Advances in simulation (London, England)最新文献

{"title":"Competency of novice anesthesia residents in performing trans thoracic echocardiography following a structured problem-based hands-on course using a trans thoracic echocardiography simulator versus video-based training: a randomized controlled assessor-blinded trial.","authors":"Bharat Yalla, Manpreet Kaur, Abhishek Nagarajappa, Rashmi Ramachandran, Vimi Rewari, Thilaka Muthiah, Bikash Ranjan Ray, Arshad Ayub","doi":"10.1186/s41077-026-00406-1","DOIUrl":"10.1186/s41077-026-00406-1","url":null,"abstract":"<p><p>BACKGROUND: Trans-thoracic echocardiography (TTE) improves the diagnostic skills of anesthesia trainees during the perioperative period. We compared performance between two educational intervention, simulation-based hands-on training and video-based training as measured by a novel TTE Competency Score (TCS). METHODS: Fifty novice anesthesia residents were randomized into an intervention group-I (received simulation-based training) and a control group-C (received video-based training). Both groups underwent evaluations of their knowledge and skills on live volunteers or ICU patients using TCS right after the training and again six months thereafter. An independent sample t-test was employed to compare TCS between the groups, while a paired t-test was used to assess intragroup TCS at the baseline, after training, and six months post-training. RESULTS: The two groups had no significant difference in the pre-test assessment scores. Immediately following the training session, Group I exhibited a significantly higher TCS compared to Group C (25.2 ± 2.7 and 22.4 ± 2.5, p = 0.01). Compared to the I-group, the C-group made more attempts to achieve competence. Group I exhibited higher confidence levels both immediately and six months later. After a six-month follow-up, the TCS scores in both groups were lower than the scores recorded immediately. CONCLUSION: This study demonstrates that a structured, problem-based simulator course improved immediate TCS and 6-month confidence compared with video-based training. However, a decline in TCS in both groups over time highlights the need for periodic refreshers within six months to improve retention. TRIAL REGISTRATION: CTRI [CTRI/2021/07/034684]. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":"11"},"PeriodicalIF":3.6,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12911289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The skin color and gender of high-fidelity simulation manikins in US simulation centers and their use in cultural humility training.","authors":"Marie Anderson Wofford, Cortlyn Brown, Bernard Walston, Heidi Whiteside, Joseph Rigdon, Philip Turk","doi":"10.1186/s41077-026-00408-z","DOIUrl":"10.1186/s41077-026-00408-z","url":null,"abstract":"<p><p>OBJECTIVE: Our objectives were to evaluate what proportion of simulation centers use high-fidelity simulation manikins to teach cultural humility, and to evaluate if manikin skin color and sex breakdown are representative of the USA population. METHODS: Surveys were sent to simulation centers from our simple random sample. Key outcomes included skin color and gender of manikins and if cultural humility was taught via simulation. Point and interval estimates were calculated for the proportion of light-, medium-, and dark-colored manikins, the proportion of female and male manikins, and the proportion of centers using simulation to teach cultural humility. Confidence intervals were employed to test the null hypothesis that light/medium/dark skin color was 60/20/20 and female/male was 50/50 which is extrapolated from the US Census data. RESULTS: Our response rate was 75% (41/55). All of the 41 responding simulation centers had manikins (1.0000, 95% CI: 0.9180, 1.0000). Twenty seven of the 41 simulation centers with manikins reported simulation scenarios with cultural humility (0.6585, 95% CI: 0.5127, 0.8044). Proportions of light-, medium-, and dark-colored manikins were 0.5150 (0.4669, 0.5625), 0.3086 (0.2651, 0.3547), and 0.1764 (0.1563, 0.1964), respectively. Proportions of male and female manikins were 0.6402 (0.6163, 0.6640) and 0.3598 (0.3360, 0.3837). The null hypotheses that skin color follows a 60/20/20 split and gender follows a 50/50 split were rejected. CONCLUSIONS: Most simulation centers surveyed teach cultural humility via simulation, however their manikins do not reflect the sex and skin tone of the USA population. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":"9"},"PeriodicalIF":3.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transfer of clinical debriefing from simulation to practice: exploring the barriers and enablers.","authors":"Charlotte Jane Dewdney, Stephen Richard Waite, Katherine Ralston, Emma Claire Phillips, Edward Mellanby, Victoria Ruth Tallentire","doi":"10.1186/s41077-025-00405-8","DOIUrl":"10.1186/s41077-025-00405-8","url":null,"abstract":"<p><strong>Background: </strong>Clinical debriefing (CD) positively impacts individuals, teams and systems and has been shown to improve patient outcomes and staff wellbeing. Although there is a growing evidence base supporting CD, it has not been routinely adopted by many healthcare organisations. Despite the work environment being an important component of transfer of learning, there has been minimal focus on how it influences implementation and maintenance of CD in practice. The overall aim of this study was to explore the work environment barriers and enablers influencing the transfer of clinical debriefing skills from simulation to clinical practice.