ASPiH UK National Simulation Development Project Summary Report
The Association for the Simulated Practice in Healthcare published this UK National Simulation Summary Report earlier this year. This National Simulation Development Project (NSDP) was funded by the Higher Education Academy (HEA), with additional funding and resources from Health Education England (HEE), and was conducted primarily by the Association for Simulated Practice in Healthcare (ASPiH). This report brings together information on the current state of play within the field of simulation based education (SBE), a key part of the technology enhanced learning agenda.
- There is a growing body of evidence to support the use of SBE in healthcare
- The funding, training and availability of faculty is a key constraint to wider adoption of SBE
- SBE is used widely for training in core technical skills for craft specialties and other disciplines
- The presence of SBE in core curricula for most medical specialties and in nursing is increasing
- SBE is established as an essential component of human factors training but remains underutilised for this purpose
- The UK has the highest number of advanced simulation centres in Europe and the UK NHS is regarded as a global leader in the field of SBE
- The key problems facing those involved in delivering SBE in the UK are similar to those experienced elsewhere in the world.
- The management, sharing and co-ordination between centres delivering SBE remains poor in many areas
- The evidence that SBE can develop and assess skills and can change behaviours and improve patient outcomes requires further research and appropriate evidence to support future investment
- The development of multi-professional training has increased but the disconnect between under and post graduate and between nurse and doctor training remains
- Over 80% of advanced simulation centres have spare capacity
- There is limited availability of virtual reality and procedural skills training simulators hampering delivery of some specialty curricula that now include simulated practice competency requirements
- Use of in-situ simulation for all healthcare professionals is increasing but requires further support for effective delivery
- The value of public and patient involvement in the design of SBE is not widely recognised
- Quality control to guide the development of robust programmes of SBE and evidence the value and outcomes of these activities is required
1. National standards or guidance (as a complement to existing professional standards) for those educators delivering SBE are urgently required. We recommend that any on-going standards framework development includes strategic leadership and support from HEE, ASPiH, NES, HEA and AoME. Input should be sought from the relevant professional bodies and should take into account existing UK and international models currently in use. Future work should address the evidence that demonstrates successful completion, and subsequent progress from novice to expert; and will provide guidance on a portfolio approach to evidence that demonstrates the standards are being maintained through an appraisal process, or similar. This could also be an opportunity to establish support and a clear professional development pathway for those seeking to pursue scholarly development, or broader leadership qualities in SBE.
2. Funding, training and management support for faculty requires urgent attention. The availability of well trained, prepared and time resourced educators using SBE resources should be a key target for HEE, Local Health Boards, PSRBs (Professional Statutory or Regulatory Body) and Health education commissioners. The availability of faculty is also one of the key constraints limiting full utilisation of SBE resources. We recommend a national funding framework to support those delivering SBE and associated recognition in job plans and career portfolios.
3. The development of guidance for SBE in relation to patient safety and human factors training. There needs to be a national lead to ensure all those delivering SBE recognise and deliver effective human factors training by using simulated environments to drive home team skills, leadership and other key issues that affect patient safety. Human factors training provision should be a key criteria for commissioners of SBE. HEA and HEE should also develop a specific programme for SBE team training for medical, nursing and AHP students.