Status of simulation in health care education: an international survey

Figures & data

Table 1 Complete list of surveyed simulation centers and local collaborators

Institute	Country	Local collaborators
University of Buenos Aires	Argentina	AR Ferreres
Sydney Clinical Skills and Simulation Centre	Australia	L Watterson
Queensland Health Clinical Skills Development Service	Australia	M Watson
Prince of Wales Hospital	Australia	R Endre
Epworth HealthCare, Private Hospital Organisation, Melbourne, Victoria	Australia	T Vawser
University of Sao Paulo, School of Medicine	Brazil	AS Neto
University of Ottawa Skills and Simulation Centre	Canada	K Thomas
Northumbria University	Canada	A Platts/S McQueen
Alberta Children’s Hospital	Canada	A Cheng
Center of Excellence for Simulation Education and Innovation, University of British Columbia	Canada	M Woschee
McGill University	Canada	L Crelinsten
School of Medicine, Shanghai Jiaotong University	People’s Republic of China	G Huang
West China Clinical Skills Training Center, Sichuan University	People’s Republic of China	Q He
Athens University Medical School	Greece	E Georgiou
The Hong Kong College of Anaesthesiologists	Hong Kong	YF Chow
MSR Israel Center for Medical Simulation	Israel	A Ziv/L MacMillan
Jordan University of Science and Technology	Jordan	MT Alwidyan
Jordan University of Science and Technology, Medical Faculty	Jordan	FM Khwaileh
University of Wongju	Korea	M Han
Yonsei University College of Medicine	Korea	HS Chung
Universidad Nacional Mayor San Marcos	Peru	PW Pujada
Umm Al-Qura University, Saudi Arabia	Saudi	S Bajammal
Kind Saud University, College of Medicine	Saudi Arabia	HC Taskiran
Center for Medical Simulation, Hospital Universitario Marques de Valdecilla	Spain	I Del Moral
Skane University Hospital	Sweden	I Ihse
University of East Anglia	UK	D Grant
SiTEL, MedStar Health	USA	Y Millo
University of South Florida Health	USA	JH Armstrong
Stanford	USA	J Lau
Beth Israel Deaconess Medical Center	USA	D Fobert
Mayo Clinic Multidisciplinary Simulation Center	USA	D Eagle/Dr Dunn
University of California, Irvine, Surgical Education Center	USA	EM McDougall
Providence Hospital and Medical Centers	USA	N Gopinath
Center for Virtual Care, University of California, Davis	USA	B Bencken
The Institute for Simulation and Interprofessional Studies, University of Washington	USA	B Ross
University of California, Davis Vascular Center	USA	D Dawson
Baystate Medical Center, Tufts University School of Medicine	USA	N Seymour
Marcia and Eugene Applebaum Surgical Learning Center at Beaumont Hospital	USA	C Shanley
Northwestern University	USA	C Pugh
Louisiana State University School of Medicine	USA	J Paige
Cedars-Sinai Center for Minimally Invasive Surgery	USA	S Towfigh
University of Texas at Arlington	USA	P Andreatta

Table 2 Demographics of simulation centers surveyed

Region	Centers (n)	Number accredited				Infrastructure of funds	Operating funds	Research		Trained experts		Location
		n	ACS	RCSPC	SSH			Y	N	Y	N	University/college	Hospital
USA	13	4	9	0	5	Good	Variable	9	4	11	2	12	1
Canada	6	3	0	2	1	Good	Variable	3	3	3	3	3	3
Australia	5	3	0	0	2	Good	Good	3	2	4	1	1	4
Europe	5	2	3	0	1	Good	Variable	4	1	5	0	4	1
South America	3	3	0	0	0	Variable	Variable	1	2	1	2	3	0
Asia	10	7	3	0	0	Variable	Variable	6	3	4	5	9	0

Abbreviations: ACS, American College of Surgeons; RCSPC, Royal College of Physicians and Surgeons of Canada; SSH, Society for Simulation in Healthcare; Y, yes; N, no.

Figure 1 Number of learners from each group.

Abbreviation: CPD, continuing professional development.

Figure 2 Estimated use of simulation activities through educational years.

Abbreviation: CPD, continuing professional development.

Table 3 Simulation use as it pertains to core competencies of practice

Competency/domain	Percent respondents reporting use of simulation	Percent respondents indicating simulation is part of the curriculum	Estimated share (%) of simulation in the curriculum
Skill acquisition/competency	80	58	37
Patient safety	78	63	20
Communication	70	63	24
Collaboration/interprofessional team training	70	58	22
Manager/resource management	35	33	19
Scholarly activities	45	40	8
Professionalism	45	40	17
Health advocacy	23	20	7

Figure 3 Average Activity Index values for different simulation types.

Table 4 Strengths and barriers to simulation indicated by centers surveyed

Strengths
35	Dedicated financial support for operating budget
27	Dedicated simulation technician
22	Support from institutional leaders
20	Curriculum development and implementation
18	Instructor training
16	Dedicated simulation nurse/RT educator with protected time
16	Research program
15	Collaboration with other leading centers
15	Dedicated medical director with protected time
15	Engaging health care workers in improving patient safety
14	Simulation operator training
9	Dedicated simulation administrator/coordinator
Barriers
29	Increased financial support
23	Dedicated simulation technician
17	Increased collaboration with other leading centers
17	Dedicated medical director with protected time
15	Instructor training
13	New scenario development
11	Research training
10	Integration of simulation into existing curriculum
8	Increased support from institutional leaders
9	Lack of outcome measurement
8	Simulation operator training
6	Dedicated simulation nurse/RT educator with protected time
9	Dedicated simulation administrator/coordinator

Notes: The numbers listed are the number of simulation centres who responded out of 42. In strengths they responded that they have the item listed, in barriers they responded that each item was a barrier to their furthered success.

Abbreviation: RT, respiratory technician.