Association For Simulated Practice In Healthcare Research Articles

Advancing outbreak simulation training: a collaborative pilot study for dual-specialty medical trainees and infection prevention and control professionals

In response to identified gaps in infection prevention and control (IPC) training within Scotland, a Short Life Working Group (SLWG) initiated an innovative outbreak simulation training programme. This study aimed to enhance the knowledge and confidence of medical microbiology and infectious diseases trainees and IPC professionals in managing Healthcare Associated Infection (HCAI) outbreaks, employing the National Infection Prevention and Control Manual (NIPCM) guidelines. Participants completed prerequisite online training in epidemiology and surveillance before engaging in a meticulously crafted Vancomycin-Resistant Enterococci (VRE) outbreak simulation, which mirrored a real-life incident and adhered to the standards set by the Association for Simulated Practice in Healthcare (ASPiH). The program incorporated Kolb's experiential learning cycle, fostering an authentic and engaging learning environment. A total of 41 individuals participated in the synchronous online training phase, with eight individuals involved in the pilot outbreak simulation. Evaluation of the training's efficacy followed Kirkpatrick's model, combining quantitative (5-point Likert scales) and qualitative (open-ended questions and participant reflections) data collection methods. Results demonstrated significant improvements in participants' knowledge, skills, and confidence in outbreak management. Feedback highlighted the realism and educational value of the simulation, with 100% agreement on its efficacy in enhancing outbreak management capabilities. The success of this pilot study underscores the potential of simulation training in IPC and paves the way for broader implementation. It emphasises the effectiveness of structured, experiential learning in equipping healthcare professionals with practical skills and confidence for managing complex HCAI outbreaks, contributing to a more competent and prepared workforce.

ASPiH Conference 2023 – Sustainable Simulation

In the past 2 years, ASPiH (Association for Simulated Practice in Healthcare) annual conferences offered a space for reflection on crucial topics central to simulation-based activities [1,2], and this year is no exception. The ASPiH 2023 theme is Sustainable Simulation. The term sustainable derives from the Latin word ‘ The simulation community has been keen to share their reflections and strategies on how sustainability can support and enhance the quality and impact of health and care simulation activities. Many of the abstracts received demonstrate that our community is aware, concerned and actively developing sustainable solutions [4–15]. One of the primary aspects of sustainable simulation is resource efficiency. Health, care and educational institutions are often limited by budget constraints and environmental concerns. Sustainable simulation strategies help them make the most of their investments in simulation technology and facilities. By maximizing the utilization of their human resources, material, equipment and space, institutions can reduce costs and minimize their environmental footprint [4,5]. Moreover, sustainability in health and care simulation promotes the development of accessible, environmentally and economically responsible technological solutions. Low-cost solutions often involve finding affordable, non-disposable alternatives to expensive simulation tools and props. Durable, reusable materials, for example, drive both eco-friendly and cost-effectiveness goals simultaneously [6,7]. On the other hand, the use of cutting-edge technologies, such as virtual reality, provides immersive learning experiences while reducing the use of disposables, associated waste and travel [8,9]. Sustainable simulation also encourages collaborative partnerships among health, care and educational institutions, and industry stakeholders. These partnerships can facilitate the sharing of resources, expertise, best practices, and the development of standardized or innovative solutions. This collaborative approach ensures that health and care simulation activities maintain a high level of quality and relevance while conserving resources [10–12]. Furthermore, sustainable simulation aligns with the broader goals of health and care education and practice. By promoting resource efficiency and responsible use of technology, it prepares health and care professionals to be mindful of resource allocation at work. This is especially relevant in a world where sustainability and health and care outcomes are interconnected [13]. Sustainable simulation practices are inherently scalable. They can be adapted to accommodate growing student populations without a proportional increase in costs or environmental impact. This scalability is essential as health and care education strives to meet the rising demand for skilled professionals [14,15]. In conclusion, sustainable simulation is a pragmatic approach to improving health and care education and practice. By adopting sustainable practices in health and care simulation-based activities, we can ensure that these invaluable training tools remain accessible, effective and aligned with the evolving needs of health and care. As we move forward, let us embrace our evolving principles of sustainable simulation as means to elevate the quality and impact of health and care education, ultimately leading to better care and a more responsible use of resources. We invite you to continue this reflection and call to action during the 2023 ASPiH Conference in Brighton, 6–8 November 2023, which has a vibrant and rich scientific programme, as illustrated by the abstracts selected for publication in this special issue of the International Journal of Healthcare Simulation. Thank you to everyone who responded to the call for abstracts for this year’s ASPiH conference and to the scientific committee members involved in the reviewing process.