</p><p><strong>Methods: </strong>Following ethical approval, medical registrars who had participated in a simulation course involving a within-scenario CD were invited to participate in semi-structured interviews. These utilised Burke and Hutchins' evaluation model as the initial conceptual framework and took place at least two months post-course. Interviews explored participants' experiences of transferring learning related to CD from simulation to the clinical workplace, and were transcribed verbatim and dual coded using template analysis.</p><p><strong>Results: </strong>Fifteen medical registrars participated in interviews between January and May 2025. The work environment influences from Burke and Hutchins' evaluation model resonated as important factors affecting adoption of CD. With the addition of subthemes generated inductively from the data, the model provided a framework for identification and articulation of the barriers and enablers to CD in the workplace. The most striking finding was participants' sense of personal responsibility to engage with CD. In addition, participants identified the requirement for cultural change to enable CD.</p><p><strong>Conclusions: </strong>Work environment influences represent both barriers and enablers of CD in relation to the transfer of learning from simulation to clinical practice. Personal responsibility and workplace culture are important drivers of CD, and attention should be paid to the influence of both constructs in this context. Recommendations for practice, based on our findings, are designed to enable educators and organisations to promote the adoption of CD in their own settings. This will help to bridge the gap and make CD the norm, not the exception.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":"8"},"PeriodicalIF":4.7,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress responses and experiences of surgical trainees in simulation-based training of advanced laparoscopic procedures in highly realistic environments.","authors":"Maria Suong Tjønnås, Sébastien Muller, Johannes Tjønnås, Mariann Sandsund, Solveig Osborg Ose, Cecilie Våpenstad, Gjermund Johnsen","doi":"10.1186/s41077-025-00400-z","DOIUrl":"10.1186/s41077-025-00400-z","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based training facilitates learning of advanced laparoscopic surgical procedures. Such procedures are challenging to master due to their technical complexity, which can elicit stress responses in surgical trainees. Previous research has demonstrated the impact of stress on trainees' learning processes in skills lab. However, there is limited data comparing trainees' stress responses during advanced procedural training using box-trainers in skills lab, to those experienced during operating training in realistic simulation environments. This study aims to explore the physiological responses, self-reported stress responses, and experiences of stress of surgical trainees during advanced laparoscopic procedural training in two different simulation environments. Insights into stress mechanisms may suggest improvements for the design of future training courses.</p><p><strong>Methods: </strong>This observational study explored participants' stress experiences through semi-structured interviews and investigated their stress responses by measuring the heart rate variability, saliva cortisol levels, and trainees' self-reported stress using a validated instrument. Participants performed advanced laparoscopic procedures on box-trainers and live animal models in operating room settings.</p><p><strong>Results: </strong>Twelve experienced surgical trainees were included in the study. No differences were observed for physiological parameters between training activity on the box-trainer simulator and live animal models. In interviews, trainees reported experiencing higher stress levels during procedural training in operating room environment. The main themes related to elevated stress were realism and functional task alignment, perceived level of risk, and interpersonal dynamics in simulation environments. The trainees perceived the increased stress response levels as beneficial for their focus and for performing advanced procedures.</p><p><strong>Conclusion: </strong>In this study, no significant differences were identified in trainees' physiological or self-reported stress responses across the two simulation settings. However, qualitative interview data revealed that trainees perceived greater stress when training with animal models in highly realistic operating room environments, suggesting the potential educational value of such immersive simulation environments.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":"6"},"PeriodicalIF":4.7,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12882263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The CHILD safeguarding simulation study: Co-designed cHild-centred Interprofessional Learning through Dialogue for healthcare professionals.","authors":"Michelle O'Toole, Walter Eppich, Clare Sullivan, Naoise Collins, Dani Hall, Aideen Walsh, Michelle Whelan, Claire Mulhall, Andrea Doyle","doi":"10.1186/s41077-025-00403-w","DOIUrl":"10.1186/s41077-025-00403-w","url":null,"abstract":"<p><p>BACKGROUND: Globally, in excess of one billion children experience violence and abuse every year, leading to upwards of 40,000 deaths. Child safeguarding education typically occurs in professional silos across healthcare, often focusing on specific undergraduate competencies. In practice, however, child safeguarding requires a multi-professional approach, necessitating effective communication in emotionally charged contexts. To address these needs, we designed an interprofessional course using simulation-based education for experienced healthcare professionals working in the emergency department. METHODS: On three occasions, we delivered an in-person, two-day course with 32 healthcare professionals from medicine, nursing, and social work. We collected data using multiple methods including participant demographics and child safeguarding