Advances in Simulation

Simulation plays a pivotal role in addressing universal healthcare challenges, reducing education inequities, and improving mortality, morbidity and patient experiences. It enhances healthcare processes and systems, contributing significantly to the development of a safety culture within organizations. It has proven to be cost-effective and successful in enhancing team performance, fostering workforce resilience and improving patient outcomes.Through an international collaborative effort, an iterative consultation process was conducted with 50 societies operating across 67 countries within six continents. This process revealed common healthcare challenges and simulation practices worldwide. The intended audience for this statement includes policymakers, healthcare organization leaders, health education institutions, and simulation practitioners. It aims to establish a consensus on the key priorities for the broad adoption of exemplary simulation practice that benefits patients and healthcare workforces globally.Key recommendations Advocating for the benefits that simulation provides to patients, staff and organizations is crucial, as well as promoting its adoption and integration into daily learning and practice throughout the healthcare spectrum. Low-cost, high-impact simulation methods should be leveraged to expand global accessibility and integrate into system improvement processes as well as undergraduate and postgraduate curricula. Support at institutional and governmental level is essential, necessitating a unified and concerted approach in terms of political, strategic and financial commitment.It is imperative that simulation is used appropriately, employing evidence-based quality assurance approaches that adhere to recognized standards of best practice. These standards include faculty development, evaluation, accrediting, credentialing, and certification.We must endeavor to provide equitable and sustainable access to high-quality, contextually relevant simulation-based learning opportunities, firmly upholding the principles of equity, diversity and inclusion. This should be complemented with a renewed emphasis on research and scholarship in this field.Call for action We urge policymakers and leaders to formally acknowledge and embrace the benefits of simulation in healthcare practice and education. This includes a commitment to sustained support and a mandate for the application of simulation within education, training, and clinical environments.We advocate for healthcare systems and education institutions to commit themselves to the goal of high-quality healthcare and improved patient outcomes. This commitment should encompass the promotion and resource support of simulation-based learning opportunities for individuals and interprofessional teams throughout all stages and levels of a caregiver's career, in alignment with best practice standards.We call upon simulation practitioners to champion healthcare simulation as an indispensable learning tool, adhere to best practice standards, maintain a commitment to lifelong learning, and persist in their fervent advocacy for patient safety.This statement, the result of an international collaborative effort, aims to establish a consensus on the key priorities for the broad adoption of exemplary simulation practice that benefits patients and healthcare workforces globally.

Cristina Diaz-Navarro

Robert Armstrong

Matthew Charnetski

Kirsty J Freeman

Sabrina Koh

Gabriel Reedy

Jayne Smitten

Pier Luigi Ingrassia

Francisco Maio Matos

Barry Issenberg

Global consensus statement on simulation-based practice in healthcare

全球共识声明：医疗保健中的模拟实践

Abstract Addressing health inequities in health professions education is essential for preparing healthcare workers to meet the demands of diverse communities. While simulation has become a widely recognized and effective method for providing safe and authentic clinical learning experiences, there has been limited attention towards the power of simulation in preparing health practitioners to work with groups who experience health disparities due to systems of inequality. Balancing technical proficiency with educational approaches that foster critical reflection and inform action oriented towards social accountability is essential. Transformational learning promotes the development of critical consciousness through critical reflection. Debriefing plays a crucial role in fostering learning in this direction by providing a structured opportunity to critically reflect on taken for granted assumptions, examine power and privilege embedded within systems and structures, and empower learners to take action toward changing those conditions. Building on the Promoting Excellence and Reflective Learning in Simulation (PEARLS) Healthcare Debriefing Tool, we propose a PEARLS Debriefing for Social Justice and Equity (DSJE) Tool that specifically directs attention to systems of inequality that contribute to health disparities for vulnerable groups across a range of simulation scenarios. This approach has two aims: (a) to transform debriefings into a critically reflective space by engaging learners in dialogue about social and structural determinants of health that may create or perpetuate inequities and (b) to foster critical reflection on what actions can be taken to improve the health and well-being of identified at risk and vulnerable groups. From this perspective, we can use the adapted PEARLS Tool to incorporate conversations about systems of inequality, equity, diversity, and inclusion (EDI) into our existing educational practices, and make concentrated efforts towards community-driven and socially conscious simulation-based education (SBE).

Niki Soilis

Elizabeth Anne Kinsella

Walter Eppich

Adam Cheng

Lindsay Beavers

Farhan Bhanji

PEARLS debriefing for social justice and equity: integrating health advocacy in simulation-based education

PEARLS 汇报法促进社会公正与公平：将健康倡导融入模拟教育

Abstract Healthcare debriefing is a cognitively demanding conversation after a simulation or clinical experience that promotes reflection, underpinned by psychological safety and attention to learner needs. The process of debriefing requires mental processing that engages both “fast” or unconscious thinking and “slow” intentional thinking to be able to navigate the conversation. “Fast” thinking has the potential to surface cognitive biases that impact reflection and may negatively influence debriefer behaviors, debriefing strategies, and debriefing foundations. As a result, negative cognitive biases risk undermining learning outcomes from debriefing conversations. As the use of healthcare simulation is expanding, the need for faculty development specific to the roles bias plays is imperative. In this article, we hope to build awareness about common cognitive biases that may present in debriefing conversations so debriefers have the chance to begin the hard work of identifying and attending to their potential detrimental impacts.

