Developing, running, and evaluating a simulation of a guideline development meeting

We developed a simulation of a guideline development group (GDG) meeting to increase people's knowledge and familiarity with the guideline development process. In this paper, we describe how we developed, ran, and evaluated the simulation and offer guidance to others who wish to do the same.

We ran five simulations in Norway, hosted by one hospital, two universities, and one public health institute. Our development process included determining the simulation's aim and objectives; defining our target audience; developing simulation content, including selecting the guideline topic; preparing meeting materials; defining, preparing and allocating roles; determining the simulation length and structure; and evaluating and improving the simulation. We gathered data regarding participants' expectations and feedback about positive and negative aspects of the simulation and made note of our observations during simulations and used this information to inform cycles of improvement.

We defined our target audience as people involved in commissioning, preparing, using, or disseminating guidelines. We selected an existing World Health Organization recommendation as our guideline topic. We prepared the same meeting materials as for a real guideline meeting, using the GRADE Evidence-to-Decision (EtD) framework. We developed roles for GDG members, chair, methodologist, guideline commissioner, and observers. We gave participants GDG member roles. The simulation included an online preparatory meeting and a face-to-face meeting. Overall, participants were positive to the simulation, describing it as useful, interesting, educational, and enjoyable. Most participants were enthusiastic about the role-play element, although some were initially sceptical. Other issues we identified include the need for sufficient time to read and discuss the evidence before making a recommendation; the importance of well-prepared chairs, methodologists, and participants; and the usefulness of preparatory meetings. Participants found the time used for simulation was suitable. Some suggested providing more information in advance. However, most had not read the materials beforehand and wished they had prepared better.

Participants participating in a simulation of a guideline development process experienced this as useful and enjoyable. By offering practical guidance, we hope to support others developing similar simulations.