Leaders' experiences of embedding a simulation-based education programme in a teaching hospital: an interview study informed by normalisation process theory.

Autor: Szabo RA; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, 3052, Australia. rebecca.szabo@unimelb.edu.au.; Department of Obstetrics and Gynaecology, Melbourne Medical School, The University of Melbourne, Melbourne, Australia. rebecca.szabo@unimelb.edu.au.; Department of Medical Education, Melbourne Medical School, The University of Melbourne, Melbourne, Australia. rebecca.szabo@unimelb.edu.au.; Gandel Simulation Service, The Royal Women's Hospital, Parkville, VIC, Australia. rebecca.szabo@unimelb.edu.au., Molloy E; Department of Medical Education, Melbourne Medical School, The University of Melbourne, Melbourne, Australia.; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia., Allen KJ; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, 3052, Australia.; Gandel Simulation Service, The Royal Women's Hospital, Parkville, VIC, Australia., Francis J; School of Health Sciences, The University of Melbourne, Parkville, VIC, Australia.; Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, VIC, 3000, Australia.; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, 3010, Australia.; Centre for Implementation Research, Ottawa Hospital Research Institute - General Campus, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada., Story D; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, 3052, Australia.
Jazyk: angličtina
Zdroj: Advances in simulation (London, England) [Adv Simul (Lond)] 2024 May 20; Vol. 9 (1), pp. 21. Date of Electronic Publication: 2024 May 20.
DOI: 10.1186/s41077-024-00294-3
Abstrakt: There is limited research on the experiences of people in working to embed, integrate and sustain simulation programmes. This interview-based study explored leaders' experiences of normalising a simulation-based education programme in a teaching hospital. Fourteen known simulation leaders across Australia and North America were interviewed. Semi-structured interviews were analysed using reflexive thematic analysis sensitised by normalisation process theory, an implementation science theory which defines 'normal' as something being embedded, integrated and sustained. We used a combined social and experiential constructivist approach. Four themes were generated from the data: (1) Leadership, (2) business startup mindset, (3) poor understanding of simulation undermines normalisation and (4) tension of competing objectives. These themes were interlinked and represented how leaders experienced the process of normalising simulation. There was a focus on the relationships that influence decision-making of simulation leaders and organisational buy-in, such that what started as a discrete programme becomes part of normal hospital operations. The discourse of 'survival' was strong, and this indicated that simulation being normal or embedded and sustained was still more a goal than a reality. The concept of being like a 'business startup' was regarded as significant as was the feature of leadership and how simulation leaders influenced organisational change. Participants spoke of trying to normalise simulation for patient safety, but there was also a strong sense that they needed to be agile and innovative and that this status is implied when simulation is not yet 'normal'. Leadership, change management and entrepreneurship in addition to implementation science may all contribute towards understanding how to embed, integrate and sustain simulation in teaching hospitals without losing responsiveness. Further research on how all stakeholders view simulation as a normal part of a teaching hospital is warranted, including simulation participants, quality and safety teams and hospital executives. This study has highlighted that a shared understanding of the purpose and breadth of simulation is a prerequisite for embedding and sustaining simulation. An approach of marketing simulation beyond simulation-based education as a patient safety and systems improvement mindset, not just a technique nor technology, may assist towards simulation being sustainably embedded within teaching hospitals.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: