The underperforming doctor in simulation: a framework proposal for simulation educators

Abstract

The use of simulation in all its forms as an educational tool is rapidly expanding. Implicit in many simulation encounters is the need to make assessments of learner performance, and translate this to judgement on clinical practice. Defining appropriate standards of performance, and hence what falls below this remains a challenge. Where underperformance is identified, there is a dearth of guidance available to the educator on how to proceed.

There is evidence and guidance available related to the management of underperformance in the clinical realm. We discuss the evidence available to the educator, and propose a framework for those involved in the planning and facilitation of simulation events to use in the event of underperformance being identified. The link between simulation and clinical performance, and minimum standards to apply is discussed, as well as strategies to document and manage when underperformance has been identified.