Advances in Simulation: From Research to Policy, How Much Evidence is Enough?

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In the second of our series with Advances in Simulation, we consider Ryan Brydges 2016 editorial – From simulation research to education policy: how much evidence is enough?  

In this article he considers the question – What level of evidence is required for translation of healthcare simulation research to policy? or institutional practice ? 

Ryan uses the specific example of recent changes to nursing training in the USA as a result of a large simulation study. The editorial considers issues of methodology and ‘tipping points’, and comes from the perspective of a researcher who has authored a number of large scale systematic reviews in healthcare simulation  

The study discussed is the NCSBN National Simulation Study: a longitudinal, randomized, controlled study replacing clinical hours with simulation in prelicensure nursing education. By Hayden JK, Smiley RA, Alexander M, Kardong-Edgren S, Jeffries PR in the Journal of Nursing Regulation. 2014;5(2):S3–S40. 

In a short period of time this study has led to large scale changes in nursing education whereby up to 50 % of clinical hours inryan brydges undergraduate nursing training can be replaced by simulation. Note this has also brought with it some clarity in standards around simulation within those programs. 

Simulcast was fortunate to have Ryan as our guest author of the editorial, together with Suzan Kardong Edgren, one of the authors of the nursing simulation study, as well as Mary Fey fromm Center for Medical Simulation in Boston as a discussant. 

Ryan Brydges (@rbrydges) is a health professions educator from Toronto Canada, and Senior Editor at Advances. 

He’s the professor in technology enabled education at St Michaels’s hospital/ University of Toronto, and the research directors at the simulation centre there. He’s been involved in systematic reviews and meta-analysis on large landmark studies in sim and technology enabled learning – research gate profile 

Mary Fey is the Associate Director of the Simulation Educator Training program (IMS) within the Centre for Medical Simulation in Boston. She has a nursing and academic background, with a PhD University of Maryland in Baltimore.  

Suzan “Suzie” Kardong-Edgren is a professor and director of the RISE Center at the School of Nursing and Health Sciences at Robert Morris University.  

The podcast offers a deep dive into the impact of simulation research and the politics of policy and change. We discussed contemporary influences on education more broadly, such as the Carnegie Foundation, and other educational policy changes such as the Competency by Design initiative in Canadian medical training. 

However the winner on the day was the discussion itself – a wonderful example of how those with different perspectives – clinical, research, practice and education – can have robust and respectful conversations.  

Thanks to our guests and to Advances for another great collaborative effort.


One thought on “Advances in Simulation: From Research to Policy, How Much Evidence is Enough?

  • Debra Nestel

    Really enjoyed the Simulcast. 30 minutes really well spent. Highly recommend for anyone with even the tiniest interest in simulation as “replacement” for clinical placements in health professions education. Well done Ryan, Mary and Suzie for your frankness – and thanks Vic for making the conversation happen – love those interim summaries! The context for the Hayden et al study offered by Suzie was really helpful – how important the social and political environment is in influencing policy!!! Ryan’s offerings on research methods, on the rhetoric of competency, and, that the policy change must not spell the end of that particular research endeavour – fascinating. Thanks Mary for acknowledging different types of evidence. I’ll add the following reference from physiotherapy for a related study – Watson, K., Wright, A., Morris, N., McMeeken, J., Rivett, D., Blackstock, F., . . . Jull, G. (2012). Can simulation replace part of clinical time? Two parallel randomised controlled trials. Medical Education, 46(7), 657-667. doi:10.1111/j.1365-2923.2012.04295.x Perhaps someone from physio in Australia can share the policy impact (if any) of this work…

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