Healthcare Simulation Domain Structure
Through the extensive work conducted over the last six years at our global events, SimGHOSTS has developed a conceptual framework for how simulation works. In the early days of SimGHOSTS it was quickly apparent that educational backgrounds, licensure, and certification in any one field or discipline did not fully prepare nor qualify any individual to the professional endeavor that we know as simulation. In short, having experience, degree, certification, or licensure in film production, audio/visual technology, information technology, business management, nursing, medicine, theatre and stage, emergency services, research, or education did not necessarily fully prepare you for the profession of simulation. Instead what we discovered that each of these domains of experience, education, knowledge, and expertise enhance simulation for the better. Taking a non-exclusionary approach we as a team stopped asking what background was best to prepare you to be in simulation, and we began to ask what does each individual bring to simulation from their education, experience, certifications, or licensure that enhances their jobs as simulation professionals.
From this we identified 8 domains that we believe form the basis for the skills, knowledge, and expertise that all simulation practitioners must possess individuals or must be included to form a functional and professional simulation team. These domains now form the framework from which we begin to educate and round-out the missing skills and knowledge required to produce highly effective simulation teams. These domains are Audio/Visual Technology, Education, Healthcare, Information Technology, Management, Research and Evaluation, Simulation, and Theatrics.
Healthcare simulation to this point has dictated that simply being a doctor, nurse, or other healthcare professional qualifies one to lead simulation. Instinctively it makes perfect sense as it is healthcare and those with backgrounds in healthcare understand it best. To provide clarity what healthcare simulation has done for a number of years is analogous to a producer of a crime drama bringing in police professionals and asking them to act, direct, write the scripts, gaff, costume, make-up, light, set the stages, and market the new show. There is nothing in a law enforcement officer's training the would qualify them to do anything other then to share their experiences, help provide context for fidelity, and advise on the content for the script for realism. In the same way, healthcare simulation needs to focus on the profession of simulation, and develop the wide range of skills, knowledge, and experience that is necessary to produce highly effective simulation experiences. This does not disqualify anyone from simulation, it merely acknowledges that a background in any one domain does not fully prepare one for simulation. Like the police officer and the crime drama, the office could very well become an actor, director, or even operate the camera, but only if they received the appropriate training and gained the necessary skills and knowledge to do so.
This is exactly what SimGHOSTS intends to offer, we see a global need to provide the type of training that will enhance all simulation professionals skills, knowledge, and expertise. Further it will enable all practitioners to gain the necessary skills, enhance their professional profiles, become professionally mobile, and be able to advance in the profession of simulation. Furthermore, organizations and institutions that implement simulation will be able to begin to build teams that address the needs that each domain demands. We believe no single individual has all the requisite knowledge, skills, and expertise, but they can be developed. Simulation is an interprofessional enterprise and demands that those that want to utilize simulation must build teams of individuals that can fully address all the domains.
Audio/Visual Technology Domain
This domain acknowledges the fact that Education represents a distinct set of skills, knowledge, understanding, and expertise that must be addressed in healthcare simulation organizations. Simulation practitioners at all levels, from technician though to management, must understand the principles behind transferring knowledge. Whether in support of those who deliver education or those who are faculty, it is a set of skills and knowledge that must be gained and maintained by all who practice simulation as a profession. From the technology specialist that must coach and train faculty and students on how to implement and integrate technology into their curriculum to the faculty who must utilize simulation to facilitate learning, all must understand the principles of adult education and the various mediums used to transfer that knowledge. Addressing this becomes a matter of hiring in the experts to add to this expertise or developing the existing staff to gain and maintain the requisite skills and knowledge in education.
This domain acknowledges that healthcare simulation has to do with healthcare and the domain represents a distinct set of skills, knowledge, understanding, and expertise that must be address in healthcare simulation environments. Simulation practitioners at all levels must at a minimum be able to communicate healthcare concepts in the context of simulation environments and events. All practitioners must have a fundamental understanding of general healthcare in order to support and facilitate the delivery of healthcare simulation education and research. In order to collaborate effectively and efficiently all who participate in delivering healthcare simulation must understand basic medical terminology, flow of care, anatomy and physiology, medical devices, roles in healthcare, laws and regulations, and general principles of patient care. Address requires that organizations bring in content experts, hire appropriate staff, or develop staff to have the necessary skills and knowledge to effectively work within a healthcare simulation team.
This domain acknowledges the information technology systems are ubiquitous throughout simulation and failure to address it leaves a deficit that is difficult to overcome. The domain further recognizes that there is a distinct set of skills, knowledge, understanding, and expertise that must be addressed for simulation to be fully utilized. Even the most basic simulation operation utilizes multiple systems and require network functionality. Basic digital literacy and technical acumen in information technology is required to be an effective simulation team member. But to fully utilize and implement information technology to meet the needs of a simulation environment this expertise must hired in, trained, and developed in simulation practitioners. Without the deep dive knowledge and skillsets in this domain, simulation teams are left with a barrier to fully utilizing the capabilities of the systems they have invested. Simulation teams must have at their disposal, those that possess the necessary skills, knowledge, and expertise to leverage Information Technology systems in the delivery of simulation experiences in education and research efforts. To address this requirement institutions must hire in those with the skills and knowledge, develop existing staff to gain and maintain mastery of these skills and knowledge, or develop relationships with internal departments or external organizations that maintain the skills and knowledge of Information Technology.
This domain acknowledges that managing and administrating systems, inventory, people and simulation logistics are fundamental aspects of the day to day operations in simulation. Whether simply managing resources and supplies, managing staff, faculty, or students, the fundamentals of management are necessary to function within a simulation team. From factors of integrating resources to achieve goals, building effective teams, working within teams, managing time, defining objectives, or coordinating systems and resources, management principles provide the necessary knowledge and skills to convert disorganized resources of people, systems, and money into useful enterprise. All those involved in simulation must understand the principles of management in order to coordinate, direct, and control resources in such a way as to achieve organizational goals.
Research and Evaluation
This domain acknowledges that simulation is used not only to educate existing healthcare practitioners, but is also used to conduct research and improve the methods that are used to teach and evaluate learners. This process aims to improve the delivery of healthcare within more complex systems. Whether in a supporting role, or as a primary researcher, all individuals involved with simulation-based education must understand and develop the necessary knowledge, skills, and expertise in the area of research to advance the field. For the simulation technology specialist, it is imperative that a level of research proficiency be developed. Even the ability to review the quality of other research can enhance understanding and lead to better practice.
This domain acknowledge that simulation is a unique discipline that requires an assortment of knowledge, skills, understanding, and expertise in order to operate efficiently and effectively within a simulation team. Without fully understanding simulation, its' history, and the broad scope of industry that utilize it, practitioners are left reinventing the wheel in order to achieve mediocre results. A requisite knowledge of the wide range of simulation practices from various industries; healthcare, aviation, information technology, business, engineering, and others form the basis to this domain, and enhance the practitioners ability to utilize simulation.
This domain acknowledges that theater and stage production are a daily aspect of simulation. Whether simply acting as the voice of a manikin, creating a realistic wound, or deciding how to get the right camera angles for debriefing or live streaming the principles and practices of theater and stage are fundamental to establishing fidelity. This domain recognizes that theater and stage is a domain of knowledge, skills, understanding, and expertise that enhance simulation and must be addressed in a simulation team. Addressing this requires that the skills be hired in, trained, or relationships developed to address the needs that this domain demands.