Hints for Starting a New Sim Lab or Jump-Starting an Old One

By: Alaina Herrington and Rebecca Cockrell

Starting a new simulation center can be overwhelming to say the least. Below are some of the lessons we learned from establishing a new simulation lab:

1. Get administrative buy-in. If your administration believes in simulation and understands the INACSL Standards of Best Practice, many obstacles will be eliminated. We have found that if faculty are left to decide for themselves whether or not to participate in simulation training, they usually will never be available. Working with the administration to set aside a day in the faculty schedule several months in advance ensures the training process will run smoothly.
2. Adapt a sitewide theory-based debriefing model. Training time is usually limited. For us, debriefing training has been more straightforward when focused on one method. Facilitators feel more confident in their debriefing skills, and students, who can anticipate how debriefings will be led, readily participate. Our school selected the Gather, Analyze, and Summarize (GAS) Model of debriefing. It was easy to implement and provides standardization across all programs.
3. Evaluate your facilitators. Initially, faculty completed a Debriefing Assessment for Simulation in Healthcare (DASH) Self Assessment Tool. After faculty were comfortable with the tool, the DASH Self Assessment Tool was used to complete peer review evaluations on every faculty member annually. Unfortunately, the feedback quality declined even after initiating DASH evaluation training. Recently, we recognized the need to change the culture of feedback within the organization. We found suggestions in two articles in Simulation in Healthcare. Roze des Ordons and colleagues (2018) recommend seeking the learner’s perspective, providing specific observations, and closing gaps early. Cheng and colleagues (2017) describe steps for efficiently implementing a peer coaching process. They suggest building a case with the benefits of peer coaching and establishing communication expectations early.
4. Establishing policies. Setting clear expectations for everyone sets the stage for success. If there is a written process, the lab will be able to meet and maintain standards. The key is to enforce your Policy and Guideline Manual. We recently went through the Society for Simulation in Healthcare (SSH) accreditation process. Having a detailed Policy and Guideline Manual made the process so much easier.

Encouraging the transition from task mastery to contextualization of skills is challenging, especially when it is easier to say, “We’ve always done it this way.” Following are some ideas to inspire faculty and students to think differently about the lab:

1. Rearrange the furniture. Considering educational gaps, do you need more task-trainer spaces or areas for simulating patient care settings? Are there specific patient care spaces that limit student access? Is there clutter or poor lighting? Are learning spaces student friendly? Does the environment encourage collaboration and dialogue between faculty and students? A simple rearrangement of furniture causes everyone to look at the space differently.
2. Simulate a health care environment. From dress code to noise level, consider ways to simulate an actual health care environment. Consider a no food or drink policy in patient care areas. Do faculty and students dress as they would in a clinical setting: hair, nails, shoes, uniform? The noise level in the lab –would it be disruptive in a patient care setting? Is there a chain of command to follow in the lab for questions or concerns?
3. Assess inventory and supplies. Is all equipment being utilized to its highest potential? Do you have items that are out of date? Do faculty know about all the resources available to them in the lab? SharePoint, Google Drive, Blackboard, and Canvas are ways to communicate lab resources. Consider using pictures of items and link them to learning activities. Consider also purchasing standard, evidence-based, peer-reviewed scenarios.
4. Establish a pattern of communication of resources and ideas. Whether through personal interactions or brief presentations during faculty meetings, repeated exposure to ideas about ways to utilize the lab is critical. We found email blasts to be ineffective and often missed by a majority of faculty. Capturing faculty when they enter the lab can be most influential, as long as follow-up discussion about ideas is intentional.
5. Celebrate the victories. Obtain feedback from students and faculty about the learning outcomes of lab experiences. Share feedback through your campus newsletter and social media, including pictures of students in the lab in accordance with the institution’s guidelines and policies. Be intentional about sharing your successes with administration. Get the word out that the lab is the place to be.

We have many other tips and tricks. Please comment below if you would like to ask us a specific question related to your program.

References

Cheng, A., Grant, V., Huffman, J., Burgess, G., Szyld, D., Robinson, T., & Eppich, W. (2017) Coaching the debriefer: Peer coaching to improve debriefing quality in simulation programs. Simulation in Healthcare12(5):319-325. doi: 10.1097/SIH.0000000000000232

Roze des Ordons, A., Cheng, A., Gaudet, J., Downar, J., & Lockyer, J.M. (2018). Exploring faculty approaches to feedback in the simulated setting: Are they evidence informed? Simulation in  Healthcare, doi: 10.1097/SIH.0000000000000289