Development of a Survey Instrument Grounded in Resident Voice to Measure Key Drivers of Learning in Simulation.

BACKGROUND: Simulation based education (SBE) is frequently driven by competencies necessary to document progress in residency. These competencies, however, are missing crucial factors that matter to residents. Unfortunately, there is no current validated tool that captures learning experiences grounded in factors that residents voice as important. This study was designed to uncover meaningful resident-derived factors within SBE to inform development of a learner-centered tool and provide educators with actionable information to guide simulation curriculum design and improvement.

METHODS: An exploratory sequential mixed methods study was deployed within an accredited emergency medicine (EM) residency at an academic center. Resident focus groups were conducted and themes generated through thematic analysis were collected. A survey tool was developed and underwent a content validation process. Pilot deployment was delivered to EM residency programs across the country. Responses were analyzed for demographics, descriptive statistics, and internal consistency.

RESULTS: Four major themes emerged, each serving as distinct sections of the tool. The Psychological Safety and Learning Effectiveness theme encompasses meaningful resident engagement. The Integration of Experience and Evidence theme connects SBE to evidence-informed practices. The Learner-responsive Simulation Design theme captures learning principles that emphasize metacognitive maturity. The Clinical Reasoning Structure theme provides insights on translation to practice. Quantitative analysis revealed considerable demographic diversity and range analysis with a variable yet expected spread. Cronbach's alpha demonstrated strong consistency for relevant and academically-based constructs and expected modest consistency for nuanced constructs.

CONCLUSIONS: A survey instrument grounded in resident voice was developed and positioned to measure key drivers for residents in SBE. This tool demonstrates early evidence of validity, purposeful internal consistency, and feasibility through pilot testing. Simulation educators may use the instrument to identify strengths and gaps within simulation curricula, evaluate the impact of curricular interventions over time, guide resident-informed program improvements, and facilitate benchmarking across institutions.