Simulation Culture Organizational Readiness Survey (SCORS)

As part of the Evaluating Healthcare Simulation tools, the Simulation Culture Organizational Readiness Survey (SCORS) was developed by Leighton, Foisy-Doll, and Gilbert (2018) to assist administrators in evaluating institutional and program readiness for simulation integration. The SCORS will assist organizational leadership to better understand the necessary components to address PRIOR to purchasing simulation equipment, with the goal of increasing effective and efficient integration of simulation into the academic or organizational education curriculum.

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Permission to Use FREELY: General use is already permitted by posting the statement: I understand that I have been granted permission by the creators of the requested evaluation instrument to use it for academic, clinical and/or research purposes. I agree that I will use the evaluation instrument only for its intended use, and will not alter it in any way. I will share findings as well as publication references with the instrument creator(s). I am allowed to place the evaluation instrument into electronic format for data collection. If official ‘Permission to Use’ letter is required, please contact the primary author. Include the purpose of the official request (research, grant), the intended use of the tool and with what population.


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Why the Simulation Culture Organizational Readiness Survey (SCORS) was Developed: The Simulation Culture Organizational Readiness Survey (SCORS) was developed to assist administrators in evaluating institutional and program readiness for simulation integration. Around the world, healthcare simulators sit unused on beds, in closets, and often still in their boxes. This is costly to the organization because the unused technology ties up valuable fiscal resources, there is poor or absent uptake of simulation, a failure to link course and program outcomes, and creates a disservice to learners who are not exposed to effective evidence-based teaching practices.

Failure to ensure organizational readiness and lack of strategic planning prior to purchase of simulation equipment is often a verbalized cause of why the equipment is unused or under-used. Historically, point-of-use simulationists self-educate, learn from conference presenters and by reading journals. No matter their excitement, ideas, or attempts to integrate, they do not have decision-making power or budgetary control.

As a result of this, we decided to create a tool that will assist organizational leadership to better understand the necessary components to address PRIOR to purchasing simulation equipment, with the goal of increasing effective and efficient integration of simulation into the academic or organizational education curriculum.

How the Simulation Culture Organizational Readiness Survey (SCORS) was Developed: These reports, standards, and guidelines were used to create the SCORS:


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The SCORS has 38 items in 4 subscales, answered using a 5-point Likert scale:

  • Defined Need & Support Change (9 items)
  • Readiness for Culture Change (11 items)
  • Time, Personnel & Resource Readiness (12 items)
  • Sustainability Practices (4 items)
  • Current Readiness & Progress (2 items)

Reliability and Validity of the SCORS

Sample: 103 healthcare educators (52% 4-year institutions, 24% community college, hospitals 7%, graduate programs 3% and other 14%)

Expert Panel: Six expert simulationists with graduate degrees and a minimum of 5 years experience with simulation-based education completed the content validity tasks necessary to establish validity of the tool.

Validity: Content validity indexes for each survey item ranged from .67 – 1.00. Two items had a CVI of .50. Feedback was incorporated and wording changes were made. All items were retained in the survey.

Using the SCORS: The SCORS is designed for evaluation of organizational readiness for integration of simulation. While most respondents were nurses, the sample included academic and clinical educators and leaders. The SCORS can be completed by individuals, but there may be more value in completing the survey as a team. This provides the opportunity for input from leadership as well as the front-line simulatonists. Because oftentimes, everyone is not on the same page, meaningful conversations can occur that will increase understanding of the requirements for successful simulation integration.



Guidebook: The SCORS Guidebook: A Companion for Completing the Simulation Culture Organizational Readiness Survey was created to provide additional guidance in how to complete the SCORS. All persons completing the tool should be familiar with the information contained in this Guidebook. It is available for download if you decide to consider use of the tool.

Evaluation: The SCORS is useful for evaluating an organization’s readiness to begin or improve simulation integration in their program (academic or clinical). Results can be used to:

  1. Identify areas of strengths and weaknesses that may impact successful integration of simulation
  2. Prioritize areas that require improvement
  3. Guide budgeting needs related to simulation

Scoring: The scoring criteria for the SCORS is embedded in the Guidebook. Consider prioritizing results according to subscales of highest need and those areas that can quickly be improved.

References:

  • For additional detail regarding the development and psychometric analysis of the SCORS:
  • Leighton, K., Foisy-Doll, C., & Gilbert, G. E. (2018). Development and psychometric evaluation of the Simulation Culture Organizational Readiness Survey (SCORS). Nurse Educator, 43(5), 251-255. doi: 10.1097/NNE.0000000000000504
  • Agency for Healthcare Research and Quality. (2015). Readiness assessment. Retrieved from http://www.ahrq.gov/teamstepps/readiness/index.html
  • Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
  • Patillo, R. E., Hewett, B., McCarthy, M. D., & Molinari, D. (2010). Capacity building for simulation sustainability. Clinical Simulation in Nursing, 6(5), e185-e191. doi: 10.1016/j.ecns.2009.08.008
  • Taplay, K., Jack, S. M., Baxter, P., Martin, E. K. (2014). Organizational culture shapes the adoption and incorporation of simulation into nursing curricula: A grounded theory study. Nursing Research & Practice, Article ID 197591. doi:10.1155/2014/197591
  • Suggested Webpage Citation: Leighton, K., Foisy-Doll, C., & Gilbert, G. E. (2018). Simulation Culture Organizational Readiness Survey. Retrieved from
  • If you need an official ‘Permission to Use’ letter, or have questions about this tool, please contact Dr. Kim Leighton.

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Return to the Evaluating Healthcare Simulation tools webpage.


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