London

Standards of Simulation & Code of Ethics

Overview

Standards in healthcare simulation play a crucial role in ensuring quality, consistency, and effectiveness across simulation practices. These standards encompass various aspects, including facility design, scenario development, faculty & participant training, assessment methodologies, and debriefing processes. By adhering to established standards, healthcare simulation programs can enhance patient safety, improve clinical outcomes, and foster professional development among healthcare professionals.

Globally there are a number of Organisations that a centre can align to for Standards of Best Practice and we are confident that they are all routed in the same goal to improve simulation giving the user the best, evidence based experience.  It is for that reason that we cannot endorse any one particular Organisation, but merely raise the awareness that we do follow standards of best practice in our centre and broadly discuss these below.

Published Standards

Our Belief

It is important to note that the above are voluntary and centres are not obliged to align with any particular Organisation and their standards, however, where the standard exists, it is wise to examine and align to best practice within the healthcare simulation arena

One of the foundational standards in healthcare simulation is the design and operation of simulation facilities. Facilities should, like ours be purpose-built or adapted to facilitate realistic and immersive simulation experiences. This includes features such as appropriate room layouts, environmental controls, audio-visual equipment, and debriefing spaces. Standards like those set forth by the Society for Simulation in Healthcare (SSH) provide guidelines for designing and outfitting simulation centres to optimise learning outcomes and participant engagement.

Another critical aspect of simulation standards revolves around scenario development. Scenarios should be crafted to reflect real-world clinical situations, incorporating evidence-based practices and clinical guidelines. Standardised patients or high-tech simulators may be used to portray realistic clinical presentations, adding authenticity to the simulation experience. Additionally, scenarios should be aligned with specific learning objectives and performance metrics to facilitate meaningful learning and skill acquisition among participants.

Participant training is another area where standards play a vital role in healthcare simulation. Training programs should be standardised and structured to ensure consistency and effectiveness. This includes pre-briefing sessions to prepare participants for the simulation, hands-on practice opportunities, and post-scenario debriefings for reflection and feedback. Standardised training protocols help ensure that participants receive consistent instruction and support throughout their simulation experiences, ultimately enhancing their clinical competence and confidence.

Debriefing processes are integral to healthcare simulation standards, facilitating reflection, discussion, and learning following simulation experiences. Debriefings should be structured, supportive, and focused on specific learning objectives, encouraging participants to analyse their performance, identify areas for improvement, and develop action plans for future practice. Standardised debriefing methodologies, such as the Debriefing Assessment for Simulation in Healthcare (DASH) tool or the Diamond Model, provide frameworks for conducting effective debriefings and promoting meaningful learning outcomes.

Adherence to standards in healthcare simulation is essential for ensuring the quality and effectiveness of simulation-based education and training. By following established guidelines and best practices, simulation programs can enhance patient safety, improve clinical outcomes, and promote professional development among healthcare professionals. Additionally, standardized processes and protocols help streamline simulation operations, optimise resource utilisation, and foster a culture of continuous improvement within healthcare organisations.

Overall, standards in healthcare simulation serve as a blueprint for excellence, guiding the design, implementation, and evaluation of simulation-based education and training programs. By embracing these standards, healthcare organizations can harness the full potential of simulation to enhance patient care, advance clinical practice, and empower healthcare professionals to deliver high-quality, evidence-based care.

Simulation Code of Ethics

Society for Simulation in Healthcare (SSH)

Our simulation service has embraced the SSH Code of Ethics, illustrating its dedication to maintaining standards and ensuring appropriate simulation practices consistently. All team members and supporting faculty, encompassing both technical and clinical domains, are expected to acquaint themselves with and adhere to the SSH code. This commitment ensures that simulations are conducted ethically, professionally, and in alignment with the highest standards of patient care.