A75Strengthening simulation quality assurance through the ‘Sim QA bundle’

The All Wales Simulation-Based Education and Training Strategy 2022 – 2027 specifies as one of its aims to promote quality assured simulation-based education and training across healthcare in Wales underpinned by standards and evaluated to ensure best practice in safe learning environments [1]. The Simulation Team at Health Education and Improvement Wales (HEIW) has been working closely with the simulation community in Wales to identify their needs through iterative consultation during meetings, focussed discussions and webinars. In 2021 stakeholders agreed that HEIW would promote the application of the Association for Simulated Practice in Healthcare (ASPiH) standards [2] and professional regulatory and statutory body standards relevant to SBET. Since then, a number of quality assurance tools as well as faculty development opportunities have been developed in order to embed these standards into simulation faculty development programmes and cascade their routine inclusion into everyday SBET practice. Quality assurance (QA) resources developed by the Simulation Team at HEIW between August 2021 and February 2023 were packaged as the ‘Sim QA Bundle’ ( HEIW Simulation Quality Assurance Bundle The ‘Sim QA Bundle’ consists of four components: Faculty development and continuous professional development (CPD): available resources include free access to the Essential Faculty Development Course, regular webinars, workshops and conferences. Content development: guidance provided includes a standardized scenario scripting template, with links to relevant literature. Content delivery: a standardized approach to debriefing has been developed which is supported by education opportunities and cognitive aids. Evaluation tools: generic evaluation forms have been designed to assess the learners’ experience, faculty perspectives and adherence to standards. The Simulation Quality Assurance Bundle provides a wide range of resources available to simulation practitioners in order to promote and support the delivery of high-quality simulation-based education and training across the healthcare workforce in Wales. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

ASPiH 2022 Conference – All things being equitable: Diversity, inclusion, and simulation

Building upon the use of simulation to improve systems, as considered during last year’s conference The simulation community has been attentive to the issues raised and must not shy away from exploring deeper these underlying issues that may impair adequate care. Sensitive to this need, diversity and inclusion are the themes of this year’s Association for Simulated Practice in Healthcare (ASPiH) annual conference. Many abstract submissions show how these topics can be meaningfully incorporated within simulation activities, scenario design, debriefings, and are applicable to various simulation modalities But diversity and inclusion are also highly relevant with regards to our colleagues in the clinical setting as well as within our simulation circle. We need to consider our own educational community of practice by being role models in terms of diversity and inclusivity. We hope to see a very diverse and inclusive groups of delegates attending the 2022 ASPiH Conference in Birmingham, 6-8 Thank you to everyone who responded to the call for abstracts for this year’s ASPiH conference. Thank you also to all the reviewers involved in the selection process as we couldn’t run the conference without you. Now is the time to start thinking about your contribution for next year! 1. Moneypenny M, Weldon SM, Hamilton C, Buttery A, Alinier G. ASPiH 2021 Conference–Moving upstream: using simulation to improve systems. International Journal of Healthcare Simulation. 2022;1(1):1–2. 2. Lee P, Le Saux M, Siegel R, Goyal M, Chen C, Ma Y, Meltzer AC. Racial and ethnic disparities in the management of acute pain in US emergency departments: Meta-analysis and systematic review. The American journal of emergency medicine. 2019;37(9):1770–7. 3. Drabish K, Theeke LA. Health impact of stigma, discrimination, prejudice, and bias experienced by transgender people: a systematic review of quantitative studies. Issues in mental health nursing. 2022;43(2):111–8. 4. Knickle K, Weir K, McNaughton N. Authoring and othering: examining bias in scenario design. International Journal of Healthcare Simulation. 2021;1(1):45–8. 5. Bignell A, Baxey E, Saunders A, Ortega-Vega M. Reducing Restrictive Practices- Using simulation education to tackle mental health stigma. International Journal of Healthcare Simulation. 2022. doi: 10.54531/WCNV4657 (In this current special issue) 6. Welsh H, Clay G, Fisher M, Ortega-Vega M, Virk K, Evans G. The Power and Influence of the Theatre on Immersive 360° Videos. International Journal of Healthcare Simulation. 2022. doi: 10.54531/CRTF6001 (In this current special issue) 7. Wadsworth J, Blair J, Millett R, Damberg K, Esposito M, Van Vuren E, Marshall E. Using a systems-based approach to explore the enablers and barriers to equality, diversity, and inclusion within a simulation-based education service. International Journal of Healthcare Simulation. 2022. doi: 10.54531/INKE9149 (In this current special issue) 8. Paul O, Connor DB. Fostering diversity in healthcare simulation. International Journal of Healthcare Simulation. 2022 Jul 29(null):1–2. 9. Kulkarni S, Tsigerides J, Sule Medha. Walk in Their Shoes - Immersive 360-degree VR experience of Diversity and Inclusivity in the NHS. International Journal of Healthcare Simulation. 2022. doi: 10.54531/LADH8978 (In this current special issue) 10. FitzGerald C, Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Medical Ethics. 2017;18(1):1–8. 11. Vora S, Dahlen B, Adler M, Kessler DO, Jones VF, Kimble S, Calhoun A. Recommendations and guidelines for the use of simulation to address structural racism and implicit bias. Simulation in Healthcare. 2021;16(4):275–84.

