtually and materials for the participants were made available online.

Table 1.

Workshop session topics

Cultivating Simulation Champions Workshop Series
Week	Content
#1	•Certification discussions •Certification test plan •Educational theories •Simulation pedagogy •Development of learning objectives
#2	•Review of INACSL Standards of Best Practice: SimulationSM •Resources for CHSE exam review •Professional organizations for simulation educators •Simulation glossary
#3	•Simulation lab management •Use of technology in simulation •Types of simulation •Pre-briefing •Debriefing •Use of standardized patients
#4	•Leadership in simulation •Lab accreditation •Professional development •Research in simulation •Interprofessional education •Evaluation of expected outcomes
#5	•Exam Prep – review of 30 questions practice exam

Evaluation

A self-administered knowledge post-test was given after each session to evaluate the learners with 5–10 multiple choice questions. At the end of the 5-week course, learners were asked to complete a course evaluation survey. Certificates of Completion were issued to learners who attended at least four of the five sessions.

Outcomes

Fifty academic faculty and clinical partners registered to attend the course and 97% (n = 47) attended the five sessions. The three who were unable to complete the course reported they were unable to align their schedules with the times that were offered. Table 2 shows the learner-reported demographic workplace identities.

Table 2.

Participant workplace identities

	Academic faculty	Clinical educators	Identified as both academic and clinical educators
Nursing	20	10	3
Medicine		6
Physical therapy	1
Clinical partners		2
Physician Assistant	2
Unknown	3

Thirty-seven people completed the post-course evaluation (79%). Participants strongly agreed the primary course objectives (94-97%) were met. Participants noted ‘This program gave me the confidence and structural framework to develop simulation education for my students’, ‘I will directly apply these best practices to my teaching practices and ongoing research in simulation’ and ‘I learned so much about simulation and how to integrate it into practice’. These results reflect the value to both academic and clinical educators. No participants reported any negative outcomes from attending the workshop. All 47 learners earned certificates of completion, and to date, 5 learners have earned their simulation healthcare certification. The knowledge post-tests were not graded, instead used as a formative facilitator-led discussion-style question and answer session.

What’s Next

This innovative approach to educating ‘Simulation Champions’ may be a useful and effective model and serve as a template for other academic and/or healthcare institutions trying to enhance simulation pedagogy. It offers a feasible, flexible and practical approach to meet the growing needs of educators interested in using simulation. The online aspect of the course makes it ideal for rural areas where access to simulation centres may be difficult.

For the next Cultivating Simulation Champions course, we plan to make minor changes to the PowerPoint presentations such as incorporating the Association for Standardized Patient Educators Standards of Best Practice in the standardized patient presentation and using the newly revised IPEC Core Competencies in the interprofessional presentation. We also plan to offer a hybrid (in person and virtual) option now that the COVID-19 restrictions have been lifted. We feel this may encourage more academic and clinical educators to attend. We plan to evaluate the overall effectiveness of the course and the impact the course had on faculty implementing simulation into their respective courses/educational offerings. In addition, we plan to further explore other simulation topics and facilitation methods that could be added to enhance the course and potentially implement a follow-up course.