Readiness planning: how to go beyond "buy-in" to achieve curricular success and front-line performance

Christopher J Roussin; Grace Ng; Mary K Fey; James A Lipshaw; Henrique P Arantes; Jenny W Rudolph

doi:10.1186/s41077-024-00317-z

Readiness planning: how to go beyond "buy-in" to achieve curricular success and front-line performance

Adv Simul (Lond). 2024 Dec 23;9(1):50. doi: 10.1186/s41077-024-00317-z.

Authors

Christopher J Roussin^{1

2

3}, Grace Ng⁴, Mary K Fey⁵, James A Lipshaw⁶, Henrique P Arantes^{7

8}, Jenny W Rudolph^{9

10

11}

Affiliations

¹ Applied Learning for Performance and Safety (ALPS), Center for Medical Simulation, 100 First Avenue, Suite 400, Boston, MA, 02129, USA. [email protected].
² Harvard Medical School, Boston, USA. [email protected].
³ Department of Anesthesia Critical Care and Pain Medicine, Center for Medical Simulation, Beth Israel Deaconess Medical Center, 100 First Avenue, Suite 400, Boston, MA, 02129, USA. [email protected].
⁴ Faculty Development Programs, Center for Medical Simulation, 100 First Avenue, Suite 400, Boston, MA, 02129, USA.
⁵ Applied Learning for Performance and Safety (ALPS), Center for Medical Simulation, 100 First Avenue, Suite 400, Boston, MA, 02129, USA.
⁶ Instructional Design & Media, Center for Medical Simulation, 100 First Avenue, Suite 400, Boston, MA, 02129, USA.
⁷ IMEPAC, 1889 Minas Gerais Street, Araguari, Minas Gerais, Brazil.
⁸ Hospital Universitario Sagrada Familia (HUSF), 1889 Minas Gerais Street, Araguari, Minas Gerais, Brazil.
⁹ Harvard Medical School, Boston, USA.
¹⁰ Department of Anesthesia Critical Care and Pain Medicine, Center for Medical Simulation, Beth Israel Deaconess Medical Center, 100 First Avenue, Suite 400, Boston, MA, 02129, USA.
¹¹ Innovation, Center for Medical Simulation, 100 First Avenue, Suite 400, Boston, MA, 02129, USA.

Abstract

Simulation program staff and leadership often struggle to partner with front-line healthcare workers, their managers, and health system leaders. Simulation-based learning programs are too often seen as burdensome add-ons rather than essential mechanisms supporting clinical workforce readiness. Healthcare system leaders grappling with declining morale, economic pressure, and too few qualified staff often don't see how simulation can help them, and we simulation program leaders can't seem to bridge this gap. Without clear guidance from front-line clinicians and leaders, the challenge of building and maintaining sustainably relevant simulation offerings can seem overwhelming. We argue that three blind spots have limited our ability to see the path to collaborations that support front-line workforce readiness: We wrongly assume that our rigor in designing and delivering programs will lead to front-line participant engagement and positive impact, we overestimate the existence of shared priorities, mindsets, and expertise with our would-be partners, and we contribute to building a façade of superficial education compliance that distracts from vital skill development. How do we design simulation-based training programs that are valued, supported, and sustained by key partners over time? (1) By seeing ourselves as partners first and designers second; (2) by using a boundary spanning design process that shifts the primary psychological ownership of training outcomes to our partners; and (3) by focusing this shared design process on workforce readiness for the situations that our healthcare partners care about most. Drawing on lessons from more than 800 readiness plans developed by participants in our courses and the authors' successes and mistakes in partnering with healthcare teams for front-line readiness, we introduce the concepts, commitments, and practices of "readiness planning" along with three detailed examples of readiness planning in action.

Keywords: Change leadership; Clinical outcomes; Curriculum design; Healthcare quality; Patient safety; Simulation; Training design.