Developing an all-wales definition of simulation-based education
Authors: Hawker Clare , Jones Bridie , Cooke Sara- Catrin , Mitra Suman , Hoole Alice , Bartholomew Bethan , Diaz-Navarro Cristina 
Published: November 2022

Health Education and Improvement Wales’s (HEIW) simulation team is in the process of developing a Simulation-Based Education (SBE) strategy for Wales which will include a definition of SBE. The simulation team originally agreed a working definition of SBE for Wales when the team was formed. However, numerous definitions of simulation or SBE exist in the literature. A shared understanding of SBE is required to optimise its use as an educational strategy [1]. We aimed to reach consensus upon an All-Wales definition of SBE.
Ethical approval for the study was granted by Cardiff University. A participant information sheet was provided and informed consent obtained from all participants. A modified Delphi technique was used [2], comprising three rounds of online surveys. Definitions and characteristics of simulation described in the existing literature formed the basis of the first survey round [3]. Any statements not reaching consensus and any new statements offered by participants during round one were included in the second survey round. In the final round, participants were asked to rank all statements which reached consensus in rounds one and two in order of priority from 1- the most important to 10- the least important. Responses were inversely scored and collated. Three members of the research team reviewed and validated the consensus statements at the end of each round.
A total of 27 participants from a range of professional backgrounds (nurses, doctors, allied health professionals, and simulation technicians) agreed to be part of the expert panel, of whom 26 (96%) completed the round one survey, 26/26 (100%) returned the round two survey, and 22/26 (81%) responded to the round three survey. Participants reached consensus with high levels of agreement (where the median was less than or equal to 2 with a small IQR; less than or equal to 1.5) upon 39 statements organised under five sections. The highest ranked statement from each section were included in the final definition and the agreed upon definition is shown in
Final definition agreed following the modified Delphi technique for the term ‘Simulation-based education’
This appears to be the first study to have used a Delphi technique to agree an interprofessional definition of SBE at a national level. Future planned work would be to share the developed definition more widely with key stakeholders from across the four nations of the UK. There is scope for this to lead to further work on reaching UK-wide consensus or internationally.
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2. Keeney S, Hasson F, McKenna H. Consulting the oracle: ten lessons from using the Delphi technique in nursing research. Journal of advanced nursing. 2006;53(2):205–212.
3. Hsu CC, Sandford BA. Minimizing non-response in the Delphi process: How to respond to non-response. Practical Assessment, Research, and Evaluation. 2007;12(17):1–6.