experience (n = 32), observational field notes, individual semi-structured interviews (n = 14) and focus groups (n = 4). We analyzed the data using landscapes of practice theory as a sensitizing concept. RESULTS: Using landscapes of practice theory, we deductively generated three key themes from our data: (1) collaborative learning, (2) the medium of language, and (3) creating a safe space. These themes encapsulate our participants’ experiences in navigating interprofessional learning within newly established teams, during simulated child safety scenarios in the emergency department. Findings also detail participants’ knowledge gains and confidence in reporting child safeguarding concerns. CONCLUSIONS: This co-designed interprofessional simulation-based child safeguarding course created space for learners to renegotiate safeguarding as a shared, interdependent responsibility. Authentic, emotionally charged scenarios in a psychologically safe environment helped participants tolerate uncertainty, rehearse reporting decisions, and develop a shared safeguarding lexicon. The resulting design principles may assist educators seeking to foreground psychological safety, authentic collaboration and the child’s voice in interprofessional safeguarding education. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":"7"},"PeriodicalIF":3.6,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How interprofessional simulation supports medical students' transition to clinical practice.","authors":"Libby Thomas, Gabriel Reedy","doi":"10.1186/s41077-025-00392-w","DOIUrl":"10.1186/s41077-025-00392-w","url":null,"abstract":"<p><strong>Introduction: </strong>Interprofessional education (IPE) improves outcomes for staff and patients, yet most pre-licensure training remains siloed. Simulation-based education (SBE) enhances clinical and communication skills, with particular benefit during transitions in training. While immersive simulation is costly, could integrating IPE and SBE at key transition points optimize its educational impact? This study explores how interprofessional simulation can support transitions to practice, and what unique value it can contribute to the learning experience.</p><p><strong>Methods: </strong>This phenomenological study explored medical students' experience of an interprofessional SBE programme. Adopting a sequential, mixed-methods design, students were asked about their experiences of participating in interprofessional simulations using various data collection methods over their transition from pre-licensure to professional practice. Methods included surveys (n = 229), one-on-one interviews (n = 29), focus groups (13 participants) and 1-year follow up interviews (n = 7). The qualitative data from interviews and focus groups are reported here. Codes and meaning units were developed and then scrutinized to develop a nuanced understanding of how the elements of the interprofessional simulation experience intertwined and the impact this had on the students.</p><p><strong>Results: </strong>Three overarching themes were identified from the analysis and were explored in greater detail: realism, gaining confidence and learning to observe (noticing). Interprofessional SBE provides the realistic environment for a unique educational experience in which students develop skills of observing interprofessional clinical practice, and can gain confidence for the transition into that practice. The implications are that the time and effort invested in overcoming the obstacles to offering interprofessional SBE lead to learning outcomes that may not otherwise be achieved. The results are further discussed through three theoretical lenses: Meyer and Land's threshold concepts, Richards' interdependent agentic capabilities and Lave and Wenger's legitimate peripheral participation.</p><p><strong>Conclusion: </strong>Interprofessional simulation offers students immersive, emotionally resonant experiences that enhance confidence, professional identity, and integration into clinical teams. These simulations prompt reflection on future roles and foster deeper understanding of interprofessional dynamics. The study identifies specific attributes of simulation that meaningfully contribute to learning, extending current SBE literature. By using a qualitative lens, this research highlights the unique value of interprofessional SBE in preparing students for collaborative practice and the complexities of modern healthcare.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":"2"},"PeriodicalIF":4.7,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12784531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building collaborative prescribers: development and analysis of a novel simulation-based role exchange education programme between pharmacy and medical students.","authors":"Niall O'Boyle, Peter Currie, Roisin O'Hare, Richard McCrory, Niall Leonard, Stephen Kirk","doi":"10.1186/s41077-025-00399-3","DOIUrl":"10.1186/s41077-025-00399-3","url":null,"abstract":"<p><p>BACKGROUND: Undergraduate curricula across a number of healthcare professions have increased their focus on interprofessional education. From 2026 all pharmacy graduates in the UK will be independent prescribers, which will require them to develop skills of patient history taking and clinical assessment. Likewise, medical graduates will face increasingly complex prescribing challenges in an aging population with chronic illnesses, polypharmacy and personalised medicine. Developing these skills via collaborative practice is essential to meet the healthcare challenges of the future. METHODS: We developed a novel interprofessional educational programme focused on medical admissions for final year medical and pharmacy students in a teaching hospital between January and March 2025. We utilised the concept of role