June 10, 2022By Lance Baily

Development of Distance Simulation Educator Guidelines in Healthcare

The abrupt disruption of in-person instruction throughout healthcare during the COVID-19 pandemic resulted in the rapid adoption of distance simulation. Designed as an immediate alternative to providing immersive simulation-based education, this massive instructional shift – combined with the lack of educator training in this domain – led to challenges for both learners and educators. This HealthySimulation.com article details a study conducted by Rami A Ahmed, DO, MHPE, FACEP, and colleagues, meant to disseminate the first set of competencies required of and unique to effective distance simulation educators.

Put together by the MGH Institute of Health Professions Ph.D. Program Course HE951 in collaboration with the healthcare Distance collaboration prepared in September 2021, the team used a seven-step process to create this initial draft:
1) Identification of professional roles that encompass the skills of an ideal Distance Simulation Educator via expert review and consensus
2) Analysis of 25 professional roles (simulation, education, management, technology, and others) through research, interviews, and creation of a rubric for each profession
3) Presentation of individual draft reports and discussion
4) Curation of rubrics
5) Review by internal experts
6) Review by external experts
7) Review by a comprehensive research team

“The pandemic allowed us to get a taste of what education will be like 10 years from now. Distance simulation is not only here to stay, it is our future. In our 2020 Healthcare Distance Simulation Collaboration Survey, 86% of respondents indicated that they would continue some form of distance simulation when the world ‘returned to normal,’ Janice C. Palaganas wrote in the published guidelines. “Can we really say, then, that we as simulationists are competent at what we do if we don’t have some sort of knowledge about how best to do distance simulation?”

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During the modified Delphi study, the researchers sought to validate the content of carefully and rigorously synthesized literature. To do so, experts were invited from around the globe to participate in the study with mandatory attendance at an annual healthcare simulation conference. At the conference, they were requested to openly discuss the guidelines presented as competencies in this landmark document. Each competency was divided into “Basic” and “Advanced” levels, and agreement was sought for each level individually.

“There were over 82 international experts with 12 identified backgrounds from 16 countries providing expertise towards the development of these comprehensive guidelines. We had very rich conversations surrounding several basic and advanced guidelines, looking at them from various viewpoints, and exploring technical considerations, educational theory, cultural considerations, and diversity topics,” shared Ahmed. “We are very excited about the depth and breadth of these first set of distance simulation guidelines for the international community.”

Watch Recorded CE Webinar: “Development of Distance Simulation Educator Guidelines in Healthcare

Presented by Rami A Ahmed, DO, MHPE, FACEP, this one-hour, advanced CE webinar discusses the development of the first set of consensus guidelines for distance simulation educators in healthcare. Learning objectives include to:

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  • Discuss the development of consensus guidelines for distance simulation educators in healthcare.
  • Describe the implications of the new consensus guidelines for all simulation educators in healthcare.
  • Identify future faculty development and research opportunities stemming from the new consensus guidelines for simulation educators in healthcare.

Ultimately, the number of competencies within the Delphi process changed from 66 to 59, basic sub-competencies from 216 to 196, and advanced sub-competencies from 179 to 182. Kappa scores for all competencies ranged from 0.60 to 1.00 with full consensus after 3 rounds. Therefore, this document provides the first set of consensus guidelines to distance simulation educators in healthcare.

According to the publication’s authors, this work served as the foundation for a Nominal Group Technique study on specific questions needing further discussion, and a Delphi study to create the final draft of the guidelines. Researchers recommend awareness of these guidelines and feedback to the Distance Simulation Collaboration for any thoughts or suggestions on the final (post-Delphi study) Healthcare Distance Simulation Educator Development Guidelines. They anticipate that even after the Delphi study, their published guidelines will continue to be revised as the knowledge, skills, and capabilities increase in distance simulation.

“As anybody of knowledge or educational method develops it will naturally grow as researchers and scholars identify successful and unsuccessful approaches and push the boundaries of what we know about this new approach to simulation education,” added Ahmed.

To formulate these recommendations, the group first focused on health professions educators as content experts in healthcare simulation education and what that role entails as far as proficiencies needed and particularly for the distance setting. They also work to target orientation training for HPEs so they are best prepared to work within the platform(s) they will use as well as keep abreast of new technologies which continue to emerge. Special emphasis on creating and maintaining psychological safety in a distance debriefing was given. Additionally, they sought to include distance simulation and distance debriefing design and evaluation as a core element of HPE training.

“There is so much we still do not know about distance simulation, yet it that has the potential to truly leverage all the positive aspects of simulation and connect the world of immersive training in a way never thought possible. The potential for scholars and content experts to have the ability to instantly disseminate their knowledge and expertise to learners involved in immersive simulation training is very exciting,” expressed Ahmed.

More About Rami A Ahmed, DO, MHPE, FACEP

Dr. Rami Ahmed is a Professor of Emergency Medicine and serves as the Simulation Division Chief and Simulation Fellowship Director at the Indiana University School of Medicine. He completed an Academic Fellowship in Medical Simulation at the Gilbert Program in Medical Simulation at Harvard Medical School and is a Harvard Macy Education Scholar. He completed a Master’s in Health Professions Education at the University of Illinois at Chicago.

He was awarded the Donald O’Hara Faculty Prize for Excellence in Teaching at Harvard Medical School, the National Faculty Teaching Award from the American College of Emergency Physicians, and the SAEM Simulation Academy “Distinguished Educator” award in 2020. Dr. Ahmed has trained 20 simulation fellows and has over 85 peer-reviewed publications on the utilization and study of simulation. He started the first medical simulation fellowship in the State of Ohio and the State of Indiana. His personal research focuses on medical simulation fellowship curriculum design and the utilization of telesimulation.

Read the Full Distance Simulation Educator Guidelines

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