We must continue to be mindful that the goal of healthcare simulation is not the simulation itself. It is easy to be enamored with the ability to re-create asp
ects of the healthcare environment with equipment that is fun to work with and makes the participant go “WOW!!!!” It is also fun to surprise participants from time to time and experience the joy of seeing a participant or group achieve an “ahaaaa” moment created by one of our simulations.
However fun, useful, exciting and relevant the situation; the simulation is not the ultimate goal. This concept must be in the back of every successful simulation faculty member. The goals of the activity are driven by the objective and assessment tools that the simulation is designed to accomplish. The ultimate goal is better trained and more confident healthcare providers of all levels!
Whether you are considering what simulation equipment to purchase, designing the audio and visual systems, data collection or floor plans of a new program, it will serve you well to continue to focus on the mission. Many times the ability to recreate fanciful renditions of highly complex situations takes over as the chief aim and end up costing more money and consuming more resources then may be necessary. The mission that is detailed enough to allow a drill-down to the learning objective level to help guide the procurements sensibly.
I can not tell you how many times we have had a well meaning faculty member see a fancy simulator at a national meeting and then return home to want to purchase one. Then as we take the time to analyze the goals of what the goal of the education that the faculty member is setting out to accomplish, we find that the newest, fanciest, whiz-bang simulator is necessary after all. Often times a lesser-cost piece of equipment will suffice.
Don’t get me wrong, I still get excited every year on exhibit hall floors seeing the new technology becoming available for our profession and ostensibly designed to benefit healthcare providers and patients for the future. But we must keep that enthusiasm under control to be able to make objective decisions on the types of purchases we make and the designs we create.
Similarly the designs of our scenarios including what we include and exclude should go though a similarly rigorous evaluation process. There is no sense making a scenario more complicated to set up, execute and break down unless each element contributes directly to the learning objectives.
This will allow us to hit the bull’s eye with effectiveness and efficiency in the use of simulation into the future. That will help us toward the real goal!
Thank you Paul– great post. I would like to add other stimuli that often rest in spending more than is needed for equipment that are really overkill for the identified objectives.
–grants: although grants are getting harder to obtain, they are still the primary way for academic sumulation programs to acquire new simulators. Often when money comes in this way, purchasing impetus changes from objective-based decision making to “we have to spend this money” based decisions. Also, I can’t tell you how often I get calls from colleagues from around the country that start with “I have been asked to make a wish list that is due tomorrow. What should I buy?” This is not a wise or fair way to treat our subordinates, who would much rather be able to assess their objectives and their curriculum and be able to make an informed recommendation. Administrators must be better at giving the decision process adequate time. The result in these kind of cases is that items are purchased and set aside until an oppropriate objective is eventually defined.
–another impetus for making purchasing decisions comes from two origins: potential program enrollees (and their parents) as well as institutional directors and administration. In academia, there is a lot of competition to attract students. Nice shiney advanced simulators with all the bells and whistles are now a “distractor” when parents and their children are evaluating a program. “Are these the best?” Or “institution b” has newer simulators” as they cluck their tongues at perfectly adequate simulators”. In hand with this are administrators that want to attract these learners, and their tuition, so pressure comes from both groups. Grants are sought and budgets are adjusted.
Subject matter experts and their department leadership should be making these decisions void of these distractors. When more money should be going towards the hiring of professional workforce to support these technologies, and those that relay on them, memory gets tied up on new purchases that are likely not necessary.
This is a discussion that needs to continue all over our country and beyond. There are too many purchases sitting in storage and too many educators that don’t have the support staff to integrate these technologies so that their investment is used as it should be.
Thanks Paul!
Michael,
I think you hit the nail on the head identifying “the hiring of professional workforce to support these technologies” as the missing link to the success of the simulation centers. All too often the simulators are purchased without personnel to develop and execute the education the simulators support. It is a trend that has occurred for a long time and one that often results in sub par performance of a simulation center. Without the education developers and operators needed to help realize learning objectives, build curriculum and assessments that are aligned with those objectives, and execute the education, the simulators are just simulators and the ultimate goal of developing a better performing healthcare workforce is still distant.