Facilitator development for pre-registration health professions simulation: a scoping review.

Abstract

Objective: This scoping review aimed to map the current evidence on content, delivery, evaluation, and recommendations for the development of simulation facilitators in pre-registration health professional programs, across all simulation modalities and stages of simulation delivery, guided by the Facilitator Competency Rubric and Kirkpatrick's Model.

Introduction: Simulation-based education is an established and effective strategy in health professions education. While facilitator competencies are broadly defined, best practices for developing facilitators in pre-registration programs remain unclear. As simulation methods evolve, the need for consistent and adaptable facilitator development strategies becomes increasingly important. Despite global standards, approaches to facilitator development vary significantly across institutions. Consequently, there is no standardized approach to simulation facilitator development within pre-registration health professional programs.

Eligibility criteria: Included papers focused on simulation facilitator development in pre-registration health professional programs within academic settings. Excluded papers focused on practice settings, post-licensure programs, or scenario design, as well as incidental mentions of facilitator development and non-retrievable or non-scholarly sources.

Methods: Using JBI's scoping review methodology, a comprehensive search of CINAHL (EBSCOhost), Embase (Ovid), ERIC (EBSCOhost), MEDLINE (Ovid), and ProQuest Dissertations and Theses Global was conducted for papers in any language since 2005. Screening and data extraction were conducted independently by pairs of reviewers, with discrepancies resolved through discussion or with a third reviewer. Data extraction followed a piloted tool. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed through content analysis. Data were presented using tables, charts, and narrative summaries. There were no deviations from the a priori published protocol.

Results: This review included 22 articles published between 2012 to 2024, encompassing primary research, quality improvement, and descriptive accounts. The literature was analyzed based on the review's 5 research questions, mapping facilitator development intervention design, delivery, evaluation, and recommendations. The content of facilitator development revealed that debriefing was the most covered component; however, most interventions (73%, n=16) incorporated multiple elements from the Facilitator Competency Rubric. Interventions varied in content. Delivery methods ranged from workshops to formal programs, with the majority (73%, n=16) being synchronous and in-person. Frequency and duration varied widely, with some interventions consisting of single sessions lasting a few hours, while others extended over several weeks. Evaluation methods also varied, with a range of tools used to measure reactions, learning, and in some cases (9%, n=2), behavior change.

Conclusions: Interventions to develop simulation facilitators showed significant variability in design, terminology, and focus, with an emphasis on debriefing and novice facilitators. The findings highlight the need for standardized approaches, alignment with global best practice standards, and the use of holistic evaluation tools. Future research should incorporate longitudinal designs, comprehensive needs assessments, and robust theoretical frameworks to strengthen facilitator development across the educational continuum, ensuring the evolution of simulation-based education.

Review registration: OSF https://osf.io/wf9zc/overview.