SASS: South African Simulation Survey – a review of simulation-based education

Abstract

Background: Simulation-based education (SBE) has been shown to be an effective and reproducible learning tool. SBE is used widely internationally. The current state of SBE in South Africa is unknown. To the best of our knowledge this is the first survey that describes the use and attitudes towards SBE within South Africa. Methods: An online survey tool was distributed by email to: i) the South African Society of Anaesthesiologists (SASA) members; and ii) known simulation education providers in South Africa. The respondents were grouped into anaesthesia and non-anaesthesia participants. Descriptive statistics were used to analyse the data. Ethics approval was obtained: HREC REF 157/2017. Results: The majority of the respondents provide SBE and integrate it into formal teaching programmes. There is a will amongst respondents to grow SBE in South Africa, with it being recognised as a valuable educational tool. The user groups mainly targeted by SBE, were undergraduate students, medical interns, registrars and nurses. Learning objectives targeted include practical skills, medical knowledge, critical thinking and integrated management. Amongst anaesthesia respondents: the tool most commonly used to assess the quality of learner performance during SBE, for summative assessment, was ‘expert opinion’ (33%); the most frequent methods of evaluating SBE quality were participant feedback (42%) and peer evaluation (22%); the impact of SBE was most frequently assessed by informal discussion (42%) and learner feedback (39%). In anaesthesia SBE largely takes place within dedicated simulation facilities on site (47%). Most respondents report access to a range of SBE equipment. The main reported barriers to SBE were: finance, lack of trained educators, lack of equipment and lack of protected time. A limited number of respondents report engaging in SBE research. There is a willingness in both anaesthesia and non-anaesthesia groups (96% and 89% respectively) to collaborate with other centres. Conclusion: To the best of our knowledge this publication provides us with the first cross-sectional survey of SBE in anaesthesia and a selection of non-anaesthetic respondents within South Africa. The majority of respondents indicate that SBE is a valuable education tool. A number of barriers have been identified that limit the growth of SBE within South Africa. It is hoped that with a commitment to ongoing SBE research and evaluation, SBE can be grown in South Africa.

The PIER framework for healthcare simulation integration in undergraduate physiotherapy education

“…The Healthcare Simulation Dictionary provides two descriptions of a facilitator, namely, an individual participating in any part of simulation implementation and/or delivery, or an individual directly facilitating the achievement of a desired outcome in an SBLE [ 32 ]. Due to the various roles fulfilled by educators in the simulated environment [ 33 , 34 ], careful consideration was given to labelling the element of competent facilitator. Opting for the term, facilitator, implies that the educator is not necessarily required to participate in all framework phases.…”

“…Opting for the term, facilitator, implies that the educator is not necessarily required to participate in all framework phases. Notably in educational environments where there is a shortage of healthcare educators [ 6 ], especially educators trained in the use of simulation as educational methodology [ 33 ], and limited institutional financial resources [ 6 , 28 ], makes identification of facilitative roles when integrating the framework essential. The authors suggest that appropriate educators be identified for the various facilitative roles required by the framework.…”

“…The role of briefing differs from the previously described student-centred preparation, in that it specifically relates to individual SBLE orientation and role clarification. Diverse student populations might not be accustomed to the simulated learning environment and may require focused psychological preparation and attention to their role during the SBLE, if they are to participate in the learning experience optimally [ 33 ].…”

How to plan for simulation integration into undergraduate physiotherapy training

“…Maintaining a safe learning environment could explain why stability was only achieved in the Delphi survey on statements relating to the student-to-educator ratio during formative and summative assessments, as SBLEs are not routinely used during either immersive or practical skills-based assessments in SA healthcare education. [27] The use of SBLEs for summative assessments therefore requires further investigation. If, however, SBLEs were to be considered for use, especially in summative assessments, identification of valid and reliable assessment tools during the planning phase is essential, [25] which was confirmed by the panel members.…”

The operational approach to and challenges of high-technology clinical simulation in South Africa

“…[4] Research has been published on the application of high-technology clinical simulation as a training tool for specific clinical scenarios in South Africa (SA). [7][8][9][10] However, little has been reported on the operational approach taken and challenges faced when creating and running a high-technology clinical simulation facility in SA. Swart et al [7] stated that financial constraints to obtain simulators and a lack of dedicated simulation technicians, trained educators and time for simulation activities are the major barriers to simulation implementation.…”