Article Text

0020 The development of a new ‘integrated simulation-based education framework’
  1. Suzanne Gough
  1. Manchester Metropolitan University, Manchester, UK


Background A literature review failed to identify a framework to facilitate the instructional design of SBE in physiotherapy. Instructional design models,1 technology enhanced learning2 and nursing simulation3 frameworks have previously been used to guide the development of some healthcare SBE initiatives.1–4

Methodology A sequential, two phased explanatory mixed methods was study selected to provide a comprehensive examination of the use of simulated learning in cardio-respiratory physiotherapy in the UK. Phase 1 consisted of two national surveys during 2009–10. Phase 2 featured the use of video-reflexive ethnography (VRE)to explore performance, behaviours and personal experiences of final year (pre-registration) physiotherapy students. A new conceptual ‘integrated simulated learning framework’, was developed from phase 2 methodological design, VRE analysis and educational and SBE pedagogy.

Results The new framework consists of 3 distinct but interlinking, essential components to be considered when designing, developing and evaluating SBE including: ‘preparation’, ‘intervention’ and ‘evaluation/research’. The ‘preparation’ component includes three constituent elements: learner, facilitator and educational practices. Intervention: The ‘intervention’ component features three separate elements: the ‘simulation design characteristics’, ‘pre-brief and debrief’ and ‘linked learning activities’. ‘Evaluation/research’: It is essential that an evaluation of the simulated learning intervention is undertaken to evaluate effectiveness/assess learning outcomes.1,2,3 Evaluation should be undertaken to explore the impact of learning from SBE through to practice. Following evaluation, information may then be analysed, and actioned accordingly within curriculum/programme/course review.

Conclusion This framework presents 3 major interlinking components for consideration when designing SBE, whether this be for a short course or embedded within healthcare curricular. One of the key additions of the proposed framework was to illustrate that evaluation and research cyclically drive changes in SBE. The new framework is proposed to support the instructional design of SBE in healthcare. Further testing of this framework is required in physiotherapy and other healthcare disciplines.


  1. Chiniara G, Cole G, Brisbin K, Huffman D, Cragg B, Lamacchi M, Norman D. and Canadian Network for Simulation in Healthcare Guidelines Working Group. Simulation in healthcare: a taxonomy and a conceptual framework for institutional design and media selection. Med Teach. 2013:35:1380–1395

  2. Department of Health. A framework for technology enhanced learning. London: Department of Health, Crown Copyright, 2011

  3. Jeffries PR. A framework for designing, implementing, and evaluating simulations. Nurs Educ Perspect. 2005:26:97–104

  4. Ravert P, McAfooes J. NLN/Jeffries simulation framework: State of the science summary. Clin Simulation Nurs. 2014;8:410–411

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