Implementation strategies for high-performance health care simulation centres : A multicentre exploratory case study in China

Aihua YAN, Li LI*, Jianping LV, Dinesh A. MIRCHANDANI

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

3 Citations (Scopus)


The number of health care simulation centres (HSCs) in mainland China has increased exponentially recently. However, the performance of these centres varies significantly between hospitals. The aim of this study is to address two research questions: (i) what are the critical factors for implementing high-performance HSCs and (ii) how are these critical factors used in the development of implementation strategies to achieve satisfactory performance?.

Following a literature review on information technology (IT) implementation, we identified a framework comprising four key dimensions for HSCs implementation: technology, organisation, environment and individuals. This TOEI (technology-organisation-environment-individual) framework was then used as a basis for a multicentre case study through which data collection and analysis proceeded. We collected 12 one-to-one in-depth interviews alongside secondary data from six high-performance HSCs in mainland China.

Our study identifies critical TOEI factors that collectively influence HSC implementation performance and major activities at the six high-performance HSCs. Three strategies for implementing high-performance HSCs are also identified: facility management platform, education and training centre and innovation centre.

HSC implementation is an holistic approach. The critical TOEI factors collectively build a foundation for centre activities. An HSC's implementation strategy highly relies on organisational strategic goals. Additionally, HSCs in mainland China face some common challenges such as faculty retention and future opportunities such as expanding the research scope. Our study also provides insights for hospital leadership, medical associations and policymakers.

Original languageEnglish
Pages (from-to)535-546
Number of pages12
JournalMedical Education
Issue number5
Early online date6 Feb 2022
Publication statusPublished - May 2022
Externally publishedYes

Bibliographical note

We would like to acknowledge all the interviewees from the six health care simulation centres who have participated in our research.

Conflict of Interests:
The authors declared no conflict of interest.

Ethics Statement:
This study has been received IRB approval from the first author's institute research committee.

Author Contributions:
AY conceived and designed the project and was responsible for data acquisition, analysis, interpretation, and writing. LL made substantial contribution to the design of the project, data acquisition, interpretation, and writing. JL contributed to the data acquisition, analysis, and interpretation. DAM made substantial contribution to the data interpretation, writing, and editing.

Publisher Copyright:
© 2022 Association for the Study of Medical Education and John Wiley & Sons Ltd.


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