Are You Ready for Simulation? Part 1 of the 7-Part Series Dissecting the Sim Ops Standard

By: Tonya Schneidereith, Colette Foisy-Doll, and Kim Leighton

When simulation was shown to be an effective substitute for clinical experiences when certain criteria are met (Alexander et al., 2015; Hayden, Smiley, Alexander, Kardong-Edgren, & Jeffries, 2014), the news was so exciting that administrators, faculty, and staff jumped into simulation without thinking through the details necessary to ensure a successful program. In the first part of this seven-part series, we talk about how to determine if your program is ready for simulation.

Simulation integration into a nursing program without thoughtful consideration can result in unrealized goals and objectives, frustration, and poor student outcomes (INACSL Standards Committee, 2017; Leighton, Foisy-Doll, & Gilbert, 2018). Therefore, planning for this shift is imperative, and many questions must be answered before implementation. Is there a clearly defined need for simulation? Will it replace traditional clinical practice time in the program and, if so, what percentage? Who will facilitate simulations?

One of the biggest questions is: how accepting is the organization of the pedagogy of simulation? This change may require a fundamental shift in teaching methods, from doing things the way they’ve always been done through lecture toward a more active way of learning. Is your organization willing to change the culture and challenge the status quo?

checklistOne approach to assessing organizational readiness is to employ a valid and reliable tool, such as the Simulation Culture Organizational Readiness Survey (SCORS) (Leighton et al., 2018). Adapted with permission from Fineout-Overholt and Melnyk’s (2015) survey on organizational readiness for evidence-based practice and used in coordination with a companion guidebook, the SCORS tool examines four areas of organizational culture readiness: 1) defined need and support for change, 2) readiness for culture change, 3) time, personnel, and resource readiness, and 4) sustainable education development to embed culture (Leighton et al., 2018).

Let’s briefly look at questions raised in each section:

1) Defined need and support for change:

  • Is there a clear need for simulation?
  • Is there objective data to drive simulation integration?

2) Readiness for culture change:

  • Do your faculty and staff understand the mission and vision of the parent organization?
  • Is there a clear link between the goals of simulation and those of the parent organization?
  • Do your faculty and staff want to focus on simulation?
  • How willing are your faculty and staff to implement a change?

3) Time, personnel, and resource readiness:

  • Is leadership willing to develop a culture that will accept change?
  • Is the organization willing to allocate time, resources, and personnel to support simulation?
  • Are there individuals who will serve as simulation champions?

4) Sustainable education development to embed culture:

  • How will you include students in simulation initiatives?
  • What champions can be developed in other disciplines to encourage interprofessional education involvement?
  • What are the plans for comprehensive curricular integration?
  • How will you plan to update equipment and space?
  • How can you involve stakeholders to maximize use of simulation?

Once completed, the survey generates subsection and total survey scores that point to level of readiness using a five-item scale as follows: None, A Little, Somewhat, Moderately, and Very Much. Examining each scored subscale and item will help identify where energy and resources should be directed to better prepare the organization for simulation.

Consider using this valid and reliable tool to help strengthen your organization’s readiness for change and increase the potential for a successfully integrated simulation program. By having a comprehensive understanding of the intricacies involved in meeting overall programmatic needs, you will increase efficiency, meet your educational goals, and create sustainability (Leighton et al., 2018). You can find the SCORS tool and companion guidebook (Foisy-Doll & Leighton, 2017) available for free download at


Alexander, M., Durham, C. F., Hooper, J. I., Jeffries, P. R., Goldman, N., Kardong-Edgren, S., . . . Tillman, C. (2015). NCSBN simulation guidelines for prelicensure nursing programs. Journal of Nursing Regulation, 6(3), 39-42.

Fineout-Overholt, E., & Melnyk, B.M. (2015). Organizational Culture & Readiness for System-Wide Integration of Evidence-Based Practice Survey. In B.M. Melnyk & Fineout-Overholt (Eds.), Evidence-based practice in nursing and healthcare: A guide to best practice (3rd ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins.

Foisy-Doll, C. & Leighton, K. (2017). Simulation Culture Organizational Readiness Survey companion guidebook©.

Hayden, J. K., Smiley, R. A., Alexander, M., Kardong-Edgren, S., & Jeffries, P. R. (2014). The NCSBN national simulation study: A longitudinal, randomized, controlled study replacing clinical hours with simulation in prelicensure nursing education. Journal of Nursing Regulation, 5(2 Supplement), S2-S64.

INACSL Standards Committee. (2017). INACSL Standards of Best Practice: SimulationSM: Operations. Clinical Simulation in Nursing, 13, 681-687.

Leighton, K., Foisy-Doll, C., & Gilbert, G. E. (2018). Development and psychometric evaluation of the Simulation Culture Organizational Readiness Survey. Nurse Educator, 43(5), 251-255.

2 thoughts

  1. As one of the committee members who wrote this standard, I appreciate the information being shared. I would like to acknowledge my other colleagues Wendy Thomson, Teri Boese, Scott Crawford, Jesika Gavilanes, and H. Michael Young whom I worked closely with for over a year to produce these needed standards. Hopefully, people are utilizing them in conjunction with assessing their program as it relates to the SSH accreditation standards. The hope is that these standards can provide guidance on the necessary infrastructure to ensure consistency across simulation programs.

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