exchange in simulation to foster development of mutual skills as well as enhanced professional identity formation and unique role recognition. We researched participant’s ability to work collaboratively, their skill development and their perceptions of IPL using a mixed methods approach. Pre and post course questionnaires using the Interprofessional Education Collaborative (IPEC) self-assessment tool were completed by participants in addition to questions on skill acquisition and free text questions regarding their experiences of the programme. Statistical analysis using independent t-testing was performed and a summary of narrative data was used to analyse the qualitative data. RESULTS: The cohort size was 59 students (25 medical and 34 pharmacy). The pre-course response rate was 92% (n = 23) for medicine and 88% (n = 30) for pharmacy and the post course response rate was 88% (n = 22) for medicines and 91% (n = 31) for pharmacy. A total of 106 responses were analysed. A significant improvement was observed across: Interprofessional Values, Interprofessional Interactions and total score. Review of student comments identified several benefits and areas for future development. Students rated the course highly and 96% (n = 51) believed that they would be able to use the skills and knowledge gained in their future practice. CONCLUSIONS: Authentic simulated scenarios designed to align with professional practice, facilitated by role exchange, improves interprofessional collaboration and mutually develops skills in history taking and prescribing. This programme supports new standards for education in both medicine and pharmacy but delivery remains challenging due to its resource-intensive nature. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":"5"},"PeriodicalIF":3.6,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12837176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring effects of resilience-focused debriefing on reflection and teamwork in interprofessional simulation-based education - a mixed method study.","authors":"Torben Nordahl Amorøe, Hans Rystedt, Lena Oxelmark, Peter Dieckmann, Karin Jonsson, Cecilia Escher, Johan Creutzfeldt, Paulin Andréll","doi":"10.1186/s41077-025-00398-4","DOIUrl":"10.1186/s41077-025-00398-4","url":null,"abstract":"<p><strong>Background: </strong>Interprofessional simulation-based education (IPSE) holds the potential to prepare healthcare students to handle the complexity of healthcare. However, complexity and resilience are traditionally not addressed deliberately in IPSE. The aim of this study was to explore the effect of resilience-focused debriefing (RFD) that addresses complexity and resilience, on reflection and teamwork in IPSE for pre-graduate healthcare students.</p><p><strong>Methods: </strong>In a convergent mixed methods intervention study, 149 nursing and medical students in their last semester participated in a full-day IPSE course with five progressively challenging scenarios. Fifteen facilitators were instructed to use RFD. Qualitative date, comprised of transcripts from nine debriefings, were analysed using topic analysis. An intervention check was performed to assess the use of RFD. Quantitative data comprised pre-post ratings of team performance in videorecorded scenarios (1 and 5) from 18 groups using the Team Emergency Assessment Measure (TEAM). Additionally, a study-specific rating scale was employed to assess the extent of participants' perceived challenges during scenarios.</p><p><strong>Results: </strong>RFD helped facilitators to guide the students' attention to the complexity of teamwork and how to manage such complex situations successfully by adapting crisis resource management principles and performing resilient actions (e.g., attunement, adaptive leadership), both as individuals and as teams. Applying RFD brought the students' attention to how they were able to succeed despite the difficulties they encountered. Although the assessed team performance was on an acceptable level, students initially had difficulties in recognizing and learning from actions that led to successful outcomes. The significant decrease in the degree of challenges experienced suggests that students developed a greater tolerance for complexity. Nevertheless, the quantitative data showed that there was no pre-post difference in team performance as assessed by TEAM.</p><p><strong>Conclusions: </strong>RFD can be used to increase healthcare students' attention to the complexity of interprofessional teamwork in acute dynamic situations and help them recognize and learn from both successful actions and overcoming challenging situations. Although we did not find a significant gain in team performance, the integrated results suggest that RFD may potentially improve interprofessional teamwork. Further research is warranted to develop instruments measuring team performance that are sensitive to various aspects of resilience, as well as to deepen the understanding of RFD in the simulation-based education.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":"4"},"PeriodicalIF":4.7,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12831296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a faculty simulation-based education strategy: a Delphi study to build consensus and aid decision making.","authors":"Nebras Alghanaim, Samantha Rogers, Jo Hart, Gabrielle Finn","doi":"10.1186/s41077-025-00393-9","DOIUrl":"10.1186/s41077-025-00393-9","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based education (SBE) improves learner competence, patient safety and workforce readiness. Yet, existing frameworks such as INACSL and ASPiH provide limited guidance on developing sustainable, institution-wide strategies, particularly in decentralised, multidisciplinary contexts. This study aimed to create a faculty-wide SBE strategy using the e-Delphi method to build consensus among diverse stakeholders.