Developing a faculty simulation-based education strategy: a Delphi study to build consensus and aid decision making

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BACKGROUND: Simulation-based education (SBE) improves learner competence, patient safety and workforce readiness. Yet, existing frameworks such as INACSL and ASPiH provide limited guidance on developing sustainable, institution-wide strategies, particularly in decentralised, multidisciplinary contexts. This study aimed to create a faculty-wide SBE strategy using the e-Delphi method to build consensus among diverse stakeholders. METHOD: The study was conducted at a UK higher education institution without a centralised simulation centre. An e-Delphi process was used to refine strategic statements across three survey rounds. Panellists were purposively sampled and included internal and external academics, postgraduate and undergraduate students, and international contributors from 7 countries and 15 healthcare-related professions. Initial statements were derived from established SBE frameworks and refined based on quantitative agreement (≥ 80% consensus) and thematic analysis of free-text feedback. RESULT: Of 111 invited participants, 41 completed Round 1, increasing to 43 in Rounds 2 and 3. The process produced 39 final strategic statements grouped under eight strategic priorities: (1) Leadership and governance; (2) Communication and networking; (3) Training and development; (4) Standards and quality assurance; (5) Research and evaluation; (6) Accessibility; (7) Preparation and planning; and (8) Finance. These priorities map to three overarching themes-Connectivity, collaboration and partnership; Promoting quality; and Stability, sustainability and growth of SBE. The strategy embeds SBE into institutional processes, aligning it with budgeting, infrastructure planning, workforce development, and digital transformation. It emphasises multi-level governance, sustainability planning, technology integration and inclusivity through student patient and public involvement and engagement (PPIE) representation. CONCLUSION: The e-Delphi method effectively built consensus on a comprehensive SBE strategy tailored to a decentralised, multidisciplinary faculty. The strategy goes beyond existing frameworks by integrating sustainability, multi-level governance, and structured technology planning, while embedding student and PPIE perspectives. It offers a scalable, replicable model for institutions seeking to align simulation provision with strategic priorities, accreditation standards and equitable access. Future research should examine the strategy's impact on educational outcomes, workforce readiness and its adaptability across disciplines and institutional contexts.

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