Tipping the Scales: Prioritizing Mentorship and Support in Simulation Faculty Development

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To the Editor:
We read with great interest the article by Peterson et al1 on simulation faculty development. We applaud the authors on creating a structured and comprehensive approach with an aim to ensure consistent standards for simulation-based instruction in healthcare at their institution. Although we admire this formal structure and agree with the authors' aim to reduce instruction variability, we are concerned that it may create a barrier to entry for interested facilitators. Specifically, based on our cumulative experiences in conducting faculty development in simulation, the “volunteered” time commitment and deadlines to complete the certification plan may prove to be too onerous for busy healthcare workers, as evidenced by the author's 19% participation at their institution. Although potentially more nuanced than a tiered approach, we strongly believe that mentorship, a customized education plan, and incentives are among the most important aspects of faculty development in simulation.
The authors acknowledge the importance of mentorship as the cornerstone for faculty development. An important aspect of serving as a mentor in healthcare is understanding a humanistic approach to learning; mentees often carry a large load (ie, clinical work, administrative responsibilities, family commitments) and are provided little support (ie, nonclinical time, administrative assistants, childcare). A mentor and faculty development program should tip the scales in favor of support to ensure high participation and sustainability; otherwise, our efforts will be less successful. We suggest a faculty development program that prioritizes a nurturing relationship between mentor and mentee and ability to customize a core curriculum without deadlines. We have found success with a more informal approach, where mentees can begin with observation and peripheral participation (eg, playing confederate roles in simulation scenarios) and then progress to leading simulations and debriefing. While this approach is more abstract, it allows the mentee to take on increasingly greater roles within the simulation curriculum while receiving coaching and feedback.2 The mentor should be in tune with their mentees development and offer specific plans for improvement respecting clinical responsibilities and demands. Furthermore, there is an equally important role for a structured educational component overseen by each mentor. Examples include discussing peer-reviewed articles on simulation and debriefing together, recommending national meeting attendance (ie, International Meeting on Simulation in Healthcare), and networking.
In addition, we believe that incentivizing faculty to complete the certification program will improve participation and completion rates. As simulation facilitators, we are not alone in volunteering hundreds of hours in personal development, curriculum development, and implementation. However, as the need for skilled facilitators grows, we must incentivize them to enter the field of simulation-based education to ensure quality. This can be done in many ways: certification of hours spent in training and fellowship or Master's level designation, awards for excellence in teaching, prioritization for promotion, monetary compensation for time, inclusion in ongoing publications, continuing medical education credit, quality improvement designation, and more. The implementation of a faculty development program will rely on whether facilitators, their supervisors, and the healthcare system value the work put in.
We are impressed by the creation of this curriculum but are concerned that this may be difficult to achieve at many institutions across the country. Given this, we suggest prioritizing mentorship, a customized education plan, and incentives to assist faculty development in simulation; the need is there. Faculty can gain expertise through informal observation, experiential learning, and reflection.3 It would be interesting to compare the effectiveness of a formal curriculum such as this tiered model to other training programs such as informal apprenticeships targeting a personalized training experience.
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