</p><p><strong>Method: </strong>The study was conducted at a UK higher education institution without a centralised simulation centre. An e-Delphi process was used to refine strategic statements across three survey rounds. Panellists were purposively sampled and included internal and external academics, postgraduate and undergraduate students, and international contributors from 7 countries and 15 healthcare-related professions. Initial statements were derived from established SBE frameworks and refined based on quantitative agreement (≥ 80% consensus) and thematic analysis of free-text feedback.</p><p><strong>Result: </strong>Of 111 invited participants, 41 completed Round 1, increasing to 43 in Rounds 2 and 3. The process produced 39 final strategic statements grouped under eight strategic priorities: (1) Leadership and governance; (2) Communication and networking; (3) Training and development; (4) Standards and quality assurance; (5) Research and evaluation; (6) Accessibility; (7) Preparation and planning; and (8) Finance. These priorities map to three overarching themes-Connectivity, collaboration and partnership; Promoting quality; and Stability, sustainability and growth of SBE. The strategy embeds SBE into institutional processes, aligning it with budgeting, infrastructure planning, workforce development, and digital transformation. It emphasises multi-level governance, sustainability planning, technology integration and inclusivity through student patient and public involvement and engagement (PPIE) representation.</p><p><strong>Conclusion: </strong>The e-Delphi method effectively built consensus on a comprehensive SBE strategy tailored to a decentralised, multidisciplinary faculty. The strategy goes beyond existing frameworks by integrating sustainability, multi-level governance, and structured technology planning, while embedding student and PPIE perspectives. It offers a scalable, replicable model for institutions seeking to align simulation provision with strategic priorities, accreditation standards and equitable access. Future research should examine the strategy's impact on educational outcomes, workforce readiness and its adaptability across disciplines and institutional contexts.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"10 1","pages":"65"},"PeriodicalIF":4.7,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12690964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resolving latent safety threats identified through in situ simulation: a multicentre mixed-methods study.","authors":"Jennifer Weller, Kate Fahey-Williams, Kaylene Henderson, Jane Torrie, James Hamill, James Moore, Carlos Campos, Andrew MacCormick","doi":"10.1186/s41077-025-00401-y","DOIUrl":"10.1186/s41077-025-00401-y","url":null,"abstract":"<p><strong>Background: </strong>In situ simulation can identify latent safety threats in healthcare, yet there has been limited focus on how these threats are subsequently addressed. Adopting a systematic approach to identifying, reporting, and resolving threats found during in situ simulations could enhance clinical safety and system resilience. This study investigated the resolution of safety threats detected through in situ simulation courses in Aotearoa New Zealand hospitals, aiming to quantify resolution rates and examine factors influencing successful resolution.</p><p><strong>Methods: </strong>This multicentre study used an exploratory sequential mixed-methods design. We collected data on latent safety threats identified after in situ simulations using a structured reporting tool and assessed their resolution three months post-course. Associations between resolution and threat classification, risk assessment score, course type, and hospital size were analysed. Qualitative interviews with hospital simulation convenors explored contextual and experiential factors affecting resolution.</p><p><strong>Results: </strong>Across 20 courses in 15 hospitals, 278 safety threats were identified at the three-month follow-up, with 28% resolved. Threats involving equipment, environmental layout, and tasks were more often resolved than those related to teamwork or organisational factors. Smaller hospitals showed higher resolution rates; multilevel regression confirmed hospital size and threat classification as significant predictors of resolution. Qualitative thematic analysis of 15 interviews identified five key themes: influence of threat type; motivation to resolve the threat; identifying and communicating the threat; clinician agency within their organisation; and hospital structures and processes to support resolution of identified safety threat. Tangible threats within clinicians' control were addressed more readily, often through straightforward interventions; conversely, threats requiring cross-departmental collaboration or structural change remained unresolved due to limited authority, time, and institutional support.</p><p><strong>Conclusion: </strong>While in situ simulation effectively identifies latent safety threats, threat resolution remains limited. Our findings highlight the need to align institutional processes with frontline clinicians' insights. Effective threat mitigation depends on both threat characteristics and organisational context. To fully realise the opportunity presented by in situ simulation to improve patient safety, healthcare systems must move beyond threat identification to actively support resolution-by empowering clinicians, enabling multidisciplinary collaboration, and embedding clear processes for follow-up and accountability.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":"3"},"PeriodicalIF":4.7,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12801849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}