The Healthcare Simulation Code of Ethics was established for those involved in healthcare simulation community. All Codes of Ethics are established ethical guidelines for how a professional organization and their constituents should conduct themselves. Many healthcare professions have a code of ethics that their members cite as they become a member of the profession. Developed by a committee within the Society for Simulation in Healthcare (SSH), the Healthcare Simulationist Code of Ethics has been formulated by a global Code of Ethics working group to support the quality and ethical practice of healthcare simulation around the world. Any organization involved in healthcare simulation, whether a member-based association, a manufacturer, an educational institution, a hospital, or any other, are encouraged to adopt the Healthcare Simulationist Code of Ethics (CoE). This article by Jill Sanko, PhD, APRN, CHSE-A, FSSH showcases the SSH Code of Ethics for use in medical simulation.
Historical Perspective of A Code of Ethics
Perhaps the most widely known code of ethics is the Hippocratic Oath. The main promise of this famous cornerstone of medical ethics is to “do no harm”; the commitment, often paraphrased as “primum non nocere,” stands as an example for the ethical work done by clinicians in healthcare.
While the Hippocratic Oath is mostly commonly associated with the oath that physician’s pledge, the commonly known saying has served as the inspiration for many other professional codes of ethics in healthcare. The Hippocratic Oath, written between the fifth and third centuries BC, is widely attributed to Hippocrates, an ancient Greek physician often referred to as the “father of medicine. Though the Hippocratic Oath has been modernized, and is rarely used in verbatim, the legacy and promise of the original doctrine has stood the test of time, with many healthcare students and new providers pledging a school specific or personally written oath inspired by the original notion that physicians should uphold a promise to care for patients in an ethical way. Nurses and nursing students take a modified Hippocratic Oath called the Nightingale pledge, where they pledge to practice faithfully, act compassionately, follow legal and ethical requirements, and keep patient and family information confidential.
The American Physical Therapy Association supports the use of an oath to express a commitment to patients, clients, and the profession, and has a model oath that physical therapist education programs can use or adapt for their use. Emergency Medical Technicians (EMTs), paramedics, and Emergency Medical Services professionals all take an oath. In a similar fashion, social work professionals also take a professional oath.
Healthcare Simulationists Code of Ethics
Given the ubiquitous existence of healthcare professional oaths it stood to reason that healthcare simulation should adopt one to guide our profession. Moreover adoption of an ethical standard is an important milestone in the maturation of a professionโs trajectory. In January of 2018 simulationists from around the world convened to establish the Healthcare Simulationist Code of Ethics (CoE). The group included individuals from simulation organizations, industry, and ethicists.
Since the CoEโs inception, 32 organizations and 93 institutions have adopted the CoE. The CoE has been translated into 18 languages and has helped provide a foundational guide for conducting simulation-based education, supported by a strong ethical foundation. Anyone who wants to adopt the as well as posters to hang at their organization directly from the website. Formal adoption is encouraged by the Society for Simulation in Healthcare, along with many other leading simulation organizations. Those wishing to formally adopt the Code of Ethics can follow the instructions on the CoE website, but below are the basic instructions.
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Member and non-member healthcare simulation organizations, manufacturers, educational institutions, hospitals, and any other organization doing simulation work can adopt the CoE. The formal processes to complete adoption vary by institutional type.
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Member associations and healthcare simulation institutions are listed on the website as formal adopters of the CoE if they meet the following criteria: 1. The CoE cannot be edited or changed as published, except by adding an annotation. 2. The governing body of the adopting agency has formally voted to adopt the CoE, which includes approval and the intent to comply with and aspire to the concepts in the CoE for member organizations. For healthcare simulation institutions, there needs to be an agreement to adopt the CoE and a commitment to aspire to its ideals. Annotations of the code may be needed depending on the organization / institution. Guidelines for annotation of the CoE are found in the instructional download.
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Collaborations with Other Organizations
Though the CoE is already translated into several languages, there may be countries that need to translate the code. Collaborations with other organizations that might benefit from the translated version are encouraged, as a collaborative approach to translation will strengthen the translation and bolster the broader understanding and adoption. Translations should be sent to the Society for Simulation in Healthcare so it can be posted on the CoE page for others to use.
The creation of the CoE has marked a pivotal milestone in the field of healthcare simulation and laid the important foundation for how simulation-based healthcare education ought to be conducted from an ethical perspective. This foundation has changed the field in important ways. The adoption of the Code of Ethics alongside the INACSL Healthcare Standards of Best Practice encourages professional development for healthcare simulationists, ensuring they stay current with best practices to meet the needs of learners. The CoE ensures that all individuals involved in simulation are treated with integrity, respect, and compassion, fostering an ethical culture. The CoE assists to emphasize more inclusive and community-focused approaches to conduct simulation-based healthcare education, aligning with evolving societal values, legal and ethical considerations, which include belonging, pluralism, justice, and accessibility.
Adopting codes of ethics in a field of practice forever alters the profession through the establishment of clear standards of conduct, the promotion of and advancement of ethical decision-making, and through the construction of trust within the profession and with the public. Codes provide guidance on moral principles, address potential conflicts, and protect vulnerable populations. Moreover, they serve to help shape and solidify a professional identity and can be used to assess unethical conduct. The field of healthcare simulation can now stand on a strong foundation of ethics from which we can continue to educate and inspire the next, current, and future generation of healthcare providers, leaders, and educators.
More About SSiH โ The Society for Simulation in Healthcare
โWith over 5,000 members SSH, aka The Society for Simulation in Healthcare, is the worldโs largest organization dedicated to medical simulation. The purpose of SSH is to serve a global community of practice enhancing the quality of healthcare. The nonprofitโs mission is to serve their members by fostering education, education, professional development, and the advancement of research and innovation; promote the profession of healthcare simulation through standards and ethics; and champion healthcare simulation through advocacy, sharing, facilitating, and collaborating. SSH seeks to reduce errors in patient care and improve clinical performance through the use of simulation.