A unified approach to faculty development

Due to the effect of the global pandemic and rising student cohort numbers, simulated practice placements are being implemented into nursing curricula. To deliver simulation-based education (SBE) within the Higher Education Institutions (HEI) staff must be adequately prepared. For SBE to be effective, thoughtful consideration to appropriate staff training is important [1]. A structured unified approach is more beneficial as it sets the same aspirations and contributes to a shared philosophy [2]. This unified approach meant both Health Board and HEI staff were being trained to delivery simulation in the same way, which was new for this HEI. Creating a faculty for simulation emulates a community of practice and also comprises essential networking with other simulationists [2]. It helps support Benner’s novice to expert theory as staff start of as novices and subsequently develop emulating that robust educational training for SBE faculty development is essential [3]. Importantly, it addresses quality assurance and governance frameworks in meeting the requirement of the International Nursing Association for Clinical Simulation Learning (INACSL) [3], Association for Simulated Practice in Healthcare (ASPiH), and Nursing and Midwifery Council (NMC) standards. The overall aim of this innovation was to implement a unified approach to faculty development training for academic staff within an HEI. Three training sessions were delivered in January and February 2022. HEI staff attended a one-day session. Health Board Simulation Educators facilitated the sessions for the HEI Academic Staff. Using a unified approach to this faculty development had a positive outcome in supporting HEI staff to be upskilled in the delivery of SBE. It has also resulted in the subsequent development and implementation of a 2-day training course comprising the following sessions: Session 1 – Introduction to clinical skills and simulation and writing learning outcomes and scenarios; Session 2: Technology supporting simulation; Session 3: Preparation, briefing, and debriefing; Session 4: Running an immersive simulation session. This in-house training programme will continue to be delivered to HEI staff undertaking SBE and evaluated. Using a unified approach enhances the quality and parity of the delivery of SBE within the HEI. A unified approach to faculty development within the HEI will continue to be delivered to upskill staff in SBE. Collaboration with clinical partners in faculty development is crucial in the delivery of SBE to ensure a unified evidence-based approach. 1. Bryant K, Aebersold ML, Jeffries PR, Kardong-Edgren S. Innovations in simulation: Nursing leaders’ exchange of best practices. Clinical Simulation in Nursing. 2020;41:33–40. 2. Peterson DT, Watts PI, Epps CA, White ML. Simulation faculty development: a tiered approach. Simulation in Healthcare. 2017;12(4):254–259. 3. Hallmark BF. Faculty development in simulation education. Nursing Clinics. 2015;50(2):389–397.

Developing a new simulation-based decision-making and team-working course for advanced clinical practitioners

The development of the Advanced Clinical Practitioner (ACP) framework at Lancashire Teaching Hospitals began in 2017. There are now 13 non-medical consultants, 73 Qualified Advanced and Specialist Clinical Practitioners, and 25 trainee ACP’s across the organisation. Part of the competency framework included the ability to manage common medical emergencies that are not necessarily a routine part of that ACP’s case load, for example managing a patient with chest pain on a surgical ward or assessing a ward patient following a fall. A one-day simulation-based course was developed to allow ACP’s to manage patients with these conditions in a safe and supportive environment. The day includes a lecture introducing human factors and decision-making theories, followed by six scenarios with debriefing facilitated by senior faculty to discuss learning points with the group. Scenarios were designed in line with ASPiH standards [1] to include clinical competencies which are not common-place in the trainee’s current working environments, giving them a chance to undertake the management of these rarer occurrences in a safe and controlled environment. Feedback was collected using anonymous self-scoring feedback forms and was overwhelmingly positive, with candidates feeling more confident in managing these clinical scenarios in practice. All candidates felt the scenarios were pitched to the correct level. Written feedback also highlighted how beneficial it was to get together as a group for shared learning across different directorates. Simulation-based learning can improve the confidence of ACP’s in managing unfamiliar clinical emergencies. In future courses will be advertised and opened to ACP’s from other Trust’s to allow further discussion. 1. Association for Simulated Practice in Healthcare. Simulation-Based Education in Healthcare. 2016. Standards Framework and Guidance. Association for simulated practice in healthcare (ASPiH) standards for simulation-based education.

