How to Map Clinical Simulation Into the Curriculum in Competency-Based Education

Purposeful integration of clinical simulation in nursing education programs is essential to provide quality experiential learning opportunities for students. To achieve integration, mapping the simulations throughout the curriculum is required to identify competency acquisition and gaps. With the transition to competency-based education, nursing programs are required to demonstrate where and how the competencies are obtained. Clinical simulation is an answer for demonstrating and measuring competencies. This HealthySimulation.com article by Teresa Gore, PhD, DNP, APRN, FNP-BC, CHSE-A, FSSH, FAAN, will provide an overview of a systematic approach to clinical simulation mapping across the curriculum.

Healthcare Simulation Standards of Best Practice – INACSL

The International Nursing Association for Clinical Simulation and Learning (INACSL) has developed the Healthcare Simulation Standards of Best Practice to advance the science of simulation, share best practices, and provide evidence-based guidelines for implementation and training. The first set of Standards was published in 2011 and continues to evolve over time as more evidence is published regarding best practices in clinical simulation. Developing a set of best practices can help any healthcare simulation flourish, as these guidelines help promote successful learning and training outcomes. These Standards provide a detailed process for evaluating and improving simulation operating procedures and delivery methods that every simulation team will benefit from. Adoption of the “INACSL Standards of Best Practice: Simulation” demonstrates a commitment to quality and implementation of rigorous evidence-based practices in healthcare education to improve patient care by complying with practice standards.

Healthcare Simulation Standards of Best Practice Simulation Design Standard

Simulation-based experiences are purposefully designed to meet identified objectives and optimize the achievement of expected outcomes. All simulation-based experiences require purposeful, systematic, flexible, and cyclical planning. To achieve expected outcomes, their design and development should consider criteria that facilitate their effectiveness. Following this standard supports the development of relevant, educationally sound simulation-based experiences.

Criteria Necessary to Meet this Standard

1. Simulation-based experiences (SBE) should be designed in consultation with content experts and simulationists knowledgeable in best practices in simulation education, pedagogy, and practice.
2. Perform a needs assessment to provide the foundational evidence of the need for a well-designed simulation-based experience.
3. Construct measurable objectives that build upon the learner’s foundational knowledge.
4. Build the simulation-based experience to align the modality with the objectives.
5. Design a scenario, case, or activity to provide the context for the simulation-based experience.
6. Use various types of fidelity to create the required perception of realism.
7. Plan a learner-centered facilitative approach driven by the objectives, learners’ knowledge and level of experience, and the expected outcomes.
8. Create a prebriefing plan that includes preparation materials and briefing to guide participant success in the simulation-based experience.
9. Create a debriefing or feedback session and/or a guided reflection exercise to follow the simulation-based experience.
10. Develop a plan for evaluation of the learner and of the simulation-based experience.
11. Pilot test simulation-based experiences before full implementation.

Healthcare Simulation Standards of Best Practice Outcomes and Objectives

Establish learner outcomes influenced by accreditation, program, curriculum and/or patient care needs that are measurable and appropriately scaffolded to learner knowledge, skills, and attitudes. Following this standard supports the development of relevant/ educationally sound simulation-based experiences using SMART Objectives and simulations that are appropriately leveled for the experience of the learners..

Criteria Necessary to Meet this Standard

1. Create objectives for the simulation-based experience to meet defined outcome based on formative or summative evaluation.
2. Identify appropriate simulation modality to meet the learning objectives/outcomes.
3. Identify appropriate fidelity to meet the learning objectives/outcomes.
4. Establish guidelines for facilitation of SBE to meet objectives.

View the LEARN CE/CME Platform Webinar How to Implement INACSL’s Healthcare Simulation Standards of Best Practice Into Your Program to learn more!

‌Steps for Curriculum Mapping Simulations

Mapping curriculum is a method of measuring the program against national accreditation standards. Some nursing programs do not have a specific faculty member responsible for the entire simulation program. These programs assign the course faculty and/or year of education level faculty. Curriculum mapping of the program’s simulations is one way to conduct a needs assessment. The AACN Essentials have numerous competencies that undergraduate and graduate nursing students should obtain prior to graduation.

When mapping, the faculty can review and edit the objectives to ensure SMART objectives are used. Bloom’s Taxonomy provides the terminology to make the objectives Specific, Measurable, Achievable, Realistic, and Time-Phased. The steps for curriculum mapping and develop include: 1) perform a needs assessment, 2) define the goals and learning objectives, 3) identify resources, 4) develop educational strategies and implement the curriculum, and 5) evaluate and modify the curriculum.

1. Determine how to document the mapping
   1. Software Program
   2. Spreadsheets
   3. Word or Google Documents
2. Identify which simulations occur each semester
3. List the overall objectives of each simulation (Outcomes & Objectives Standard)
4. List the scenario-specific objective for each simulation (Outcomes & Objectives Standard)
5. Conduct a needs assessment (Simulation Design Standard)
6. Construct the goals and objectives that can be met with a simulation (Simulation Design Standard, Outcomes & Objectives Standard)
7. Identify the resources needed for each simulation and what is currently available (Operations Standard)
8. Determine the modality required for each simulation to achieve the best outcomes and meet the objectives (Simulation Design Standard, Outcomes & Objectives Standard)
9. Identify the method of evaluating all aspects of the simulation: Learner, Facilitator, and Simulation

Ongoing Quality Improvement Process

The final step is to determine how to evaluate the curriculum and simulations on an ongoing basis. There are multiple processes available to educators using quality improvement science. Quality improvement is a continuous method to evaluate the effectiveness of the process and the changes needed. Some of these methodologies are:

• Plan-Do-Study-Act (PDSA)
• Six Sigma and Lean Six Sigma
• Define-Measure-Analyze-Improve-Control (DMAIC)
• Total Quality Management (TQM)
• Five Whys Analysis

View the LEARN CE/CME Platform Webinar How to Map Healthcare Simulation Objectives to Program Outcomes to learn more!

Gap Analysis

Once the data has been obtained and evaluated, a gap analysis is conducted to determine the areas of meeting the accreditation standards and the areas for improvement. The Healthcare Simulation Standards of Best Practice should be used in the development of clinical simulations to meet the identified gaps and meet identified learning competencies for each learner.

The International Nursing Association for Clinical Simulation in Nursing

INACSL, aka the International Nursing Association for Clinical and Simulation Learning non-profit organization, is dedicated to advancing healthcare simulation science. With over 3,100 members worldwide, the organization’s mission is to be the global leader in the art and science of healthcare simulation through excellence in nursing education, practice, and research. INACSL’s goal is also to advance the science of nursing simulation by providing professional development, networking resources, and leadership in defining healthcare simulation standards of best practice. HealthySimulation.com is a proud media partner with INACSL.

Learn More About the Healthcare Simulation Standards of Best Practice for Clinical Simulation Programs!