Introduction

Simulation has been used by humans to assist with teaching and learning since the beginning of time. People learn from past experiences and refine lessons learned to improve their future. More recently, simulation-based training and education have been used extensively in several high-risk fields, such as aviation, the military, and health care.[1] Throughout the healthcare industry, simulation has served to improve patient outcomes by training learners to deal with problems, behaviors, and actions utilizing critical thinking, communication, and teamwork skills. The use of simulation requires thoughtful planning to provide relevant, valuable, realistic case scenarios that meet the learning objectives.  

A simulation technician is an individual who specializes in both the technologies and methods used in the planning, preparation, and execution of simulation-based healthcare training and education events. These individuals are essential members of every simulation team. Simulation technicians may also be called simulation operations specialists, simulation technology specialists, among other similar titles. Like the title, the roles and responsibilities of the simulation technician vary depending on the type of program they support - nursing, medical, allied health, in-situ - as well as the type simulation center they support. While there is variance, there are core roles and responsibilities that each simulation technician will hold. 

Function

A simulation technician has a core set of responsibilities. In a survey-based study, "equipment setup and breakdown, programming scenarios into software, operation of software during simulation, audiovisual support for courses, and on-site simulator maintenance" were the most common responsibilities reported as core to the simulation technicians who responded to the survey.[2]  

• Equipment setup and breakdown includes setting up patient simulators, task trainers, hospital equipment, supplies, and audiovisual equipment.[3]  
• Patient simulators come with proprietary software to control all of the anticipated physiological changes. Simulation technicians program these changes and anticipated interventions. They also operate this software during simulation activities.[3] 
• Operating the software can either be on-the-fly (without or with minimal programming) or using existing programmed scenarios.  
• Audiovisual support for courses can include the audiovisual equipment primarily used for live streaming and reviewing simulation activities, video production equipment, and other types of media for content delivery.  Many programs strongly suggest the use of recordings during debrief sessions or for individual self-review.
• Regardless of the type of simulator, all simulators need some level of on-site maintenance. Necessary maintenance could be as simple as the regular cleaning and replacement of disposable parts, or as complex as tracking down an electrical or networking issue (within warranty guidelines).

Outside of these core responsibilities, simulation technicians engage in many other responsibilities based on the type of center and programs supported by that center. Additional responsibilities include, but are not limited to:

• Inventory management and ordering of soft supplies and assets
• Technology (desktops, laptops, mobile devices) management, maintenance, and implementation within warranty guidelines
• Software (operating systems, applications, simulator software) management, maintenance, and implementation
• Administration and operation of learning/center management systems to record simulations, manage case information, collect faculty and standardized patient evaluations, track learner contact hours, and report on center data and utilization.
• Scheduling simulation activities and resources
• Utilizing and maintaining medical equipment such as IV pumps, ventilators, anesthesia machines, standard defibrillators, and automated external defibrillators (AEDs.)
• Preparing and applying moulage - simulated injuries, wounds, bruising - to standardized patients and simulators
• Development and maintenance of case scenarios, setup guidance, utilization tracking, and center management documentation
• Research, purchase, and implementation of new technologies, simulators, and task trainers
• Leading or assisting with technology and simulation best-practice training for faculty and staff, including safe simulation practices.[4]

Simulation in settings outside of academic or standalone simulation centers may have different responsibilities that are specific to each setting.

• In-situ simulation responsibilities may include:
  • supporting hospital quality improvement initiatives,
  • interfacing with department schedulers to ensure room/space availability,
  • utilizing portable audiovisual devices
  • stringent accounting of simulation supplies and equipment to prevent mixing accidental inclusion of simulated supplies, medication, or equipment from reaching real patients
  • recruitment of confederates or participants.[5][6]

Issues of Concern

When adding a simulation technician to a simulation-based healthcare education team, a primary concern is the financial impact. Many organizations find it challenging to get buy-in and financial support for this additional human resources expense. Smaller institutions often have nursing and other allied health faculty pulling double-duty, handling the additional responsibilities of a simulation technician. While this may not be the best practice, circumstances are such that this is not uncommon. Some analysis has already shown the benefits of adding simulation technicians to a workforce. However, additional research and analysis are needed to fully understand the impact of simulation technicians on not only the education team but also both learner and patient outcomes.

Curriculum Development

A simulation technician has a unique perspective, which adds value to the curriculum development process.  Scenario design for simulation is a complicated task.[7] Following a template like Teach SIM can help streamline this process; however, simulation-based healthcare education typically involves multiple pieces of technology and logistical considerations that may be lacking from such a template.[8] Simulation technicians can match learning objectives to the appropriate level of fidelity for the simulation event and to the type of task trainer or simulator that includes necessary features such as IV insertion or CPR performance feedback.[9] A simulation technician is an expert in the technology and operations needed to deliver quality simulation experiences; including them in the scenario development process ensures that scenarios are compatible with the available technology and to account for operational considerations early in the planning phase.

Clinical Significance

The addition of a simulation technician to a simulation-based healthcare education team positively impacts the team's ability to deliver quality simulations, and to evaluate those simulation activities accurately.  One study utilizing the principles of cognitive load theory found that instructors included technical challenges and global team function as feedback when a technician was not present during the simulation.  When a technician was present for the simulation, the feedback centered around "content-based, specific observations of learners."[10] A technician's presence allowed the instructors to focus on their areas of expertise - healthcare content and evaluation of learners.  The technician focused on their area of expertise - technology and its challenges.

The recommendation is that simulation-based healthcare education teams include an educator, a content expert, and a simulation technician.[11] Simulation technicians can apply best practices to increase the fidelity of simulation activities, match appropriate technology to the learning objectives, and enrich learner experiences with moulage.[12][13] The quality of simulation-based healthcare education directly impacts learner outcomes. A simulation technician brings valuable knowledge and expertise to the education team that can enhance the quality of this type of healthcare education.

Enhancing Healthcare Team Outcomes

Healthcare simulation is a marriage of healthcare and technology, both of which are continually updating, changing, and finding new pathways for innovation.  Bridging healthcare concepts with technology and simulation education best practices is the overarching role of a simulation technician. The middle ground is where quality simulation education experiences exist, allowing healthcare professionals training and experience to enhance their individual and team performance, thus improving patient safety and patient outcomes.