Using simulation to support a new theatre setup

Following the redevelopment of the day case theatre complex at Chorley District General Hospital it was identified that new ways of working were required, and changes to patient processes would need to be made. Some of these were normal, expected, adaptations to be made when moving to a new working environment, such as the location and storage of equipment. The Resuscitation and Simulation Team, led by the associate Clinical Lead for Simulation, modelled the theatre list for the first day using simulated patients and in line with the ASPiH standards [1]. This gave the theatre staff the opportunity to run through cases in real time and gauge when patients needed to be sent for, how long was needed for setting up, and at what time they could safely call for the next patient without causing unnecessary delays or having patients waiting in corridors. Each step in the process was followed by a debriefing so that the actions could be discussed and any changes made. The feedback was positive and team members found it extremely useful to simulate their upcoming lists. As expected, there were several patient flow related issues raised, mainly around timings and logistics ( Issues identified following simulation of a theatre list Simulation of normal business can be successfully used to improve patient safety and the confidence of clinical staff when developing new clinical areas. 1. Association for Simulated Practice in Healthcare. Simulation-Based Education in Healthcare. 2016. Standards Framework and Guidance. Association for simulated practice in healthcare (ASPiH) standards for simulation-based education.

Using experiential-based simulation learning to develop adult nursing students’ communication skills to support practice

In the light of the practice placement limitations due to COVID-19, the Faculty Practice Simulation Group at a University in South West England, commissioned a pilot programme of simulated practice components for 200 second year adult nursing students over five consecutive days. The aim was to support the development of communication skills required by the Nursing and Midwifery Council Standards [1]. In partnership with an external communication skills organisation, the University provided each student with 37 hours of simulated practice placement, focused on communication skills through participative simulation with simulated patients (SPs) in bespoke, authentic scenarios. This included facilitated participation, structured live feedback from SPs, discussion with students, debriefing and reflection according to ASPiH guidelines for best practice in simulation [2]. Scenarios were designed to challenge and explore the range of skills required in Annex A of the Standards [1], at a level expected of first year students. Learning outcomes included the development of caring conversation techniques, patient management and colleague communication in multiple, varied situations. Students interacted with SPs and relatives who reflected diverse characteristics and ages, and a range of physical and mental health challenges. Students also interacted with simulated colleagues in a variety of professional situations. 106 students completed feedback questionnaires consisting of 41 5-point Likert items, before and after their sessions. Facilitators noted that students described the simulation as a meaningful learning opportunity which allowed them to explore and develop their communication skills and better prepared them for the practice element of their degree. They also noted that students said they preferred simulation as it gave them time to stop and think and to get advice and ideas from their colleagues. This was particularly so in ‘breaking bad news’ scenarios as most had never had to approach this and appreciated the opportunity to consider and practise their response. Consequently, students stated that simulation would have been even more beneficial had it been timed prior to attending practice placement. Facilitators observed the improvement in communication skills was in student’s confidence and their awareness and sensitivity, particularly in complex multi-factorial situations. Evaluations for the programme have yet to be analysed. Experiential learning through simulation-based education with SPs provides a powerful approach, offering a safe and supportive environment, which avoids unsafe situations and enables students to effectively practise and prepare for real world experiences. 1. Nursing and Midwifery Council, Standards of Proficiency for registered nurses. 2. Simulation-Based Education in Healthcare. 2016. Standards Framework and Guidance. Association for simulated practice in healthcare (ASPiH) standards for simulation-based education.

Is Research in Simulation as Accessible as Traditional Clinical Research? A Review of the 'Association for Simulated Practice in Healthcare' Conference.

