Episode 89

The Real Investment in Simulations Isn’t the Equipment

Guest name: Francisco Castelblanco
Guest title: Chair, Continuing Professional Development & Area Health Education Center Director
Guest company: MAHEC, Asheville, NC
Host: Zahra Massicotte

Brief description of the episode

Better healthcare simulation starts with trained educators. Francisco Castelblanco, DNP, RN, Chair, Continuing Professional Development & Area Health Education Center Director of MAHEC joins Zahra to explain why educator capability should be the first investment a program makes, and how it shapes every decision that follows, from choosing the right modality to designing scenarios, leading debriefs, and measuring whether learning changes performance.

Key Takeaways:

- Start with the learning objective, the learner type, and what participants should be able to do afterward—not with the available equipment.
- Adapt the design to the learner level. Middle-school students, nursing students, residents, and practicing professionals require different objectives and experiences.
- Use the simplest modality that can build the competency. Procedural repetition such as suturing can be practiced with basic trainer boxes, fruit skins, or animal tissue.
- Combine modalities when the objective requires more complex thinking or interaction. VR can be used alongside people in the room and standardized patients who speak, respond, and can be physically examined.
- Involve curriculum and learning-design expertise so that each activity maps to measurable outcomes.
- Train the simulation educators before buying more hardware.
- Build their capability in selecting modalities, designing scenarios, operating equipment, facilitating the experience, and leading the debrief.
- Define the program’s goals before deciding which equipment to purchase. Expensive tools may go unused when they are not connected to a clear local need.
- Treat technology as a means of meeting an objective, not as evidence that a program is advanced.
- For distributed or rural programs, train a local facilitator who can continue delivering the experience after the visiting team leaves.
- Run scenarios under actual working conditions, including off-hours and without advance notice. The objective is to test how the system performs under realistic conditions.
- Observe more than clinical decisions. Look at where equipment is located, which roles respond, who is unavailable, and what happens when a key clinician is occupied elsewhere.
- Use the debrief to identify changes to equipment placement, staffing, responsibilities, and response processes.
- Repeat the scenario after changes are made to determine whether the response has improved.
- Make communication a primary or secondary objective within clinical simulations rather than separating it into a generic soft-skills exercise.
- Require participants to state what they are doing, what they need another team member to do, and how responsibilities will be divided.
- Design interprofessional scenarios around a shared workflow: review the patient, create a plan, decide who will ask which questions, complete part of the encounter, debrief as a team, and return to finish the interaction.
- Assess whether learners understand what each profession contributes and whether the team can coordinate around the patient—not simply whether each participant knows their individual role.
- MAHEC: https://mahec.net
- Simulation Center, MAHEC: https://mahec.net/cpd/simulation-center
- Further reading: Simulation-Based Learning Solutions for Higher Ed

The Real Investment in Simulations Isn’t the Equipment

Brief description of the episode

Key Takeaways:

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