The NHS in the simulator

McShane, Martin; Smith, Richard

doi:10.1136/bmj.b4868

Cited by 8 publications

(4 citation statements)

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“…The Windmill simulation of 2009 explored the consequences of drastic funding cuts in the UK National Health Service. 25 Although there was no formal evaluation describing its educational benefits, a commentary in the British Medical Journal described the simulation as ‘stunningly real to those involved.’ 26 The experience of taking part in similar simulations seems to have influenced the future behaviour of participants. 27 There is now an increasing demand from health care staff to use policy simulation to provide an evidence-based approach to issues such as health care rationing and formulation of future policy.…”

Section: Behavioural Simulationmentioning

confidence: 99%

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Behavioural simulations in health care policy: Current uses and future developments

Cohen

Darzi

Vlaev

2013

J Health Serv Res Policy

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The process and consequences of change to a health care system can have unintended, detrimental effects. Various types of simulations have been developed in order to try to predict the effects of change in a health care system. Such methods are in widespread use in industrial, military and higher educational institutions. This review essay focuses on participatory behavioural simulations, in which multiple participants are placed into a realistic, interactive simulation environment and asked to respond to a given set of circumstances, such as a change in policy. The processes and outcomes are driven by the actions and interactions of the participants and not by chance, allowing participants to see the consequences of their actions in a safe environment. The use of simulation in health care policy is presented, together with the evidence for its contribution to policy prediction, education and behaviour change among those designing and implementing health care policies. A method based on best evidence for design, implementation and evaluation of future simulations and participants is proposed.

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Section: Behavioural Simulationmentioning

confidence: 99%

“…29 Similarly, some of the processes and outcomes of the Windmill 2009 simulation predicted events later that year. 26…”

Section: Behavioural Simulationmentioning

confidence: 99%

Behavioural simulations in health care policy: Current uses and future developments

Cohen

Darzi

Vlaev

2013

J Health Serv Res Policy

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“…While both SL and GDM are strongly linked with organisational performance and success, 10 developing these skills in healthcare management teams in practice is largely descriptive and anecdotal. [11][12][13] In the NHS, the 'Windmill' series 14 and the "Lateral Play" 15 were the first to explore SL and GDM in the context of healthcare reforms considering various stakeholders. As part of their simulation design, experts were consulted to identify the main drivers and tensions to be explored in the simulation event, and to provide feedback and performance debriefings to facilitate the learning experience.…”

Section: Introductionmentioning

confidence: 99%

Shared leadership in tertiary care: design of a simulation for patient safety decision-making in healthcare management teams

et al. 2020

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IntroductionSimulation-based training (SBT) on shared leadership (SL) and group decision-making (GDM) can contribute to the safe and efficient functioning of a healthcare system, yet it is rarely incorporated into healthcare management training. The aim of this study was design, develop and validate a robust and evidence-based SBT to explore and train SL and GDM.MethodUsing a two-stage iterative simulation design approach, 103 clinical and non-clinical managerial students and healthcare professionals took part in an SBT that contained real-world problems and opportunities to improve patient safety set within a fictional context. Self-report data were gathered, and a focus group was conducted to address the simulation’s degree of realism, content, relevance, as well as areas for improvement.ResultsParticipants experienced the simulation scenario, the material and the role assignment as realistic and representative of real-world tasks and decision contexts, and as a good opportunity to identify and enact relevant tasks, behaviours and knowledge related to SL and GDM. Areas for improvement were highlighted with regard to involving an actor who challenges SL and GDM; more preparatory time to allow for an enhanced familiarisation of the content; and, video debriefs to reflect on relevant behaviours and team processes.ConclusionsOur simulation was perceived as an effective method to develop SL and GDM within the context of patient safety and healthcare management. Future studies could extend this scenario method to other areas of healthcare service and delivery, and to different sectors that require diverse groups to make complex decisions.

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“…' Theodore Roethke Reading McShane and Smith's BMJ article 1 on a simulated exercise on how to cut expenditure, what becomes clear is how successive reorganisations of the NHS in England have created a creature of great complexity. The Department of Health, strategic health authorities, acute trusts, medical schools, primary care trusts, community health organisations, private companies, social care, commissioning and monitoring organisations, National Institute for Health and Clinical Excellence, and the Care Quality Commission are probably the main players.…”

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confidence: 99%

Quis custodes ipsos custodiet?

Hedger¹

2010

Br J Gen Pract

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The NHS in the simulator

Abstract: NHS funding is set to fall in real terms but it is unclear how the system will cope. Martin McShane and Richard Smith describe their experience of a simulation exercise designed to find out

Cited by 8 publications

References 0 publications

Behavioural simulations in health care policy: Current uses and future developments

Behavioural simulations in health care policy: Current uses and future developments

Shared leadership in tertiary care: design of a simulation for patient safety decision-making in healthcare management teams

Quis custodes ipsos custodiet?

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