BackgroundMeta-analysis of simulation teaching has shown to be an effective teaching methodology. The Association for Simulated Practice in Healthcare (ASPIH) annual international, multidisciplinary conference is recognised as the leading UK meeting for simulation-based education. We hypothesise that simulation-based research presented at this conference is currently less accessible than more traditional clinical research presentations.MethodWe reviewed the abstracts of all research presented at the 5th ASPIH Conference, 2014 and then utilised the Bhandari methodology to assess whether an abstract had subsequently been published in a peer review journal. Our secondary aim was to assess for recurring themes that may predict publication.ResultsTwenty-seven of 197 (14%) abstracts presented at the 2014 meeting were subsequently published. The mean lead time to publication from the conference was 23 (2 - 61) months. Two positive predictive factors for publication were oral presentations (vs poster), and a Kirkpatrick level above 1.ConclusionThe publication rate for abstracts from respected clinical conferences is 30%, but the publication rate for ASPIH abstracts is significantly below this. The potential reasons for this may include a lack of simulation specific journals. Authors should aim to publish simulation-based research in peer reviewed publications to help progress the role and the value of simulation in medical education.

Certification, accreditation and professional standards: striving to define competency, a response to ASPiH Standards for Simulation-Based Education: Process of Consultation, Design and Implementation.

For the past decade, competency has been a consistent theme in medical education literature. Authors have pondered its definition, questioned appropriate assessment of competency and wrestled with how to certify competency.1 Barriers to implementing competency-based education and assessment are well documented.2–9 Through their various lenses, these authors have grappled with the complexity of codifying and assessing competent practice. Among the healthcare simulation community, similar work has emerged. Many of the world’s largest and most prominent simulation societies and associations have spent much of the past decade codifying and determining appropriate assessment for our own competent practice. Associations have crafted professional standards, certification exams and accreditation processes after careful and deliberate codification of competent practice in the simulation of patient care. The simultaneous rise of these efforts is fortuitous, as simulation can provide reliable, consistent, valid and predictable means to assess competent practice. Developing competency-based education and assessment programmes and defining professional standards have several common practices: identifying desirable outcomes, analysing the observable behaviours and attributes that lead to those outcomes and translating those ideas into clear and concise statements. At the heart of each of these initiatives is our concern for patient safety, desire for efficiency and respect for evidence-based teaching and assessment practices. In 2017, the Association for Simulated Practice in Healthcare (ASPiH) published Simulation-Based Education in Healthcare: Standards Framework and Guidance.10 With this publication, they join a list of eight other professional societies and networks identified by Nestel and colleagues as engaged in …

ASPiH standards for simulation-based education: process of consultation, design and implementation

Standards are paramount for any practice specialty trying to improve performance. Setting a standard provides a benchmark from which to measure progress. Prior to entering clinical practice, medical professionals must demonstrate through testing and performance that they have acquired the knowledge and skills to meet a set of expected actions and abilities for their specialty. This is what helps to define each specialty, and the profession creates the assurance that care will be uniform and follow the guidelines put forth by its accrediting bodies. Now, given the work done by the Association for Simulated Practice in Healthcare (ASPiH) and others, simulation-based education (SBE) is better able to demonstrate to all who rely on it—students, educators, employers and patients—that consistency and quality can be achieved in this educational delivery and methodology. Leaders from the ASPiH should be applauded for their comprehensive review of simulation-based education practice and expected norms for its use in their constituent regions of the United Kingdom. Having accepted and supported reference points provides guidance for the development and sustainability of programmes. While much of what was explored in the process of writing and defining both the standards and the accompanying guidelines reiterates the work conducted by other organisations around the world, the information from this independent review supports and narrows the diversity of independent practice in simulation around the globe and moves one step closer to the revolution predicted by Gaba.1 SimGHOSTS is an affiliated non-profit membership association that focuses specifically on the technical …

ASPiH standards for simulation-based education: process of consultation, design and implementation.

There is widespread enthusiasm and emerging evidence of the efficacy of simulation-based education (SBE) but the full potential of SBE has not been explored. The Association for Simulated Practice in Healthcare (ASPiH) is a not-for-profit membership association with members from healthcare, education and patient safety background. ASPiH's National Simulation Development Project in 2012 identified the lack of standardisation in the approach to SBE with failure to adopt best practice in design and delivery of SBE programmes. ASPiH created a standards project team in 2015 to address this need. The article describes the iterative process modelled on implementation science framework, spread over six stages and 2 years that resulted in the creation of the standards. The consultation process supported by Health Education England resulted in a unique document that was driven by front line providers while also having strong foundations in evidence base. The final ASPiH document consisting of 21 standards for SBE has been extensively mapped to regulatory and professional bodies in the UK and abroad ensuring that the document is relevant to a wide healthcare audience. Underpinning the standards is a detailed guidance document that summarises the key literature evidence to support the standard statements. It is envisaged the standards will be widely used by the simulation community for quality assurance and improving the standard of SBE delivered.