title: A stepwise model for simulation-based curriculum development for clinical skills, a modification of the six-step approach.
abstract: BACKGROUND
  Despite the rapid growth in the use of simulation in health professions education, courses vary considerably in quality. Many do not integrate efficiently into an overall school/program curriculum or conform to academic accreditation requirements. Moreover, some of the guidelines for simulation design are specialty specific.
  
  
  METHODS
  We designed a model that integrates best practices for effective simulation-based training and a modification of Kern et al.'s 6-step approach for curriculum development. We invited international simulation and health professions education experts to complete a questionnaire evaluating the model. We reviewed comments and suggested modifications from respondents and reached consensus on a revised version of the model.
  
  
  RESULTS
  We recruited 17 simulation and education experts. They expressed a consensus on the seven proposed curricular steps: problem identification and general needs assessment, targeted needs assessment, goals and objectives, educational strategies, individual assessment/feedback, program evaluation, and implementation. We received several suggestions for descriptors that applied the steps to simulation, leading to some revisions in the model.
  
  
  CONCLUSIONS
  We have developed a model that integrates principles of curriculum development and simulation design that is applicable across specialties. Its use could lead to high-quality simulation courses that integrate efficiently into an overall curriculum.
authors.affiliation: Medical Education Department, College of Medicine, King Saud University, P.O. Box 2925(45), Riyadh, 11461, Saudi Arabia. nehalkhamis@yahoo.com.|Medical Education and Pathology Departments, College of Medicine, Suez Canal University, Ismailia, Egypt. nehalkhamis@yahoo.com.
authors.forename: Nehal N
authors.initials: NN
authors.lastname: Khamis
authors.affiliation: Surgery Department, University of Washington Medical Center, Seattle, WA, USA.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Satava
authors.affiliation: Medical Education and Thoracic Surgery Departments, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Sami A
authors.initials: SA
authors.lastname: Alnassar
authors.affiliation: General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Kern
mesh_terms: D002983:Clinical Competence; D003479:Curriculum / Q000592:standards*; D006801:Humans; D017145:Models, Educational; D013043:Specialties, Surgical / Q000193:education*
keywords: Curriculum development; Model; Simulation; Six step