March 26, 2021By Jeanne Carey, RN, CHSE-A

Clinical Simulation Programs: A Breakdown of Leadership Titles, Positions & Roles

Running a healthcare simulation program is a complex endeavor that requires an array of knowledge, skills and abilities. While some medical simulation programs rely on random opportunity to fill open slots, the most successful medical simulation programs are intentional in their team-building (Palaganas, Maxworthy, Epps & Mancini, 2015). Regardless of the size of the sim lab team and how the program was built, someone needs to be “in charge.” The people responsible for overseeing a healthcare simulation program operate under a variety of titles that may or may not accurately convey the scope of their role or the necessary qualifications. This article will discuss the role of a healthcare simulation director, and explain how this role may vary from facility to facility.

The person heading the healthcare simulation program is oftentimes referred to as “the director” and in many academic-based programs, this person is a member of the faculty. This may seem like the logical choice; after all, clinical simulation is a teaching/learning methodology and faculty are educators. However, the clinical simulation director role frequently incorporates executive and administrative responsibilities, such as budget preparation, strategic planning, marketing, outreach and personnel training. Questions healthcare simulation professionals may ask when further considering the totality of a director role include:

  • Is this an appropriate position for faculty to assume?
  • Do the qualifications of a faculty member translate to the duties of the director position?
  • Does assuming this role help or hinder a faculty member’s professional progress toward tenure or promotion?
  • Might a staff member be successful in the role of director and if so, would this designation impact the responsibilities assigned to this position?

A recent job posting for a director of a healthcare simulation center at a large university lists three and a half pages of the duties and responsibilities of the position, along with the desired qualifications, special knowledge, skills and abilities of interested applicants. Yes, directing a large, multi-discipline simulation program is a huge opportunity. And yet, the role description goes on to say that the successful candidate must be willing and able to devote at least 50% of their time to this role.

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  • From this information, potential candidates are left wondering how demanding these responsibilities will be and what they will be expected to do with the remainder of their time. Other potential challenges to placing a faculty member in the role of the director of a clinical simulation program may arise because:
  • Faculty positions are often defined by workload percentages as referenced above and workloads vary from one semester to the next. Providing oversight to a robust simulation program while also navigating changing assignments can be challenging.
  • Many institutions of higher learning assess faculty for reappointment, promotion and tenure according to the four types of scholarship defined in the Boyer model: scholarship of discovery (research), scholarship of integration (collaboration/IPE), scholarship of application (service) and scholarship of teaching and learning. Oftentimes, serving as the director of a simulation program is not seen as meeting any of the criteria included in these four categories. Therefore, the time spent running the healthcare simulation program may limit the faculty member’s ability to achieve their professional goals (Renwick, Selkrig, Manathunga & Keamy, 2020).

Faculty schedules do not follow the “normal” Monday-through-Friday, 9-a.m.-to-5 p.m. operational template. They may be on a 10-month contract, but the work of running a healthcare simulation program cannot take a three-month hiatus (O’Meara, Jaeger, Misra, Lennartz, & Kuvaeva, 2018).

According to the INACSL Standards of Best Practice for Simulation, operations do not use the terms “director” or “faculty.” Instead, these best practices are concerned with ensuring clinical simulation programs possess the necessary infrastructure, people and processes for implementing high-quality simulation-based education. When discussing the personnel involved in operating a simulation program, the standards highlight the importance of business acumen and technical skills. The need for a well-defined strategic plan is also specified.

The standard acknowledges the advent of formal education and training programs in healthcare simulation and suggests these are the preferred qualifications for key personnel (INACSL Standards Committee, 2017). Note, the admission requirements for several of these graduate programs in healthcare simulation do not stipulate the applicant holds a particular undergraduate degree or even has healthcare experience. Instead, a graduate of one of these programs would possess the requisite knowledge, skills and abilities to direct a clinical simulation program, but at many institutions, would not be qualified to accept a faculty position.

Accreditation standards put forth by the Society for Simulation in Healthcare (SSH) state a healthcare simulation program is directed by a qualified individual with appropriate authority and time. Programs seeking accreditation must be able to demonstrate their director is assigned sufficient time in this role to support the mission and vision of the program. SSH does not require the person tasked with directing the program to hold the title of “director.” Instead, they recognize a variety of organizational structures exist and some programs may share the leadership responsibilities among several members of the simulation team (Society for Simulation in Healthcare, 2016).

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Making the director role a staff position can alleviate many of the difficulties experienced by faculty charged with running a clinical simulation program. Staff work year-round, often on more regular schedules. They are more available during regular business hours to oversee the daily operations of the program, meet with stakeholders and vendors, problem-solve IT issues and collaborate with outside interests. The staff member’s position can be dedicated to running the clinical simulation program, and professional advancement can be based on performance in this role.

The bottom line: No two healthcare simulation programs are alike and variations in organizational structures are inevitable. “Director” may or may not be an official title, and the duties of this role can be effectively executed by an individual or a team possessing the essential knowledge, skills and abilities. The person or persons assigned to fill the role of director must have sufficient time allotted to do the work of the role. Other assignments cannot compete with the responsibilities of running the clinical simulation program. Therefore, hiring a non-faculty, professional staff member as director can mitigate some of the struggles encountered by faculty assigned to lead healthcare simulation programs.

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