In 2011 and 2017, the Society for Simulation in Healthcare Research Committee convened summits to develop a forward-thinking agenda for simulation research. After the second summit, the Society for Simulation in Healthcare Research Committee sought expert opinion on the most important research questions in healthcare simulation. This study used systematic methodology to develop a prioritized research agenda for healthcare simulation. Methods: A modified Delphi approach was conducted in 3 survey rounds. During round 1, individuals with expertise in healthcare simulation research were recruited to submit important research questions. Submitted questions were reviewed and duplicates were removed. Remaining questions were synthesized into a concise, high-level list for further rating. During round 2, these reformulated questions were distributed to the same experts who ranked their importance on a 5-point Likert scale. Average question importance ratings were calculated and shared during round 3, and a final vote was taken to identify the highest priority items. Results: Seventeen experts submitted 74 questions, which were reduced to 21 reformulated items. Variability in expert responses decreased significantly across survey rounds, indicating that consensus had been achieved. The top 3 research question identified by the experts were related to (1) the impact of system level simulation interventions on system efficiency, patient safety, and patient outcomes; (2) the return on investment of simulation for healthcare systems, and (3) whether a dose-response relationship exists between simulation training and performance/patient outcomes. Conclusions: The agenda developed in this study may help guide and focus researcher efforts and funding agency decisions, ultimately helping advance the field.

IntroductionTranslational research has been identified as a research priority for the National Institutes of Health (NIH) and the Society for Simulation in Healthcare (SSH). Despite a larger focus on translational research in recent years, the overall amount of simulation-based translational research remains low. Greater understanding of how to approach translational simulation is required to inform novice simulation and translational researchers. This study sought to answer the following research questions: How do simulation experts describe the barriers and facilitators to implementing translational simulation programs? How do simulation experts describe their various approaches to implementing translational simulation programs? What recommendations do simulation experts describe for overcoming barriers to implementing translational simulation programs?MethodsA qualitative instrumental case study was used to elicit multiple instances of translational simulation research to gather an in-depth description from study participants. Three data sources were used: documents, semistructured interviews, and a focus group.ResultsData analyses revealed 5 major themes: clarifying goals and definitions, special considerations, social networking, research, and factors external to the simulation program.ConclusionsKey findings include a lack of a standardized definitions for translational simulation and simulation-based translational research, the challenge of demonstrating the value of translational simulation, and the need for translational simulation programs to be integrated into departmental quality, patient safety, and risk management work. The findings and advice from the experts in this research can assist new researchers or those encountering challenges in implementing translational simulations.