Implementing the Standards of Best Practice for Simulation Tonya Rutherford-Hemming, EdD, RN, ANP-BC & Lori Lioce, DNP, FNP-BC, CHSE, FAANP Carol F. Durham, EdD, RN, ANEF, FAAN The Standards of Best Practice: Simulation are a resource for quality and consistency of simulation, evaluation of outcomes, and improvement of simulation programs. The Standards provide guidelines for practice and a vital framework for strategic planning, research, and faculty development. This article discusses challenges and shares approaches to enhance implementation of the Standards into practice to improve education, increase patient safety, and reduce variability in simulation experiences. Keywords: Best practice; clinical simulation; guidelines; simulation; Standards of Best Practice S tandards for practice are important for the quality, consistency, outcomes, and improvement of simula- tion programs and instructional learning strategies. The Standards of Best Practice: Simulation 1,2 are a resource for simulation rationale, outcomes, criteria, and guidelines. The Standards can provide a vital framework for strategic planning, research, and faculty development and when implemented can lead to increased reliability and consistent clinical presen- tation. Dissemination of these international standards and guidelines is critical to advance the science of clinical simu- lation and standardize terminology while sharing evidence- based best practices. For simulation educators, this article discusses challenges and shares approaches to enhance im- plementation of the Standards into practice to improve edu- cation, increase patient safety, and reduce variability in clinical experiences. Although the Standards have been adopted into many simulation education centers, not everyone who uses simu- lation is aware of them. The Standards maximize simulation- based instruction, enhance skill acquisition, and further the science of simulation. To date, there is scarce literature outlining the best methods for standardizing simulation programs or improving implementation to enhance the educational out- comes and patient safety. Implementing the Standards The International Nursing Association for Clinical Simulation and Learning (INACSL) published Standards of Best Practice: Simulation in 2011 1 for use across all health care disciplines. This seminal document contained 7 standards (Table 1). Each standard includes a descriptive statement, rationale, outcome(s), and criteria. The descriptive statement and rationale provide summaries of the importance of the content in the standard. The outcome(s) are the intended results of following the standard, and the criteria are factors necessary to meet the outcome(s). In 2013, INACSL revised the core components of the initial Standards and expanded the Standards to include guidelines. 2 The guidelines provide examples of evidence-based practice methods for implementation of the criteria set forth in each standard. Table 1 provides an overview of each standard and rationale with a sample criteria and guideline statement. Whether implementing the Standards in an academic or practice setting, it is important to develop and maintain a consistent format for program implementation. There are multiple strategies for im- plementation, which should be based on optimal teaching and learning principles. Table 2 provides exemplars of implemen- tation strategies of the Standards. Standard I: Terminology 3 provides consistent language for simulation components to enhance understanding. 4 This standard defines simulation terms that are helpful to the fa- cilitator in creating and implementing simulation, enhances consistent communication among grant writers and researchers, and improves communication between facilitators and par- ticipants. Subsequent standards use the language presented in Standard I: Terminology. During prebriefing, pertinent ter- minology can be reviewed with students and facilitators so 96 Volume 40 & Number 2 & March/April 2015 Nurse Educator Nurse Educator Nurse Educator Nurse Educator Vol. 40, No. 2, pp. 96-100 Copyright * 2015 Wolters Kluwer Health, Inc. All rights reserved. Author Affiliations: Senior Nurse Researcher (Dr Rutherford-Hemming), Nursing Research and Innovation, Cleveland Clinic, Ohio; Simulation Coordinator and Clinical Associate Professor of Nursing, College of Nurs- ing, The University of Alabama in Huntsville, and Adjunct Faculty, CAE Healthcare Academy (Dr Lioce), Huntsville, Alabama; Clinical Professor and Director, Education-Innovation-Simulation Learning Environment School of Nursing, The University of North Carolina at Chapel Hill (Dr Durham). Dr Rutherford-Hemming is vice president for programs, Dr Lioce is vice president for operations, and Dr Durham is president of the International Nursing Association for Clinical Simulation and Learning, which supported the development of the Standards of Best Practice: Simulation. Correspondence: Dr Rutherford-Hemming, Nursing Research and Innovation, Cleveland Clinic, 9500 Euclid Ave, T3-17, Cleveland, OH 44195 (auncheel@gmail.com; ruthert@ccf.org). Accepted for publication: September 25, 2014 Published ahead of print: November 14, 2014 DOI: 10.1097/NNE.0000000000000115 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.