Defining Priority Areas for Critical Care Simulation: A Modified Delphi Consensus Project

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Emergency Medicine


Background Simulation is used in critical care for skill development, formative assessment, and interprofessional team performance. Healthcare educators need to balance the relatively high cost to deliver simulation education with the potential impact on healthcare quality. It is unclear how to prioritize simulation in critical care education, especially considering interprofessional needs across adult and pediatric populations. The objective of this study was to prioritize topics for critical care educators developing simulation-based educational interventions. Methodology A modified Delphi process was used to identify and prioritize critical care topics taught using simulation. We disseminated a multi-institutional survey to understand critical care simulation topics using a three-round modified Delphi technique. An expert panel was recruited based on their expertise with simulation-based education through the Society for Simulation in Healthcare and the Society of Critical Care Medicine lists. Critical care topics originated using content derived from multiple critical care board examination contents. Additional content for a critical care simulation-based curriculum was generated. Results Consensus and prioritization were achieved in three rounds, with 52 simulation experts participating. The first Delphi round surveyed priority topics in critical care content and generated additional topics for inclusion in round two. The second Delphi round added the content with the highest-ranked items from round one to generate a set of simulation-based topic priorities. The third Delphi round asked participants to determine the importance of each priority item taught via simulation compared to other modalities for clinical education. This round yielded 106 topics over four domains categorized into (1) Diagnosis and Management of Clinical Problems, (2) Procedural Skills, (3) Teamwork and Communication Skills, and (4) General Knowledge and Knowledge of Technical Adjuncts. Conclusions The modified Delphi survey revealed a prioritized, consensus-based list of topics and domains for critical care educators to focus on when creating a simulation-based critical care curriculum. Future work will focus on developing specific simulation-based critical care curricula.