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0037 Classifying simulation-based research using the description, justification and clarification framework
  1. Helen Church1,
  2. Alastair Graham2
  1. 1PhD Candidate in Medical Education, The University of Sheffield, Sheffield, UK
  2. 2Montagu Clinical Simulation Centre, Doncaster and Bassetlaw Hospitals NHS Foundation Trust, Doncaster, UK


Background In the first editorial of the BMJ Simulation and Technology Enhanced Learning journal (BMJ STEL) Sevdalis1 stressed the need to progress from basic evaluation studies to those that seek to understand when and how simulation-based interventions work. Simulation-based research needs to be grounded in conceptual frameworks that link individual studies in a meaningful way2 (and use educational theory in study design. Cook et al .3 called for medical education to make greater use of theory and conceptual frameworks in producing research that asks “How and why does it work?” They proposed a framework to classify the purpose of medical education research and applied it to studies published in leading educational journals. The three categories are:

Description – What was done? Single group with post-test evaluation.

Justification – Did it work? Control group with pre- and post- assessment.

Clarification – How and why did it work? Tests a conceptual framework.

Methodology Using this framework all abstracts published in the BMJ STEL supplement from the ASPiH Annual Conference 20144 were reviewed separately by the authors prior to a joint discussion where abstracts were assigned to one of the three categories.

Results 205 abstracts were reviewed and classified. Overall there were 118 (57.6%) description, 79 (38.5%) justification and 8 (3.9%) clarification studies.

Conclusions and recommendations Cook et al. (2008) reported 16% description, 72% justification and 12% clarification studies in education journals published in 2003/4. Using this framework to classify abstracts from future ASPiH conferences may encourage simulation-based research to undertake more clarification studies and make use of conceptual frameworks to ask the “How and Why?” questions that will keep the field of simulation-based research moving forward.


  1. Sevdalis N. (2014, November 5). Simulation and learning in healthcare: moving the field forward. Retrieved April 15, 2015, from BMJ Simulation and Technology Enhanced Learning:

  2. Issenberg SB, Ringsted C, Østergaard D, Dieckmann P. Setting a research agenda for simulation-based healthcare education. Simulat Healthcare. 2011:155–167

  3. Cook DA, Bordage G, Schmidt HG. Description, justification and clarification: a framework for classifying the purposes of research in medical education. Med Educ. 2008:128–133

  4. Association for Simulated Practice in Healthcare. Association for Simulated Practice in Healthcare Annual Conference 11–13 November 2014 Abstracts. BMJ STEL. 2014:A1–A88

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