Table 4 Final version of Simulation Scenarios Quality Instrument (SSQI)

1. Learning objectives

1.1 Learning objectives are written according to SMART format^*

^* SMART: Specific, Measurable, Attainable, Relevant, and Time-bound

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1.2 Learning objectives are written according to Bloom’s taxonomy^*

^* Bloom’s taxonomy is a framework consisting of six major categories: knowledge, comprehension, application, analysis, synthesis, and evaluation. Each category has its action verbs that are used in writing learning objectives

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1.3 Required pre-reading materials provided in the scenario are related to the learning objectives

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2. Target group

2.1 Learner prerequisite knowledge and skills is stated clearly in the scenario

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2.2 Learners’ number is appropriate for the scenario conduction (the instructor-to-learner ratio is based on best practice)

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2.3 (Critical actions are part of the competencies required for the learner’s profession

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3. Culture

3.1 The scenario is compatible with local laws and regulation of the healthcare system

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3.3 Patient resembles common demographic information to the local population

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4. Scenario case

4.1 The demographic information (such as age, gender, and religion) are stated clearly in the scenario case

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4.2 The anthropometric measurements (such as weight, height, and BMI) are stated clearly in the scenario case

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4.3 Medical history is stated clearly in the scenario case

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4.4 Patient current health status is stated clearly in the scenario case

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4.5 Initial physical examination findings are stated clearly in the scenario case

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5. Scenario narrative briefing

5.1 The briefing elements (such as psychological safety, confidentiality agreement…) have been addressed in the briefing section:

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5.2 Briefing time stated is enough to brief the students about the briefing elements

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6. Scenario complexity

6.1 The distractors provided in the scenario flow do not negatively impact achieving learning objectives

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6.2 The complexity of the scenario matches learner level

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7. Scenario flow

7.1 Patient parameters and/or status are aligned with the initial statues stated in the scenario case

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7.2 Patient parameters and/or status progresses according to leaner\s actions

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7.3 Scenario flow indicate appropriate prompting for leaners who do not progress according to the indicated time

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7.4 The simulation flow and overall scenario outline are clear

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7.5 The progression of scenario flow is realistic

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7.6 Scenario flow time is adhering to center’s guidelines (if no guidelines available, scenario should not exceed 25 min)

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7.7 Stated learner’s actions include critical actions stated in the “Critical action” section

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8. Fidelity

8.1 The physical context of simulation-based activity replicates the actual environment (e.g., simulator, equipment, environment, Moulage etc.) (Physical fidelity)

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8.2 Required equipment and simulators were detailed

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8.3 Elements of the scenario are related to the scenario flow (e.g., vital signed are similar to the patient diagnosis) (conceptual fidelity)

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8.4 The script provided for the SP and direction of training is clearly stated (If applicable)

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8.5 The moulage picture is related to the scenario case (If applicable)

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9. Debriefing

9.1 Appropriate debriefing method is identified to cover the objectives of the simulation session

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9.2 Debriefer experience stated and compatible with the skills level required to implement the debriefing method

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9.3 Debriefing site is stated and is appropriate for the scenario

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9.4 Debriefing time is sufficient to conduct a comprehensive session

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10. Assessment

10.1 Assessment tool cover all of the scenario’s learning objectives

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10.2 The assessment tool items are measurable and observable

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10.3 All targeted critical actions, and/or skills, procedures are addressed in the assessment tool

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10.4 The assessment tool grading system is clear

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10.5 Assessment tool used is validated (Optional)

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