Professional distinctions are a common badge of professional achievement found within most professional societies. This practice of distinction can be traced back to ancient times and can be found in ancient guild systems, religious hierarchies, academic traditions, and modern associations; today’s modern system of recognition continues the evolution of how societies have long recognized, validated, and regulated specialized knowledge and skills within focused disciplines. This HealthySimulation.com article by Jill Sanko, PhD, APRN, CHSE-A, FSSH, will discuss the professional distinctions recognized in healthcare simulation.
History of Professional Distinction
While medicine began to formally recognize “training” to signify a qualified physician (called healers in ancient times) around 2000 BCE. This recognition was expressed through the Code of Hammurabi. This code contained specific laws and regulations regarding the practice of medicine and the accountability of healers in ancient Babylonia. Later guilds were formed for training and credential purposes and served this function until the 18th and 19th centuries, when the modern education of physicians we are familiar with today became the norm. Board certification began in 1916; ophthalmology was the first to implement this structure of recognizing the specialized practice of eye-related medicine. The term “fellow” used in the context of the practice of medicine, preceded the modern educational system by several hundred years. This distinction recognized (and still does) those with additional training in an area and or membership to a specific specialized academy.
Nursing had a similar path, but did not have a fellow designation until 50 years ago when the American Academy of Nursing (AAN) was formed. There were 36 inaugural fellows of the AAN. Formal nursing education was initiated by physicians in the late 1700s, but because nursing was framed as an extension of women’s “natural” caregiving roles, the delay in recognition as a distinct, autonomous profession contributed to nursing lagging behind medicine in the adoption of professional distinction practices. In 1873, three schools of nursing opened in the US, known as the Nightingale schools, and nursing was finally on its way to having professional autonomy. The full realization of this autonomy, however, took some time, with nursing only having begun to push seriously for autonomy and advanced practice in the mid-20th century, with the development of nurse practitioner and advanced practice roles.
Other healthcare disciplines have followed suit with professional achievement distinctions. For example, a physical therapist’s highest distinction is the Catherine Worthingham Fellow of the American Association of Physical Therapy. Occupational Therapists have a Fellow distinction through their organization, the American Occupational Therapy Association, which started in 1973.
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Society for Simulation in Healthcare: Professional Distinction
Given the contemporary common practice to award distinctions of impact and excellence for healthcare practitioners, the Society for Simulation in Healthcare (SSH) envisioned a similar program to recognize those healthcare simulation professionals who have made significant and sustained impacts to the field of healthcare simulation and the SSH.
Currently, SSH has several awards of distinction. These include: Certified Healthcare Simulation Educator (CHSE), Certified Healthcare Simulation Educator-Advanced (CHSE-A), Certified Simulation Operations Specialist (CHSOS), Certified Simulation Operations Specialist- Advanced (CHSOS-A), and Fellow of the Academy of the Society for Simulation in Healthcare (FSSH).
Recognized Certifications: CHSE and CHSOS
The first of these distinctions was the CHSE distinction. The first CHSEs were awarded in 2012 to relatively few individuals who qualified via an exam. SSH provides a test blueprint, standards, a handbook, and workshops on the certification exams to guide potential candidates in their applications. This certification recognizes those individuals who have demonstrated excellence in healthcare simulation-based education. Initial certification is awarded upon successfully passing the CHSE exam and is good for three years. Subsequently, a continued demonstration of the attributes of a CHSE is completed through a recertification process. The equivalent of this certification for those individuals who work as healthcare simulation operations specialists is the CHSOS. This certification began two years later in 2014. This certification is also awarded initially via an exam for a period of three years. Renewals also follow a recertification process.
Advanced Certifications: CHSE-A and CHSOS-A
In subsequent launches of professional recognition, the SSH began awarding advanced versions of recognized distinction for both CHSE and CHSOS to CHSE-A and CHSOS-A. These are awarded via a portfolio process following the successful passing of the requisite certification exam for either the CHSE or CHSOS, respectively. Both advanced distinctions recognize those individuals who have proven themselves to be advanced educators / operations specialists in their practice of healthcare simulation, and serve as mentors and pillars of the community of practice. SSH provides a handbook and standards to guide potential candidates in their applications
Fellow of the SSH Academy (FSSH)
The highest level of distinction for the field of healthcare simulation is the Fellow of the SSH Academy (FSSH). This recognition award, known as the SSH Academy Fellowship, acknowledges practitioners, researchers, administrators, clinicians, operations specialists, and educators who have significantly impacted the discipline of healthcare simulation, have made meaningful and sustained contributions to SSH, and the broader field of healthcare simulation. Fellows are expected not only to be recognized for their past achievements but also to continue their contributions to the mission and vision of the SSH and the SSH Academy through ongoing projects and initiatives and the healthcare simulation field.
The Fellow of the Academy of the SSH will celebrate its first decade of recognizing significant and influential simulationists in 2026, as the Academy was founded in 2016. The first class of fellows was inducted in 2017 at the International Meeting on Simulation in Healthcare (IMSH) and included 26 individuals (one healthcare simulation leader, Michael S Gordon, was bestowed the recognition in Memoriam).
The process to be inducted includes submission of an application, a resume or curriculum vitae, and two letters of support from current fellows. These materials are then reviewed by trained fellows who have volunteered to review applications using a scoring rubric and a rigorous review. Applications are reviewed using a blinded method (all identifiers are removed from the application and application materials) to avoid any bias associated with names, and reviewers are instructed to notify the review coordinator of any actual or potential conflicts of interest so they can be recused from review of an applicant. Scores generated from the rubric by each reviewer are entered into a spreadsheet for review by a panel, and a Hoftsee score is generated each cycle to establish cut scores for admission to each class. Maintenance of Academy membership is through a membership renewal process that includes continued payment of dues to SSH, as well as to the Academy per policy.
