Leaders' experiences of embedding a simulation-based education programme in a teaching hospital: an interview study...

Area of Science:

• Implementation Science
• Healthcare Management
• Medical Education

Background:

• Limited research exists on embedding, integrating, and sustaining simulation programs in healthcare settings.
• Simulation-based education is increasingly recognized for its potential in improving patient safety and healthcare systems.

Purpose of the Study:

• To explore leaders' experiences in normalizing simulation-based education programs within teaching hospitals.
• To identify key factors and challenges influencing the embedding and sustainability of simulation programs.

Main Methods:

• Interview-based study with 14 simulation leaders in Australia and North America.
• Semi-structured interviews analyzed using reflexive thematic analysis, guided by Normalization Process Theory.
• A social and experiential constructivist approach was employed.

Main Results:

• Four key themes emerged: Leadership, business startup mindset, poor understanding of simulation, and tension of competing objectives.
• Leaders emphasized the importance of relationships, organizational buy-in, and a 'survival' discourse, indicating normalization is an ongoing goal.
• A 'business startup' approach and agile leadership were significant for driving organizational change and innovation.

Conclusions:

• Embedding simulation requires strong leadership, change management, and an entrepreneurial spirit, alongside implementation science principles.
• A shared understanding of simulation's purpose, beyond just education, is vital for its sustained integration.
• Marketing simulation as a patient safety and systems improvement mindset, not merely a technique, can facilitate its normalization in teaching hospitals.