SSH’s primary objectives revolve around enhancing performance and minimising errors in patient care through Simulation. Originating in the US in 2004, SSH boasts a global membership comprising physicians, nurses, allied health professionals, paramedics, researchers, educators, and developers.

The SSH code of ethics serves as an integral component of professional commitment and oversight. It serves to supplement, inform, and elevate the standard of educational delivery that healthcare professionals should strive for.

SSH Logo

front cover of the code of ethics

SSH Code of Ethics 6 principles

Integrity

Healthcare Simulationists shall maintain the highest standards of integrity including honesty, truthfulness, fairness, and judgment in all matters affecting their duties.

 

They shall:

 

  • Respect and cultivate an ethical organizational environment.
  • Provide, as appropriate, disclosure of simulation activity design assumptions, limitations, alterations, and problems.
  • Be explicit and unequivocal about the applicability of specific simulation activities and methods according to the available evidence.
  • Work to eliminate unnecessary harm to humans, animals, and the environment.
  • Honor privacy rights of individuals and organizations, and uphold the confidentiality of data and outcomes as appropriate.
  • Respect and acknowledge all intellectual and property rights and give due credit where appropriate.

Transparency

Healthcare Simulationists shall perform all healthcare simulation activities in a manner that promotes transparency and clarity in the design, communication, and decision-making processes.

 

They shall:

 

  • Adhere to accepted standards in the documentation, analysis, design, development, implementation, and evaluation of simulation activities.
  • Disclose any activities that may involve real or perceived conflicts of interest.
  • Be explicit about the nature and purpose of the simulation activity, including research activities.
  • Restrict simulation activities involving deception, ensuring that deception is minimized to the extent possible and does not involve the concealment of risk or intent to harm or punish.

Mutual Respect

Healthcare Simulationists shall respect the rights, dignity, and worth of all. They shall practice empathy and compassion to support beneficence and non-maleficence towards all involved in simulation activities.

 

They shall:

 

  • Honor the knowledge, skills, values, and vulnerability of learners and colleagues.
  • Listen to others’ points of view, seeking to understand them.
  • Exhibit humane behavior, honor diversity, and foster inclusion, avoiding prejudicial treatment.
  • Maximize safety and minimize physical and psychological risk.

Professionalism

Healthcare Simulationists shall conduct themselves in a manner that upholds the professional standards inherent in healthcare simulation.

 

They shall:

 

  • Demonstrate professional competence and attitudes.
  • Exhibit continuous personal and professional development.
  • Encourage and develop colleagues and new entrants to the healthcare simulation profession.
  • Cultivate opportunities for the advancement of the healthcare simulation protession.

Accountability

Healthcare Simulationists shall be accountable for their decisions and actions in fulfilling their duties and responsibilities.

 

They shall:

 

  • Continuously seek, reflect on, and incorporate feedback.
  • Submit themselves to professional review as required.
  • Be role models of ethical behavior.
  • Exhibit professional conduct that is a credit to the healthcare simulation community, employer, and self.
  • Identify and notify relevant parties of unsafe, unethical, or unprofessional behaviors.
  • Design and use simulations in a way that wisely uses available resources.
  • Maintain vigilance regarding not only desired outcomes, but also potential unintended consequences of the simulation activity.

Results Orientation

Healthcare Simulationists shall serve to support activities that enhance the quality of the profession and healthcare systems. Outcomes are inclusive of all parts of the process of healthcare simulation and are not exclusive to a final product.

 

They shall:

 

  • Assure the reliable and credible use of healthcare simulation, in line with acknowledged standards of practice.
  • Engage in continuous quality improvement.
  • Create and measure impact across the range of achievable outcomes, including the practice of simulation, human performance, systems improvement, and direct patient results.
  • Incorporate and embed the Code of Ethics throughout healthcare simulation and organizational culture.
  • Use the Code of Ethics to inform ethical practices in relevant fields.
  • Advance public knowledge about healthcare simulation by promoting access and sharing knowledge and experience.
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