NLN Technology Edge Blog Breaks Down INACSL Simulation Operations Standard with 7-Part Blog Series

The National League for Nursing (NLN) Center for Innovation in Education Excellence has just completed their 7-part blog series covering the specific components of the International Nursing Association for Clinical Simulation and Learning (INACSL)’s Simulation Operations Standard. This is a very helpful series for clinical educators and simulation program administrators and/or technicians looking to dive deeper into Operations for excellence in Clinical Simulation. We take a closer look at the INACSL Standards, and review each part of the 7-part series covering the 6 criteria necessary to meet this standard!

About the INACSL Simulation Operations Standard

The International Nursing Association for Clinical Simulation and Learning (INACSL) has developed the INACSL Standards of Best Practice: Simulation to advance the science of simulation, share best practices, and provide evidence-based guidelines for implementation and training. The INACSL Standards of Best Practice: Simulation provide a detailed process for evaluating and improving simulation operating procedures and delivery methods that every simulation team will benefit from. Adoption of the INACSL Standards of Best Practice: Simulation demonstrate a commitment to quality and implementation of rigorous evidence based practices in healthcare education to improve patient care by complying with practice standards


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All simulation-based education programs require systems and infrastructure to support and maintain operations. Simulation operations encompass the infrastructure, people, and processes necessary for implementation of an effective and efficient simulation-based education (SBE) program. The interactions of these pieces must form a system that integrates with larger educational and health care entities to realize the goals of SBE. SBE is no longer an adjunct to health care training and/or professional development programs but an all-inclusive integrated program requiring business acumen and technically knowledgeable personnel that serve as team members providing leadership and support in the delivery of SBE. The required knowledge, skills, and attributes to implement evidence-based best practices for simulation experiences are evolving rapidly. These skills may be possessed by an individual or shared among a team. Specialists with business, education, and technical skills promote growth, sustainability, fidelity, and achievement of goals and outcomes. The need for defining simulation operations goes beyond any role or title. Successful simulation operations are curated as dynamic collaborations among leaders, educators, learners, and adaptive relationships between departments.

Potential consequences of not following this standard place programs at risk of not achieving SBE strategic goals and objectives. If expertise is not efficiently used or not accurately recognized, programs may fail to create an effective and efficient SBE program. If fiscal appropriations cannot meet the strategic needs of the SBE program, sustainability will also be at risk and/or growth stifled. Read the full INACSL Simulation Operations Standard here.

About the NLN TEQ Blog

The NLN TEQ blog is a resource brought to you by the NLN Center for Innovation in Simulation and Technology. TEQ contributors blog on topics that keep nurse educators up-to-date with the latest innovations in simulation, e-learning, telehealth and informatics. The TEQ Blog editorial advisory board features simulation educators who have strong writing skills and an interest in being a regular blog contributor and/or peer reviewer. These nurse educators have been actively involved in the NLN Simulation Leader Program and the Health Information Technology Scholars Program (HITS). Blog content will be released biweekly with our editorial board contributors featuring submissions focused on innovative and contemporary technology thinking across the continuum of nursing education and practice.


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NLN TEQ Blog 7-Part Series

Below are brief excerpts of the full NLN TEQ Blogs available through the linked titles:

Part 1: “Are You Ready For Simulation?” – Series Introduction (Tonya Schneidereith, Colette Foisy-Doll, and Kim Leighton): When simulation was shown to be an effective substitute for clinical experiences when certain criteria are met, the news was so exciting that administrators, faculty, and staff jumped into simulation without thinking through the details necessary to ensure a successful program. In the first part of this seven-part series, we talk about how to determine if your program is ready for simulation. One of the biggest questions is: how accepting is the organization of the pedagogy of simulation? This change may require a fundamental shift in teaching methods, from doing things the way they’ve always been done through lecture toward a more active way of learning. Is your organization willing to change the culture and challenge the status quo?

