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J Educ Eval Health Prof > Epub ahead of print
J Educ Eval Health Prof. 2022; 19: 21.
Published online August 25, 2022.
[Epub ahead of print]
Content validity test of a safety checklist for simulated participants in simulation-based education in the United Kingdom: a methodological study
Matthew Bradley 
The University Hospitals Bristol and Weston NHS Foundation Trust Simulation Services, Bristol, UK
Correspondence  Matthew Bradley ,Email:
Editor:  Sun Huh, Hallym University, Korea
Submitted: May 24, 2022  Accepted after revision: July 19, 2022
Simulation training is an ever-growing means of healthcare education and often involves simulated participants (SPs), commonly known as actors. Simulation-based education (SBE) can sometimes endanger SPs, and as such we have created a safety checklist for them to follow. This study describes how we developed the checklist through a quality improvement project, and then evaluated feedback responses to assess whether SPs felt our checklist was safe.
The checklist was provided to SPs working in an acute trust simulation service when delivering multidisciplinary SBE over 4 months. Using multiple plan–do–study–act cycles, the checklist was refined by reflecting on SP feedback to ensure that the standards of the safe simulation were met. We collected 21 responses from September to December 2021 after SPs completed an SBE event.
The responses showed that 100% of SPs felt safe during SBE when using our checklist. The average “confidence in safety” rating before using the checklist was 6.8/10, which increased significantly to 9.2/10 after using the checklist (P<0.0005). The checklist was refined throughout the 4 months and implemented in adult and pediatric SBE as a standard operating procedure.
We recommend using our safety checklist as a standard operating procedure to improve the confidence and safety of SPs during safe and effective simulations.
Keywords: Checklist; Feedback; Delivery of health care; Patient simulation; Quality improvement
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