The role of a sustainable integrated systems approach to high-technology clinical simulation in South Africa
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Date
2020-11
Authors
Van Wyk, Riaan
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Free State
Abstract
Simulation-based health education is used as a training and feedback method, and its modalities can broadly be divided into two, namely low-technology and hightechnology. Due to its higher complexity, high-technology simulation has some added challenges for implementation and day-to-day operations. The aim of the study was to illustrate the role of and determine how to achieve a sustainable integrated systems approach in supporting and enhancing hightechnology clinical simulation in South Africa in order to ensure long-term success. To achieve the aim of the study, a sequential approach was followed to pursue the objectives. • The objectives were: To conceptualise the various operational subsystems of high-technology clinical simulation and determine the best practices and challenges to high-technology clinical simulation and this was achieved with a literature review. • To establish the current operational approach to and challenges regarding hightechnology clinical simulation experienced by the simulation facilities of South African public, accredited health professions training institutions. • To reach consensus amongst simulation experts on best practices for a sustainable integrated systems approach to high-technology clinical simulation in South Africa. • To explain and illustrate the integration of the operational subsystems with each other and to set out recommendations and guidelines needed to achieve a sustainable integrated systems approach in supporting and enhancing hightechnology clinical simulation in South Africa. A quantitative descriptive study was performed. Data were collected using an online, web questionnaire (Education Survey Automation Suite (EvaSys)) with representatives of public, South African simulation facilities. Forty-two health professions training institutions, representing 12 health professions were identified and approached for the survey. The questionnaire was completed for 17 facilities, of which 14 utilised high-technology simulation. Challenges were identified through the quantitative data and comments in each subsystem across the facilities. The approaches followed by the facilities are in line with the recommended approach in the literature. The challenges faced by the facilities are typically the challenges described in the literature. An electronic Delphi survey was also conducted with simulation experts. The data from the questionnaire survey were used to inform the Delphi survey. The Delphi survey was conducted with eight simulation experts over three rounds. Four hundred and one statements emerged from the Delphi survey, and on 230 (57.4%) of these, consensus was reached. The results from the questionnaire survey and the Delphi survey were used to identify challenges and provide recommendations to address these challenges. Guidelines were drafted to illustrate how the recommendations could be achieved, and how multiple subsystems overlap and are integrated with each other. The conclusion was that high-technology simulation consists of various operational subsystems that integrate with each other to ensure long-term sustainability. These subsystems are management, funding, staff and staff development, curriculum integration, physical environment, and research. Utilising an integrated systems approach can lead to sustainable, high-technology simulation in South Africa.
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Keywords
Thesis (Ph.D. (Health Professions Education))--University of the Free State, 2020, Clinical simulation, High-technology simulation, High-fidelity, Integrated approach, Staff development, Curriculum integration, Simulation rooms, Physical environment, Health education, COVID-19, Clinical medicine -- Study and teaching -- Simulation methods