Part 2: “Strategic Planning” (Tonya Schneidereith and Fara Bowler): According to the Cambridge Dictionary, strategic planning is “a process in which a company’s executives decide what they want to achieve and the best actions and use of resources for doing this.” In other words, a strategic plan is the roadmap to get you to your goals. For simulation organizations, identifying the components that comprise a successful program is one of the first steps in strategic planning. It is also Criterion 1 of the INACSL Standard of Best Practice: SimulationSM: Operations: “Implement a strategic plan that coordinates and aligns resources of the SBE program to achieve its goals”.

Part 3: “Staffing Models (Tonya Schneidereith and Fara Bowler): Criterion 2 of the INACSL Standard of Best Practice: SimulationSM: Operations is: “Provide personnel with appropriate expertise to support and sustain the SBE program”. So, who are responsible for supporting and sustaining your simulation program? First, it is important to define the role of simulation personnel. Create job descriptions that align with the parent’s organizational structure. If your institution has “Clinical Educators,” “Clinical Faculty,” or “Specialty Directors,” make sure that your job titles for simulation positions use the same wording. This will help your personnel with annual evaluations, salaries, and opportunities for promotion and advancement.

Part 4: “Systems Management” (Tonya Schneidereith and Crystel L. Farina): Criterion 3 of the INACSL Standard of Best Practice: SimulationSM: Operations is: “Use a system to manage space, equipment, and personnel resources”. What does that mean for simulation? A system, according to Merriam-Webster, is “a regularly interacting or interdependent group of items forming a unified whole.” Systems integration for simulation programs requires detailed organization to ensure that space, equipment, and personnel resources are managed efficiently. Written policies are important to delineate how educational activities are planned. Simulations should address programmatic needs, align with educational outcomes, and have clear, measurable objectives. During the planning stage, note whether objectives require low-fidelity task trainers, high-fidelity manikins, or standardized participants.

Part 5: “Financial Resources”(Tonya Schneidereith and Crystel L. Farina): In order to sustain your program, you must have a formalized plan to analyze yearly cycle costs and compare them with predicted revenues and expenses. As you prepare your budget, do not forget to include those fixed expenses related to overhead and utilities (e.g., laundry, biohazards). In addition, identify places in the budget where you may need to cut spending, and also have a list of how you could use surplus funds. Utilize your program’s mission and vision statements when making decisions about the allotment of funds and ask your financial director for assistance to confirm that your simulation budget predictions align with the program’s predictions. Quarterly financial meetings can ensure that forecasts are aligned or adjusted as needed. Also, consider annual meetings with stakeholders to help guide spending.

Part 6: “Systems Integration” (Tonya Schneidereith and Crystel L. Farina): Consider how your program periodically reviews the strategic plan and short- and long-term goals. An advisory board or committee of faculty, staff, students, and stakeholders can help regularly assess plans and goals to evaluate if your strategies are meeting benchmarks or if they require revision to stay on target. Have quarterly meetings to discuss programmatic goals and anticipated trends for the upcoming year (e.g., increased student enrollment, capital expenditures). Also determine key performance indicators for your simulation program. Examples include learner evaluations, space utilization reports, faculty teaching hours, or decreases in error or infection rates, such as medication errors or catheter-associated urinary tract infections. When possible, try to use data collection methods that have established metrics.

Part 7: “Policies & Procedures” (Tonya Schneidereith and Julie Poore): Policies are guiding principles, often related to the mission of the organization, that provide consistency across the organization. These may include who is responsible for administering the policy, an effective date, a review date, a rationale, and scope. Procedures, on the other hand, outline steps to support the policy. For example, an institution may have a policy statement on the roles and responsibilities required of simulation facilitators; the procedures will identify the necessary steps to hire, train, and evaluate the simulation facilitators. Having written policies and procedures for a simulation program make for a more efficient workplace. An exemplar can be found in the Resource Library on the Society for Simulation in Healthcare’s website. These can be housed in a central location or online, so that anyone involved in simulation operations knows what to do, how to do it, or where to go. Although policies and procedures should be specific to your organization, we wanted to highlight a few areas for you to think about.

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