May 11, 2020By Lance Baily

Healthcare Simulation Curriculum Development, Integration, and Operations

Comprehensive Healthcare Simulation: Operations, Technology, and Innovative Practice is a must-own book for Medical Simulation programs looking to maximize the efficiency of their operations. From the basic theories to advanced practices, the latest healthcare simulation book has been praised by readers as a “Must Read” item for anyone operating, managing, or starting a medical simulation center. Today then, we take a closer look at the chapter on “Developing Healthcare Simulation Curriculum Development, Integration, and Operations” from leading experts Lori Lioce, DNP, FNP-BC, CSAP, CHSE-A, CHSOS, FAANP, Executive Director and Clinical Professor and Amelia S. Lanz, EdD, RN, CNE Associate Dean, Undergraduate Programs Clinical Assistant Professor, both from the University of Alabama in Huntsville. The ideas below present just some of the chapter’s numerous ways to help Clinical Simulation Champions  develop and integration curriculum into their program operations.

This chapter provides the healthcare simulation technology specialist (HSTS) with information to understand basic educational concepts which affect healthcare simulation curriculum development, share examples of simulation processes, and discuss a simulation operation framework. The design of nursing simulation (or any other) curriculums should align with sound educational practices and simulation evidence in order to consistently deliver effective simulation in healthcare experiences and support learning outcome measurement.

Curriculum awareness begins with identification of regulations and governing standards. Every setting has accrediting bodies, and depending on the purpose of your simulation facility, one or more sets of standards may apply. Being familiar with these standards can help make more informed decisions and aid in focusing the curriculum and design for day-to-day operations. Curriculum program administrators, deans, or directors can help provide copies of strategic plans, program outcomes, and/or student learning outcomes. A well-informed HSTS must be aware of the global perspective and influence of who sets the requirements for curriculum and outcomes in their setting. This will aid in a comprehensive understanding of how simulation fits into the overall program mission and vision.

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Curriculum is a term that is often used to describe a regimen of courses that must be taken to complete a program of study. Curriculum can also be viewed in a much broader sense to encompass the experiences, assessments, evaluations, and collaborative relationships that are interwoven into an instructional program. As an evidenced-based learning strategy, surgical simulation and other medical simulation specialities can be used to support many curricular goals and objectives and can be applied using a variety of strategic methods in many settings.

The process of curriculum development may be organized using a systematic approach or using a curriculum model. Common components typically include defining the need or problem, determining learning objectives and outcomes, developing strategies/content to achieve the desired outcomes, implementing the instruction, and then evaluating outcomes. The six-step model configured by Kern, Thomas, and Hughes for medical education is one such example and is discussed further in Chap. 13. This approach has been used to guide the development of various simulation programs. Another instructional model, PADDIE, is discussed at length in Chap. 12.

Ensuring sim lab meets a specified need prior to investing time and money into development is crucial and may be overshadowed by an individual’s passion for a particular topic. Often the HSTS should have a basic understanding of where the clinical simulation fits into the curriculum to allocate resources for development. Identification of short-term or long-term support will allow staff to make decisions regarding planning, archiving, and evaluating a simulation to be sustained by the program, whereas, if a medical simulation is a one-time experience, resource allocation can be streamlined.

A needs assessment should include consideration of the learners. Once a programmatic need and goal has been identified, who will be the target audience? Will the simulation need to focus on individual or team functions to meet the identified need? The educational and practice level of the learner should be considered to help focus the design. For example, a simulation for entry-level workers or students will need to be designed differently than one that is created for experienced professionals or even more advanced students. In addition, logistical factors might place constraints on the simulation program such as manpower, scheduling, and facilities.

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Methods to determining appropriate learning objectives are well explained in many resources. These objectives are very important because the formal or informal needs assessment identifies the objectives. The simulation design all the way through the evaluation should correlate back to the objectives. This helps keep everything clear, focused, and concise operationally and educationally. Objectives must be specific to the appropriate educational level of the learner. If expectations are too high, it may set the learner up for frustration and failure. If too low, the simulation in nursing may fail to engage and challenge the learner.

In curriculum development, a method should be identified to consistently organize each simulation experience for each simulation center. Electronic file naming, scenario design templates, and storage locations should be identified. One method for organizing each case is to determine the elements consistently used in a program and use a paper binder system for hands-on delivery of the simulation. This method allows for real-time changes and notes to be added to the case during the simulation and incorporated into the evaluation after the simulation. Not all simulations will have all elements but knowing where to locate the details consistently is essential in daily operations.

So, how does a curriculum get operationalized? It may be helpful to use a common change theory such as Lewin’s Change theory for this process. This theory supports that there are three concepts in change: driving forces, restraining forces, and equilibrium. Making small steps will increase buy-in, improve educator train- ing, and help maintain change and framework adherence as the program grows. It is important not to overwhelm the stakeholders. Start simple, and roll the frame- work out in phases especially if there is existing simulation program or process. Using a change process, such as Lewin’s change process, can be helpful for curriculum integration, policy and procedure changes, or implementation and personnel training. A sim center has many moving parts, and it can be daunting to manage and deliver valid simulations.

The HSTS has an indispensable role in curriculum development and delivery. Vision, innovation, and technical knowledge can greatly expand and improve educational opportunities. There is room for creativity in curriculum development. Frameworks and process should not stifle this input but provide a supportive environment for innovative engaging education. A process for engaging the HSTS sup- ports better experiences, measurable outcomes, greater efficiency, and increased return on investment. If there is not a clear process in a facility, find a champion (it can be the HSTS), to open a discussion, propose alternatives, and work to initiate this process by setting up meetings to share ideas. These processes must be customized and should guide but not dictate practice.

Previously We Shared Chapter Excerpts on:

More Key Take Aways From Latest Simulation Operations Book Include:

  • Practical guide helps prepare professionals for the broad scope of simulation in healthcare
  • Defines the domains of medical simulation operations
  • Focuses on the development of the healthcare simulation technology specialist
  • Written and edited by leaders in the field of clinical simulation

Written and edited by leaders in the field, Comprehensive Healthcare Simulation: Operations, Technology, and Innovative Practice is optimized for a variety of learners, including healthcare educators, simulation directors, as well as those looking to pursue a career in simulation operations as healthcare simulation technology specialists. Grab your copy today:

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