title: Eight critical factors in creating and implementing a successful simulation program.
abstract: BACKGROUND
  Recognizing the need to minimize human error and adverse events, clinicians, researchers, administrators, and educators have strived to enhance clinicians' knowledge, skills, and attitudes through training. Given the risks inherent in learning new skills or advancing underdeveloped skills on actual patients, simulation-based training (SBT) has become an invaluable tool across the medical education spectrum. The large simulation, training, and learning literature was used to provide a synthesized yet innovative and "memorable" heuristic of the important facets of simulation program creation and implementation, as represented by eight critical "S" factors-science, staff, supplies, space, support, systems, success, and sustainability. These critical factors advance earlier work that primarily focused on the science of SBT success, to also include more practical, perhaps even seemingly obvious but significantly challenging components of SBT, such as resources, space, and supplies. SYSTEMS: One of the eight critical factors-systems-refers to the need to match fidelity requirements to training needs and ensure that technological infrastructure is in place. The type of learning objectives that the training is intended to address should determine these requirements. For example, some simulators emphasize physical fidelity to enable clinicians to practice technical and nontechnical skills in a safe environment that mirrors real-world conditions. Such simulators are most appropriate when trainees are learning how to use specific equipment or conduct specific procedures.
  
  
  CONCLUSIONS
  The eight factors-science, staff, supplies, space, support, systems, success, and sustainability-represent a synthesis of the most critical elements necessary for successful simulation programs. The order of the factors does not represent a deliberate prioritization or sequence, and the factors' relative importance may change as the program evolves.
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Lazzara
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Benishek
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Dietz
authors.forename: Eduardo
authors.initials: E
authors.lastname: Salas
authors.forename: David J
authors.initials: DJ
authors.lastname: Adriansen
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D004502:Education, Medical, Continuing / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007858:Learning; D058996:Quality Improvement; D014584:User-Computer Interface