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Accreditation of Simulation Fellowships and Training Programs: More Checkboxes or Elevating the Field?
Rami A Ahmed1, Ambrose H Wong, Andrew N Musits
1From the Division of Simulation (R.A.A.), Indiana University School of Medicine, Indianapolis, IN; Yale Center for Medical Simulation (A.H.W.), New Haven, CT; Lifespan Medical Simulation Center (A.N.M.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Emergency Medicine (A.C.), Maimonides Medical Center, New York City; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (M.C.), Northwell EMSL Simulation Fellowship, Northwell Health Patient Safety Institute, Hempstead, NY; VHA SimLEARN (N.L.W.), Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA; Michigan State University Learning and Assessment Center (M.K.S.), East Lansing, MI; Department of Obstetrics and Gynecology (K.B.), Albert Einstein College of Medicine, Jacobi Medical Center, NYC H+H Simulation Center; Department of Emergency Medicine (M.M.), Harlem Hospital Center, Health +Hospitals, Columbia University, New York City, NY; and Institute for Medical Simulation (D.S.), Center for Medical Simulation, Harvard Medical School, Boston, MA.
Summary Statement:
As the field of healthcare simulation matures, formal accreditation for simulation fellowships and training programs has become increasingly available and touted as a solution to standardize the education of those specializing in healthcare simulation. Some simulation experts hold opposing views regarding the potential value of simulation fellowship program accreditation. We report on the proceedings of a spirited debate at the 20th International Meeting on Simulation in Healthcare in January 2020. Pro arguments view accreditation as the logical evolution of a maturing profession: improving training quality through standard setting, providing external validation for individual programs, and enhancing the program's return on investment. Con arguments view accreditation as an incompletely formulated construct; burdensome to the "financially strapped" fellowship director, misaligned with simulation fellows' needs and expectations, and confusing to administrators mistakenly equating accreditation with credentialing. In addition, opponents of accreditation postulate that incorporating curricular standards, practice guidelines, and strategies derived and implemented without rigor, supporting evidence and universal consensus is premature. This narrative review of our debate compares and contrasts contemporary perspectives on simulation fellowship program accreditation, concluding with formal recommendations for learners, administrators, sponsors, and accrediting bodies.
