INTRODUCTION
Most postgraduate emergency medicine (EM) programs in Canada describe having a simulation curriculumReference Russell, Hall, Hagel, Petrosoniak, Dagnone and Howes1 and yet, to our knowledge, these curricula largely act in isolation. Traditionally, simulation case banks and curricula have been compiled at local educational sites out of a need for simulation-based education. Often, these cases are designed such that they are only applicable to that local site and are not usually peer reviewed to ensure accuracy and rigour. Furthermore, the simulation curriculum design process is quite labor intensive, requiring expansive case development in addition to costly technical resources and simulation facilitation expertise. Not only does isolated simulation resource development result in cumulative wasted effort due to the inefficiency of creating separate case banks at each training program, but it furthers a silo mentality within simulation-based education.
The creation of EM Sim Cases was an attempt to shift culture within simulation education to a collaborative process where contributors are recognized for their work, the work is widely disseminated, and it is available for all to use in a free, open access, and easily shareable format. It also sought to bring a level of scholarly rigour to the case development process with all cases having been trialled in a simulation setting and peer reviewed by two expert simulation educators. Recently, EM Sim Cases has been involved in efforts to distribute comprehensive simulation curricula, such as Queen's University “Nightmares Course.”Reference McMurray, Hall, Rich, Merchant and Chaplin2 Additionally, it has led to several academic projects, such as the collaborative development of a national simulation template, based on the original EM Sim Cases template, through the Emergency Medicine Simulation Educators Research Collaborative.
Rationale
EM Sim Cases was created as a potential culture change medium within simulation-based education to foster collaboration and sharing of resources. This strategy was accomplished by curating peer-reviewed simulation cases, up-to-date simulation education articles, and a universal simulation case template accessible worldwide in a Free Open Access Medical education (FOAM) Web-based format.
Description of Innovation
EM Sim Cases was created in 2015 by K. Caners and M. Kuuskne. It has since grown to have 16 educational posts, 80 simulation cases, and 8,148 average monthly views from a total of 161 countries. Topics range from neonatal resuscitation to end-of-life care.
The case repository initially consisted mainly of cases written by the co-founders. The complete case collection has now published submissions from 32 individuals from 14 unique sites in three countries. A recent re-launch with a simulation-expert-developed, consensus-derived simulation template, a complete case series, and an online needs assessment occurred in the Fall of 2019.
EM Sim Cases is a robust, nontraditional repository of peer-reviewed, FOAM simulation material. It is unique in several ways, and in preparation for this manuscript, we embarked on an audit and reflective exercise to review our past and present procedures.
First, while other organizations have applied robust peer review processes in the FOAM world,Reference Thoma, Chan, Desouza and Lin3,Reference Sidalak, Purdy, Luckett-Gatopoulos, Murray, Thoma and Chan4 peer review is still not the norm within open access education blogs, so the successful and sustained application of these processes is worth reporting.
Second, EM Sim Cases represents a case study for creating a repository for digital scholarship. Over time, it has come to be an internationally respected source of simulation cases, and has been cited in the peer reviewed literature frequently since its inception.Reference Gottlieb, Chan, Sherbino and Yarris5–Reference Baylis, Miloslavsky, Woods and Chan8 Its cases are now used across multiple EM training sites in Canada and have been used to develop entire simulation curricula for training programs around the world. This demonstrates a successful facilitation of a culture of collaboration and sharing of intellectual content within simulation education.
Finally, EM Sim Cases has also become an increasingly popular publication venue for many simulation educators seeking to create peer reviewed works of digital scholarship.
DISCUSSION
In 2020, EM Sim Cases will have been in existence for 5 years. As such, the editorial board will be seeking to refresh and revive the scholarly repository. Future directions include initiating a leadership transition for the editorial board, conducting a needs assessment of the authors and audience in part to measure impact, creating and releasing a revised pan-Canadian EM simulation case template (with iterative design changes based on real-life use), and release of case bundles designed to address educational needs. Attempts will also be made to address some of the limitations of the EM Sim Cases resource including difficulties navigating the website, editorial delays, and a relative paucity of interprofessional content.
Our author group believes there are three key elements that likely have contributed to the growth of the EM Sim Cases platform: a robust and active editorial board, a peer review mechanism for ensuring high quality content, and a common simulation template. These are detailed in Table 1.
Table 1. Three elements that have contributed to the growth EM Sim Cases
SUMMARY
EM Sim Cases is a unique FOAM repository that was created out of a desire to reduce duplication of effort within simulation-based education. The website provides a peer-reviewed case bank and simulation-based articles that are used by simulation educators around the world.
Competing interests
None declared.
