8 Secrets to Helping Your Organization Embrace Simulation

Educating your organization is as important as educating your learners.

Throughout the history of medicine, clinical learning has been based on imitating the actions of others. Medical students are expected to learn complex medical tasks by watching other clinicians perform that task. This is known as the “see one, do one” approach, or the apprenticeship model.

Certainly, the “see one, do one” approach to learning will continue to have its place. In many cases, however, experts within healthcare see simulation as an alternative, or at least a stepping-stone, between classroom learning and clinical practice. This means change.

Here are eight secrets to driving the change necessary to integrate simulation in your organization:

1. Recognize the challenge of change

The truth is that healthcare can be slow to embrace change of any kind. In the Harvard Business Review, Mike Wagner suggests that healthcare leaders who want to effectively implement changes such as medical simulation will need to motivate their teams to do the following:¹

• Welcome change
• Be willing to experiment and innovate
• Make challenging decisions — without relying on leadership approval

This may require a significant cultural shift for many institutions. But such a shift can be a critical step when managing the substantial change simulation-based learning represents.

2. Be prepared to truly lead

Navigating change requires a team-wide effort. Studies consistently show between 50 and 70% of planned change efforts fail. Why? Because change doesn’t happen on its own. Change requires a champion who is prepared to not only initiate the process, but to see it through to completion and act as a relentless advocate along the way.

Max DePree, author of Leadership is an Art, identified the three roles every successful leader must play. “The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.” Look at any successful simulation program, and you’ll find a champion who embraced DePree’s leadership mindset.

3. Pinpoint a specific, solvable problem

A number of experts advise leaders to focus on tangible problem-solving opportunities when introducing a change like medical simulation. As a result, rather than trying institution-wide change, some recommend choosing and then addressing one situation at a time.²

Seattle Children’s Hospital’s Neonatal Outreach Coordinator Jeanette Zaichkin, NNP-BC, agrees. She says that simulation learning should have a low-key introduction. “Do some demos,” she suggests. “Get their feet wet and ... start slowly. Have them experience some success. But then they also need to know that the point of simulation is to push people past their limits so that they learn something new.” 

4. Keep your solution simple and practical

“Begin with the end in mind,” as Stephen Covey would say. Start by writing a clear, focused statement of objectives that aligns to the specific problem you’ve identified (See The 7 Habits of Highly Effective Sim Experts).

Once you’ve determined your objectives, benchmark all decisions against them to make informed decisions. For example, it’s easy to get caught up in the “bells and whistles” of simulation, especially when it comes to fidelity — the degree of realism offered. But higher fidelity alone doesn’t necessarily equate to improved outcomes. Simplicity and practicality are the best ways to approach the introduction of simulation to your organization.

5. Harness the experience of your simulation peers

How do healthcare leaders begin implementing medical simulation? Many, such as Dr. Thomas Talbot of the University of Southern California, say it’s vital to first understand the simulation process. “It doesn’t start with a floor plan and a list of equipment to buy,” he says. “You should start learning how sim centers work. Go to successful centers. Go to a sim center training program.”

Dr. Amar Patel of WakeMed Health & Hospitals believes advance preparation is essential. “Go to conferences,” he says. “Reach out to experts across the country, ask the vendors for support. Learn. Take as much information as you can get your hands on and just digest it and understand it. There are so many programs doing ... amazing things out there.”

6. Develop strong internal relationships

While in-depth preparation is obviously vital, even well prepared healthcare leaders find that implementing this kind of significant change requires relationship building. According to Dr. Charles Pozner, medical director for the Neil & Elise Wallace STRATUS Center for Medical Simulation at Brigham and Women’s Hospital, leaders need to ensure strong interpersonal relationships with the people who will implement the new simulation model. After all, the staff can make or break the effort.

In short, leaders may have to nurture their connections to their teams to make the most of simulation learning.

7. Focus first on short-term gains

Implementing change of this magnitude takes time — celebrating milestones along the way prevents loss of momentum and helps keep the organization engaged in the process.

To ensure long-term success, leaders must remember the original reason for doing a simulation learning program. That is, putting the learning to work in a way that improves performance. In other words, remember that the entire point is to improve patient care and maintain improvements over time.

8. Make change stick

You’ve achieved the objectives you laid out for your organization. Short-term gains have been realized and your simulation program is firmly established. Is your work as an agent of change complete?

When everyone has embraced simulation as a tool, it’s easy to think so. But the true test is ensuring behavioral change at the patient’s bedside. Until you see behavior patterns shifting and knowledge being transferred to on-the-job actions, lasting change has not yet occurred.

Learning transfer means choosing to do it a new (and often harder and less familiar) way. Which path the employee chooses depends on many factors in their environment as well as on the training itself — and you’ve successfully achieved lasting change. ³

Summary

Simulation has become an integral part of healthcare education at all levels to achieve positive patient outcomes — and that means change is inevitable. Dr. Patel of WakeMed sums it up: “At the end of the day, we’re here to help learners be more competent and confident in their skills. And we’re here to keep our patients safe.”