Simulation Accreditation Manual for Clinical Training Sites

Overview

The National Health Training Centre (NHTC) has officially released the Simulation Accreditation Manual for Clinical Training Sites, introducing a unified national framework designed to govern, assess, and accredit simulation-based healthcare training throughout Nepal. The new accreditation manual establishes a standardized, transparent, and contextually grounded approach to clinical education, ensuring that healthcare professionals across all geographic and institutional tiers receive high-quality, competency-based training.

• Strategic Investment Guidance: Serves as an evidence-based roadmap for policymakers, professional councils, and international development partners to target infrastructure and capacity-building investments.
• Standardized Educational Benchmarks: Establishes national quality standards for simulation methodology, governance, and instruction, guaranteeing consistency across clinical sites nationwide.
• Institutional Preparedness: Equips training facilities with a structured self-assessment framework to pinpoint infrastructure, curriculum, and faculty capacity gaps.
• Continuous Quality Improvement (CQI): Shifts site evaluation from one-off compliance checks to a dynamic, cyclical process of ongoing institutional development.
• Tier-Appropriate Adaptability: Accommodates facilities at every operational level through a scalable, four-tier framework—spanning from rural health posts to advanced national simulation centers of excellence.

The manual consists of two parts:

• Part 1: Minimum Simulation Accreditation Standards (Checklist for Accreditation of Simulation in Clinical Training Sites). It outlines the tiered accreditation framework and assessment matrix for clinical training sites, aligned with national standards. The framework includes four tiers: Skills/Simulation Corner, Simulation Room, Simulation Lab, and Centre of Excellence, and defines requirements across key domains.
• Part 2: Basic Concepts of Simulation and its Operational Guidance: This section provides guidance on simulation-based methodology, including the Circle of Learning, simulation types and benefits, facilitation techniques, scenario development, and integration into healthcare training. It also covers simulation lab design, setup, operations, participant load planning, resource management, inventory and scheduling systems, and quality assurance mechanisms.

Glossary of Key Terms

• Assessment: The process that provides feedback about performance to a learner or group of learners. Can be summative or formative.
• Briefing: A conversation held preceding the start of a simulation activity where essential information is shared about the activity.
• Debriefing: A semi-structured process in which the learner is encouraged to reflect on the events of the simulation with the aim of improving future performance.
• Facilitator: An individual who provides guidance and support during simulation-based learning experiences.
• Fidelity: The degree to which a simulated experience approaches reality (also referred to as authenticity), influenced by the environment, equipment, and resources used.
• In-situ Simulation: Simulation activities taking place in the actual clinical environment, ideally with the interprofessional teams that work together.
• Objective: A statement of a specific result that the learner of a simulation activity is expected to achieve by the end of the activity.
• Observer: A person observing a simulation scenario, who might be faculty or learners themselves.
• Participant: A person engaging in a simulation activity to gain or demonstrate mastery of knowledge, skills, and/or attitudes of professional practice.
• Psychological Safety: A shared belief among participants that it is safe to take risks, ask questions, and admit mistakes without fear of negative consequences.
• Simulated Practice: Structured activities representing actual or potential situations in education and practice that allow participants to develop, enhance, analyze, or respond to realistic scenarios in a simulated environment.
• Simulation: The artificial representation of a complex real-world process with sufficient fidelity to facilitate learning through immersion, reflection, feedback, and practice without real-life risks.
• Simulation Corner: A designated space within a health facility or training center equipped for basic, scenario-based simulation training (practicing individual skills and simple team dynamics using low- to medium-fidelity tools).
• Simulation Facilitator: A trainer, mentor, or healthcare professional trained to implement simulation methods (briefing, scenario execution, debriefing) and directly guide learners.
• Simulation Faculty: Educators/trainers certified to develop simulation facilitators, design curricula, create scenarios, mentor, evaluate, and conduct research across various modalities.
• Simulation Utility: The extent to which simulation is useful, valuable, and effective in achieving educational, clinical, quality improvement, research, or systems objectives.
• Simulation Utilization: The extent, frequency, and manner in which simulation resources, facilities, and activities are actively used.
• Skills Corner: A dedicated, low-resource space within a facility where learners repeatedly practice specific clinical skills using task trainers, anatomical models, or basic manikins.
• Tier: The level of simulation facility complexity and capability under this national manual (Tiers 1–4).