Michael J. Meguerdichian

Dana George Trottier

Kimberly Campbell-Taylor

Suzanne Bentley

Kellie Bryant

Michaela Kolbe

Vincent Grant

When common cognitive biases impact debriefing conversations

当常见认知偏差影响汇报对话时

There is growing recognition that preparing health professionals to work with complex social issues in the delivery of healthcare requires distinct theoretical and pedagogical approaches. Recent literature highlights the significance of employing simulated environments which aim to immerse learners in the experiences of diverse populations and bridge the gap between academic learning and lived realities across a diverse society. Virtual Reality (VR) is gaining traction as a promising pedagogical approach in this context. VR has been argued to offer distinct advantages over traditional educational methods by allowing learners to see the world through the eyes of diverse populations, and to learn about social injustices while immersed in a mediated environment. It also has practical benefits in its capacity to expose large number of students to these topics with relatively modest resources compared to other approaches. This debate article explores VR as an innovative pedagogical approach for facilitating critical reflection, dialogue and transformative learning about social issues in health professions education (HPE). It examines the potential affordances as well as risks and dangers of integrating VR into educational programs and highlights key pedagogical, practical, and ethical considerations. Emphasis is placed on the importance of these considerations in efforts toward ethical, safe, and respectful use of VR in educational settings. This paper contributes to the ongoing dialogue on VR simulation as an innovative approach to HPE and highlights the importance of creating conditions that maximize its educational benefits and minimize potential harms.

Adv Simul (Lond)

Virtual reality simulation for facilitating critical reflection and transformative learning: pedagogical, practical, and ethical considerations

虚拟现实模拟促进批判性反思与转化学习：教学、实践与伦理考量

Abstract Simulation program staff and leadership often struggle to partner with front-line healthcare workers, their managers, and health system leaders. Simulation-based learning programs are too often seen as burdensome add-ons rather than essential mechanisms supporting clinical workforce readiness. Healthcare system leaders grappling with declining morale, economic pressure, and too few qualified staff often don’t see how simulation can help them, and we simulation program leaders can’t seem to bridge this gap. Without clear guidance from front-line clinicians and leaders, the challenge of building and maintaining sustainably relevant simulation offerings can seem overwhelming. We argue that three blind spots have limited our ability to see the path to collaborations that support front-line workforce readiness: We wrongly assume that our rigor in designing and delivering programs will lead to front-line participant engagement and positive impact, we overestimate the existence of shared priorities, mindsets, and expertise with our would-be partners, and we contribute to building a façade of superficial education compliance that distracts from vital skill development. How do we design simulation-based training programs that are valued, supported, and sustained by key partners over time? (1) By seeing ourselves as partners first and designers second; (2) by using a boundary spanning design process that shifts the primary psychological ownership of training outcomes to our partners; and (3) by focusing this shared design process on workforce readiness for the situations that our healthcare partners care about most. Drawing on lessons from more than 800 readiness plans developed by participants in our courses and the authors’ successes and mistakes in partnering with healthcare teams for front-line readiness, we introduce the concepts, commitments, and practices of “readiness planning” along with three detailed examples of readiness planning in action. Graphical Abstract

Christopher J. Roussin

Grace Ng

Mary K. Fey

James A. Lipshaw

Henrique P. Arantes

Jenny W. Rudolph

Readiness planning: how to go beyond “buy-in” to achieve curricular success and front-line performance

准备规划：如何超越“认同”以实现课程成功和一线表现

Abstract Racism continues to plague Western societies’ institutions, including the healthcare system. Despite the evidence of racism’s negative impacts on healthcare providers, administrators, patients, and families, healthcare workers report hesitancy in taking action to address racism in the workplace. Simulation, with its experiential pedagogy and foundation in psychological safety, may be an educational tool to support practical training. Guided by a social cognitive view of regulation of learning, we piloted virtual reality (VR) modules focused on addressing bias, privilege, and microaggressions. We used pre-/post-surveys, reflective journals, built-in VR platform data, and simulation debriefing session notes to better understand the effectiveness and usability of these VR modules in our organization. Overall, participants found the VR modules highly valuable, and we noted a shift in participants’ reported intentions to take action to address racism in the workplace. Participants also noted the importance of a multifaceted plan that goes beyond education to ensure a meaningful culture shift toward addressing racism at work. Practical lessons from this pilot study included the necessity of an informed debriefing plan focused on participants’ positionality and power and the need to deeply understand our institution’s information technology (IT) environment to ensure successful deployment of VR technology.

Abbreviation	Adv Simul
Journal Impact	2.99
Quartiles(Global)	HEALTH CARE SCIENCES & SERVICES(Q2)

ISSN	2059-0628
h-index	27

Publication Information	Publisher: BioMed Central Ltd，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2016，Proportion of original research papers: 0.00%，Self Citation Rate:7.10%， Gold OA Rate: 100.00%
Journal Fees	$2690Details
Average review cycle	网友分享经验：12 Weeks

Advances in Simulation

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Global consensus statement on simulation-based practice in healthcare

PEARLS debriefing for social justice and equity: integrating health advocacy in simulation-based education

When common cognitive biases impact debriefing conversations

Virtual reality simulation for facilitating critical reflection and transformative learning: pedagogical, practical, and ethical considerations

Readiness planning: how to go beyond “buy-in” to achieve curricular success and front-line performance

Readiness planning: how to go beyond “buy-in” to achieve curricular success and front-line performance

PEARLS debriefing for social justice and equity: integrating health advocacy in simulation-based education

When common cognitive biases impact debriefing conversations

Virtual reality simulation for facilitating critical reflection and transformative learning: pedagogical, practical, and ethical considerations

Using virtual reality simulation to address racism in a healthcare setting