Best Practices for Simulation Training in Healthcare Settings

Simulation-based training can be extremely effective for EMS personnel, but only if the training is done by knowledgeable faculty, using educational scenarios that reflect and are relevant to real-life EMS situations.

Unfortunately many simulation-based training courses fall short of what they could be delivering. That’s the takeaway from the National Association of EMS Educators (NAEMSE) from the SUPER study and its subsequent vision paper. 

“Specifically with regard to paramedic education, NAEMSE’s research found that while programs often had or had access to simulation equipment, almost one third of them were either not using it at all or not using it as intended,” says Kim McKenna, MEd, RN, EMT-P, lead author of the SUPER study and chair of NAEMSE’s task force on simulation. “The respondents noted that faculty training, inadequate personnel and lack of time contributed to this lack of use.”

The good news: The NAEMSE’s vision paper offers many useful suggestions for maximizing the value of EMS simulation training in healthcare settings. With the help of McKenna and NAEMSE President John Todaro, EMS World has compiled them into a trio of simulation training best practices:

#1: Improve faculty/trainer training—Medical simulation equipment is expensive. So when an EMS educational facility buys such equipment, the people in charge should enlist the manufacturer to provide expert help in training faculty and integrating the simulation equipment into the facility’s curriculum. 

“EMS educators spend a lot of money buying simulation equipment, but they don’t have a lot of experience working with this equipment,” says Todaro. “The manufacturers need to fill this gap by comprehensively training faculty in how this simulation equipment works, how it can be incorporated into the curriculum and how the results from such training can be evaluated afterward.”

Someone has to step up: According to the SUPER study, 48% of respondents felt their current level of EMS faculty simulation training was inadequate. The problem is not the level of training provided by manufacturers, but rather the fact that “it should only be the starting point, with EMS educational facilities getting support from a number of sources,” says McKenna.

#2: Make simulations part of core curriculum, not just add-ons—Lacking adequate training in how to work with EMS simulators, many educators tend to use them as adjuncts to core EMS training, rather than integrating their hands-on capabilities into all elements of the curriculum. Fortunately this shortfall can be addressed by faculty consciously seeking ways to use simulators as much as possible during training.

A case in point: “Move away from just having students ‘say’ they are doing something to actually having them ‘do’ things,” says McKenna. “As an example, actually have them draw up the dose of epinephrine in a pediatric anaphylaxis case rather than just saying how much of the drug they would administer. You will find that a substantial number of learners who can tell you the right dose struggle to actually administer it properly. The simulation allows you (and your students) to learn those important lessons and make mistakes in a safe environment rather than struggling or failing on a real call, with a real patient.”

#3: Use simulators in realistic settings—EMS simulation training is more effective when done in settings that mimic real-life scenarios, such as outdoors with a wrecked car and associated debris for a simulated roadside incident. 

“The loftiest goal of simulation is to provide highly realistic experiences in which students can safely apply knowledge and practice skills without endangering a live patient,” says the vision paper. Unfortunately, “Unpublished data from the SUPER study showed that most paramedic program simulation is conducted in the program skills lab, classroom or simulation lab, rather than in realistic field settings such as an ambulance or in situ outdoors or indoors.” To improve the outcomes of EMS simulation training, this needs to change.

The Bottom Line

“Simulators can do a lot to enhance EMS education, but only if faculty know how to use this equipment and are comfortable in doing so, and educators make a serious effort to incorporate this hands-on teaching into the curriculum,” says Todaro. “Beyond the suggestions above, the NAEMSE vision paper has a lot of good ideas for making this happen.”

James Careless is a freelance writer with extensive experience covering computer technologies.